Placebo Effects in Medicine

Kaptchuk, Ted J.; Miller, Franklin G.

doi:10.1056/nejmp1504023

Cited by 381 publications

(337 citation statements)

References 5 publications

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“…The term placebo applies to a therapeutic encounter that benefits the health status because of the patient's belief in its effectiveness, whereas nocebo applies to an intervention that worsens the health status due to the patient's failure to believe in the healing power of the intervention (17). On the other hand to consider the placebo as an 'inert substance' is erroneous (21). In a broad sense, any circumstances that influence a patient's health care (from a medical team to the hospital environment) influence the therapeutic effect.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…Empathic and professional health care create a cognitive-affective-sensory orientation, tapping into conscious and subconscious mechanisms that can predispose a patient towards reduced symptom severity and lessen reactivity to underlying pathophysiology (21). Similarly, psychosocial factors that modulate therapeutic placebo effects also have the potential to cause adverse consequences (21).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…This knowledge may indeed contribute to the nocebo effect. Although there is no evidence that placebos can shrink tumors, some experiments have shown that common symptoms of cancer and adverse events related to cancer therapies are responsive to placebo treatments (21). In the aforementioned systematic (14) found an association in the type and incidence of side effects between the treatment and the placebo arm.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

See 2 more Smart Citations

The placebo effect in thyroid cancer: a meta-analysis

Llavero-Valero

Guillén-Grima

Zafón

et al. 2016

European Journal of Endocrinology

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Context: The natural history of advanced thyroid malignancies is largely unknown. The outcome of patients included in the placebo arm of clinical trials could be reflective of their therapy-free evolution. Objective: To analyze the response rate, symptoms and adverse effects of locally advanced or metastatic differentiated (DTC) and medullary thyroid cancer (MTC) in patients treated with placebo in clinical trials. Design: PubMed (MEDLINE) and SCOPUS databases were searched through September 2015 to identify high-quality randomized controlled clinical trials. We included studies that recruited patients with DTC or MTC with a placebo arm. Methods: We conducted a meta-analysis for each category of response rate, adherence to treatment, and adverse events. An empirical Bayesian random-effect model was used. Results: We identified five clinical trials. DTC and MTC were independently analyzed. In the placebo arm, no complete response was observed; partial response occurred in 1.6% (0.6-3) and 6.4% (3.4-10.3) of DTC and MTC respectively; stable disease was described in 40.5% (34.6-46.9) and 53.9% (44.3-64.4) of DTC and MTC respectively. DTC reached a disease control rate of 42.3% (36.2-48.9) and MTC of 60.2 (50.1-71.4). Treatment discontinuation rate was 3.5% (1.9-5.5) in DTC and 5.7% (3.0-9.4) in MTC. Rate of dose reduction was 7.3% (4.8-10.5) in in MTC.Conclusions: This meta-analysis provides extensive data on the response rate and adverse effects of locally advanced or metastatic DTC and MTC in patients treated with placebo. These results may be used for comparisons with results from clinical trials without a placebo arm.

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Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

See 1 more Smart Citation

The placebo effect in thyroid cancer: a meta-analysis

Llavero-Valero

Guillén-Grima

Zafón

et al. 2016

European Journal of Endocrinology

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“…There often exists a placebo effect in that a treated patient displays benefits, even though the fake pill, theoretically should not have any effect. This phenomenon shows the power of psychologically believing you are being treated effectively [11].…”

Section: Introductionmentioning

confidence: 94%

Degenerative Disc Disease in the Active Military Special Forces and the Financial Benefits of Early Detection Using a Quadruple Blind-Study

Burgio¹,

Onyejekwe²

2018

J Bioequiv Availab

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“…Although this may allow short‐term biological effects to be recognized, such studies provide little information to the physician who wishes to know the drugs’ relative value. Placebo control is now also questioned from an ethical point of view when trials delay therapy and when the delay increases the risk of sudden unexpected death in epilepsy (SUDEP) or other adverse consequences 8, 9, 10. Most trials have been of adjunctive therapy, whereas the clearest assessment of any drug would be in monotherapy, but monotherapy trials have significant ethical and methodological defects.…”

Section: Today's Theories and Practices Which May Not Withstand The Tmentioning

confidence: 99%

The right and the wrong with epilepsy and her science

Shorvon

Schmidt²

2016

Epilepsia Open

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SummaryThis is a commentary and an opinion paper attempting a critical reassessment of the methods and practices of epilepsy research as we see it. The enormous progress in the field of epilepsy in recent years is a cause of celebration. Advances have been made on most fronts, and the position of patients with epilepsy in society has greatly improved. However, there have also been culs‐de‐sac and dead ends of modern science and clinical practice which are also intriguing. It may be true that we can learn more from our mistakes than from our successes. In this opinion paper, we have listed some of the successes and some of the failures of past epilepsy practice, and also areas of current practice and theory which we feel are likely to prove mistaken. The underlying reasons for misdirected practices and theories include, in our view, the influence of fashion, bad science, and the bureaucracies of practice and academic medicine. As a result, some findings are far from objective. Recognition is the first step to remediation, and hopefully future research will minimize some of the pitfalls mentioned in this article and bring the “End of Epilepsy,” as defined and predicted by Oswei Temkin, closer than it is today.

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Placebo Effects in Medicine

Cited by 381 publications

References 5 publications

The placebo effect in thyroid cancer: a meta-analysis

The placebo effect in thyroid cancer: a meta-analysis

Degenerative Disc Disease in the Active Military Special Forces and the Financial Benefits of Early Detection Using a Quadruple Blind-Study

The right and the wrong with epilepsy and her science

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