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There definitely is a “Placebo Effect”

Scandinavian researchers Hróbjartsson and Gøtzsche published two studies questioning the nature of the placebo effect. The studies were performed as two meta-analyses. They found that in where patients were classified as improved or not improved, the placebo group had no statistically significant improvement over the no-treatment group. Other researchers (Wampold et al.) re-analysed the data from the Hróbjartsson & Gøtzsche meta-analysis and concluded that the placebo effects for objective symptom measures are comparable to placebo effects for subjective ones and that the placebo effect can exceed the effect of the active treatment by 20% for disorders amenable to the placebo effect. What these studies show is that Placebo effect is real and can be greater than that of the drug being tested.

Some commonly prescribed medications have high placebo rates in research, it does not stop their use.

“On February 26, 2008, PLoS Medicine published a meta-analysis that my colleagues and I had conducted on antidepressant medication. Most meta-analyses suffer from publication bias, which can happen when pharmaceutical companies withhold unsuccessful trials from publication. To circumvent this, we used the Freedom of Information act in the U.S. to obtain the data on all clinical trials submitted to the Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants.

The results of our meta-analysis showed that people got better on medication, but they also got better on placebo, and the difference between the two was small. In fact, it was below the criterion for clinical significance established by the National Institute for Health and Clinical Excellence (NICE), which sets treatment guidelines for the National Health Service in the UK. Clinical significance was found only in a few relatively small studies conducted on patients with extremely severe levels of depression.” .

The above is quoted from Irving Kirsch: Mc Gill Journal of Medicine. Nov 2008; 11(2): 219–222

So while we agree that placebo control of research is of benefit determining accuracy, it is not always appropriate or essential to determine efficacy.


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