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Bundesgesundheitsblatt,... Jun 2009Placebos are medication surrogates that are able to improve symptoms in patients when prescribed by a doctor and for a patient, and that cannot be explained by a drug.... (Meta-Analysis)
Meta-Analysis Review
Placebos are medication surrogates that are able to improve symptoms in patients when prescribed by a doctor and for a patient, and that cannot be explained by a drug. In clinical testing and presumably also in clinical routine, placebo effects contribute substantially to the efficacy of medicines, at least with every-day diseases and complaints. Placebos on the one hand, and the mechanisms the response on the other, have not interfered with the development on novel drugs in past years, but have also brought about research that investigates its mechanisms and public interest in its clinical use in everyday medicine. Current knowledge grows by about 10.000 publications per year on placebo-controlled studies, and by nearly 100 papers on the placebo effect itself. This review will focus on the history of placebo use in medicine, on ethical issues related to the use of placebos, on methodological problems in placebo-controlled trials and their alternatives, and on mechanisms of the placebo response in clinical and experimental research, e.g. on type, size, dynamics, determinants, and predictors of the placebo response in the literature.
Topics: Clinical Trials as Topic; Drug Evaluation; Placebo Effect
PubMed: 19436960
DOI: 10.1007/s00103-009-0849-x -
BMJ (Clinical Research Ed.) May 2008
Topics: Humans; Placebo Effect; Placebos
PubMed: 18483026
DOI: 10.1136/bmj.39577.534688.3A -
Journal of Sport Rehabilitation May 2021While placebo effects are well recognized within clinical medicine, "nocebo effects" have received much less attention. Nocebo effects are problems caused by negative... (Review)
Review
While placebo effects are well recognized within clinical medicine, "nocebo effects" have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.
Topics: Brain Concussion; Child; Humans; Nocebo Effect; Placebo Effect
PubMed: 34050035
DOI: 10.1123/jsr.2020-0519 -
Current Sports Medicine Reports 2008Anecdotal and experimental evidence suggest that the placebo effect is seen in athletics. To this end, placebos have been used in clinical practice and athletic...
Anecdotal and experimental evidence suggest that the placebo effect is seen in athletics. To this end, placebos have been used in clinical practice and athletic performance. Positive reinforcement and the beliefs of athletes might contribute to the magnitude and direction of the effect, while supplement color, cost, and method of delivery also might be salient factors. Physiological changes similar to those resulting from active medication have been observed as the result of the administration of placebos, raising questions about placebo mechanisms. Researchers should look at design methods that will isolate placebo effects from those of experimental medication.
Topics: Athletic Performance; Brain; Humans; Placebo Effect; Research Design; Sports
PubMed: 18607223
DOI: 10.1249/JSR.0b013e31817ed050 -
Ophthalmic & Physiological Optics : the... Sep 2016
Topics: Humans; Placebo Effect
PubMed: 27580752
DOI: 10.1111/opo.12315 -
Revista Da Associacao Medica Brasileira... 2024
Topics: Homeopathy; Humans; Placebo Effect; Evidence-Based Medicine
PubMed: 38716949
DOI: 10.1590/1806-9282.20231438 -
American Heart Journal Dec 1990Many patients who are enrolled in controlled clinical trials of new drugs for the treatment of heart failure show favorable hemodynamic and clinical responses to placebo... (Clinical Trial)
Clinical Trial Review
Many patients who are enrolled in controlled clinical trials of new drugs for the treatment of heart failure show favorable hemodynamic and clinical responses to placebo therapy. This "placebo effect" results from both the creation of a supportive therapeutic environment and the spontaneous improvement that is commonly seen when measurements of symptoms and cardiac function are repeated frequently over long intervals of time. Three months of treatment with a placebo produces a reduction in symptoms in 25% to 35% of patients, an increase in cardiac output and a decrease in pulmonary wedge pressure, and an increase in exercise tolerance of up to 90 to 120 seconds. Physicians commonly seek to maximize the "placebo effect," since the goal of treatment in the clinical setting is to improve the quality of the patient's life. On the other hand, clinical investigators seek to minimize the "placebo effect," since the goal of a research study is to test the hypothesis that the new drug is superior to a placebo.
Topics: Heart Failure; Humans; Placebo Effect
PubMed: 2248215
DOI: 10.1016/0002-8703(90)90062-3 -
BMJ Evidence-based Medicine Mar 2024The placebo effect is the 'effect of the simulation of treatment that occurs due to a participant's belief or expectation that a treatment is effective'. Although the... (Meta-Analysis)
Meta-Analysis
The placebo effect is the 'effect of the simulation of treatment that occurs due to a participant's belief or expectation that a treatment is effective'. Although the effect might be of little importance for some conditions, it can have a great role in others, mostly when the evaluated symptoms are subjective. Several characteristics that include informed consent, number of arms in a study, the occurrence of adverse events and quality of blinding may influence response to placebo and possibly bias the results of randomised controlled trials. Such a bias is inherited in systematic reviews of evidence and their quantitative components, pairwise meta-analysis (when two treatments are compared) and network meta-analysis (when more than two treatments are compared). In this paper, we aim to provide red flags as to when a placebo effect is likely to bias pairwise and network meta-analysis treatment effects. The classic paradigm has been that placebo-controlled randomised trials are focused on estimating the treatment effect. However, the magnitude of placebo effect itself may also in some instances be of interest and has also lately received attention. We use component network meta-analysis to estimate placebo effects. We apply these methods to a published network meta-analysis, examining the relative effectiveness of four psychotherapies and four control treatments for depression in 123 studies.
Topics: Humans; Network Meta-Analysis; Placebo Effect; Meta-Analysis as Topic
PubMed: 37385716
DOI: 10.1136/bmjebm-2022-112197 -
Musculoskeletal Science & Practice Dec 2022While the placebo effect is increasingly recognised as a contributor to treatment effects in clinical practice, the nocebo and other undesirable effects are less well... (Review)
Review
INTRODUCTION
While the placebo effect is increasingly recognised as a contributor to treatment effects in clinical practice, the nocebo and other undesirable effects are less well explored and likely underestimated. In the chiropractic, osteopathy and physiotherapy professions, some aspects of historical models of care may arguably increase the risk of nocebo effects.
PURPOSE
In this masterclass article, clinicians, researchers, and educators are invited to reflect on such possibilities, in an attempt to stimulate research and raise awareness for the mitigation of such undesirable effects.
IMPLICATIONS
This masterclass briefly introduces the nocebo effect and its underlying mechanisms. It then traces the historical development of chiropractic, osteopathy, and physiotherapy, arguing that there was and continues to be an excessive focus on the patient's body. Next, aspects of clinical practice, including communication, the therapeutic relationship, clinical rituals, and the wider social and economic context of practice are examined for their potential to generate nocebo and other undesirable effects. To aid reflection, a model to reflect on clinical practice and individual professions through the 'prism' of nocebo and other undesirable effects is introduced and illustrated. Finally, steps are proposed for how researchers, educators, and practitioners can maximise positive and minimise negative clinical context.
Topics: Humans; Nocebo Effect; Placebo Effect; Physical Therapy Modalities; Communication
PubMed: 36368170
DOI: 10.1016/j.msksp.2022.102677 -
Perspectives in Biology and Medicine 2010Despite substantial progress in elucidating its neurobiological mechanisms, theoretical understanding of the placebo effect is poorly developed. Application of the... (Review)
Review
Despite substantial progress in elucidating its neurobiological mechanisms, theoretical understanding of the placebo effect is poorly developed. Application of the semiotic theory developed by the American philosopher Charles Peirce offers a promising account of placebo effects as involving the apprehension and response to signs. The semiotic approach dovetails with the various psychological mechanisms invoked to account for placebo effects, such as conditioning and expectation, and bridges the biological and cultural dimensions of this fascinating phenomenon.
Topics: Animals; Humans; Linguistics; Mental Processes; Neurobiology; Placebo Effect; Symbolism; Therapeutics
PubMed: 21037405
DOI: 10.1353/pbm.2010.0004