Reframing placebo in research and practice

Jonas, Wayne B.

doi:10.1098/rstb.2010.0405

Cited by 35 publications

(28 citation statements)

References 53 publications

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“…However, in our view this should not be called placebo research. What is often described as harnessing placebo effects might be better summarized as harnessing context effects or as attempts to create optimal healing environments [53,54].…”

Section: Moving From Research On Placebo Effects To Research On Contementioning

confidence: 99%

Placebo interventions, placebo effects and clinical practice

Linde

Fässler

Meißner

2011

Phil. Trans. R. Soc. B

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This article reviews the role of placebo interventions and placebo effects in clinical practice. We first describe the relevance of different perspectives among scientists, physicians and patients on what is considered a placebo intervention in clinical practice. We then summarize how placebo effects have been investigated in randomized controlled trials under the questionable premise that such effects are produced by placebo interventions. We further discuss why a shift of focus from the placebo intervention to the overall therapeutic context is necessary and what research methods can be used for the clinical investigation of the relevance of context effects. In the last part of the manuscript, we discuss why placebo or context effects are seen as positive in clinical practice when they are associated with active treatments, while placebo interventions pose major ethical and professional problems and have to be avoided.

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Section: Moving From Research On Placebo Effects To Research On Contementioning

confidence: 99%

Placebo interventions, placebo effects and clinical practice

Linde

Fässler

Meißner

2011

Phil. Trans. R. Soc. B

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“…Implementing U.S. Food and Drug Administration good manufacturing practices for dietary supplements can mitigate risk of contamination and poor quality control. 158 Incorporating emerging findings from clinical and neurobiological 159 research of contextual and placebo effects can enhance the delivery 160 and understanding of some CAM approaches. Overall, the application of preventive medicine principles and recent quality improvement initiatives can strengthen integrative medicine in the context of a healthcare system moving to value-based care.…”

Section: Discussionmentioning

confidence: 99%

Disease Prevention and Health Promotion

Ali

Katz

2015

American Journal of Preventive Medicine

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As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels of prevention, acknowledging the relative deficiency of research on the effectiveness of practice-based integrative care. One goal of integrative medicine is to make the widest array of appropriate options available to patients, ultimately blurring the boundaries between conventional and complementary medicine. Both disciplines should be subject to rigorous scientific inquiry so that interventions that are efficacious and effective are systematically distinguished from those that are not. Furthermore, principles of preventive medicine can be infused into prevalent practices in complementary and integrative medicine, promoting public health in the context of more-responsible practices. The case is made that an integrative preventive approach involves the responsible use of science with responsiveness to the needs of patients that persist when conclusive data are exhausted, providing a framework to make clinical decisions among integrative therapies.

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“…Wayne Jonas [58] discusses some possible dilemmas that may derive from the current framing of placebo research. In particular, he presents the scenario of a physician who has to decide on the utilization of a treatment that is 'not better than placebo' but nonetheless is more effective than standard care.…”

Section: Overview Of the Theme Issuementioning

confidence: 99%

“…Therefore, alternative ways to harness the advantages of placebo effects in daily clinical practice are required. As will be debated in this theme issue, several approaches have been suggested, such as the description of placebos without deception, the application of conditioning protocols and the creation of an optimal healing environment [24,30,58].…”

Section: Introductionmentioning

confidence: 99%

Introduction to placebo effects in medicine: mechanisms and clinical implications

Meißner

Kohls

Colloca

2011

Phil. Trans. R. Soc. B

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The field of placebo research has made considerable progress in the last years and it has become a major focus of interest. We know now that the placebo effect is a real neurobiological phenomenon and that the brain's 'inner pharmacy' is a critical determinant for the occurrence of psychobiological and behavioural changes relevant to healing processes and well-being. However, harnessing the advantages of placebo effects in healthcare is still a challenge. The first part of the theme issue summarizes and discusses the various kinds of placebo mechanisms across medical fields, thereby not only focusing on two main explanatory models-expectation and conditioning theory-but also taking into account empathy and social learning, emotion and motivation, spirituality and the healing ritual. The second part of the issue focuses on questions related to transferring knowledge from placebo research into clinical practice and discusses implications for the design and interpretation of clinical trials, for the therapeutic settings in daily patient care, and for future translational placebo research.

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Reframing placebo in research and practice

Cited by 35 publications

References 53 publications

Placebo interventions, placebo effects and clinical practice

Placebo interventions, placebo effects and clinical practice

Disease Prevention and Health Promotion

Introduction to placebo effects in medicine: mechanisms and clinical implications

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