Journal ArticleDOI
Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.
Reads0
Chats0
TLDR
A systematic review of clinical trials in which patients were randomly assigned to either placebo or no treatment found that placebo had no significant effect on binary outcomes, regardless of whether these outcomes were subjective or objective.Abstract:
Background Placebo treatments have been reported to help patients with many diseases, but the quality of the evidence supporting this finding has not been rigorously evaluated. Methods We conducted a systematic review of clinical trials in which patients were randomly assigned to either placebo or no treatment. A placebo could be pharmacologic (e.g., a tablet), physical (e.g., a manipulation), or psychological (e.g., a conversation). Results We identified 130 trials that met our inclusion criteria. After the exclusion of 16 trials without relevant data on outcomes, there were 32 with binary outcomes (involving 3795 patients, with a median of 51 patients per trial) and 82 with continuous outcomes (involving 4730 patients, with a median of 27 patients per trial). As compared with no treatment, placebo had no significant effect on binary outcomes, regardless of whether these outcomes were subjective or objective. For the trials with continuous outcomes, placebo had a beneficial effect, but the effect decreas...read more
Citations
More filters
Journal ArticleDOI
OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines
Weiya Zhang,R W Moskowitz,George Nuki,S Abramson,R D Altman,Nigel K Arden,Sita M A Bierma-Zeinstra,K D Brandt,P Croft,Michael Doherty,Maxime Dougados,Marc C. Hochberg,David J. Hunter,K Kwoh,L S Lohmander,Peter Tugwell +15 more
TL;DR: Twenty-five carefully worded recommendations have been generated based on a critical appraisal of existing guidelines, a systematic review of research evidence and the consensus opinions of an international, multidisciplinary group of experts for the management of hip and knee osteoarthritis.
Journal ArticleDOI
Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration.
TL;DR: This elaboration and explanation document is developed from a review of the literature to provide examples of adequate reporting in trials of nonpharmacologic treatments and should help to improve the reporting of RCTs performed in this field.
Journal ArticleDOI
A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
Alexandra Kirkley,Trevor B. Birmingham,Robert Litchfield,J. Robert Giffin,Kevin Willits,Cindy J. Wong,Brian G. Feagan,Allan Donner,Sharon Griffin,Janet E. Pope,Peter J. Fowler +10 more
TL;DR: In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthro scopic débridement were no better than those after a placebo procedure.
Journal ArticleDOI
Placebo-induced changes in FMRI in the anticipation and experience of pain.
Tor D. Wager,James K. Rilling,Edward E. Smith,Alex Sokolik,Kenneth L. Casey,Richard J. Davidson,Stephen M. Kosslyn,Robert M. Rose,Jonathan D. Cohen +8 more
TL;DR: fMRI experiments found that placebo analgesia was related to decreased brain activity in pain-sensitive brain regions, including the thalamus, insula, and anterior cingulate cortex, and was associated with increased activity during anticipation of pain in the prefrontal cortex, providing evidence that placebos alter the experience of pain.
Journal ArticleDOI
Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)
Jean Pascal Lefaucheur,Nathalie André-Obadia,Andrea Antal,Samar S. Ayache,Chris Baeken,David H. Benninger,Roberto Cantello,Massimo Cincotta,Mamede de Carvalho,Dirk De Ridder,Hervé Devanne,Vincenzo Di Lazzaro,Saša R. Filipović,Friedhelm C. Hummel,Satu K. Jääskeläinen,Vasilios K. Kimiskidis,Giacomo Koch,Berthold Langguth,Thomas Nyffeler,A. Oliviero,Frank Padberg,Emmanuel Poulet,Simone Rossi,Paolo Maria Rossini,John C. Rothwell,Carlos Schönfeldt-Lecuona,Hartwig R. Siebner,Christina W. Slotema,Charlotte J. Stagg,Josep Valls-Solé,Ulf Ziemann,Walter Paulus,Luis Garcia-Larrea +32 more
TL;DR: There is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rT MS of the left dorsolateral prefrontal cortex (DLPFC).
References
More filters
Journal ArticleDOI
Bias in meta-analysis detected by a simple, graphical test
TL;DR: Funnel plots, plots of the trials' effect estimates against sample size, are skewed and asymmetrical in the presence of publication bias and other biases Funnel plot asymmetry, measured by regression analysis, predicts discordance of results when meta-analyses are compared with single large trials.
Journal ArticleDOI
Meta-Analysis in Clinical Trials*
TL;DR: This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Journal ArticleDOI
Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials.
TL;DR: Empirical evidence is provided that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias.
Journal ArticleDOI
The powerful placebo
TL;DR: It is interesting that Pepper could say as recently as 10 years ago "apparently there has never been a paper published discussing the important subject of the placebo," but in 1953 Gaddum1 said: Such tablets are sometimes called placebos, but it is better to call them dummies.