placebo & sham

[Guest guest]

....and another one by Stephen Birch on the topic. The large German AP trial

for headaches is also being discussed in the journal (see http://www

liebertonline.com/toc/acm/12/3).

 

 

J Altern Complement Med. 2006 Apr;12(3):303-10.

 

 

A review and analysis of placebo treatments, placebo effects, and placebo

controls in trials of medical procedures when sham is not inert.

 

Birch S.

 

Stichting (Foundation) for the Study of Traditional East Asian Medicine

(STEAM), Amsterdam, The Netherlands.

 

Researchers examining the efficacy of medical procedures make assumptions

about the nature of placebo. From these assumptions they select the sham

interventions to be used in their trials. However, placebo is not well

defined. A number of definitions are contradictory and sometimes misleading.

This leads to problems in sham-controlled studies of medical procedures and

difficulties interpreting their results. The author explores some of the

contradictory definitions of placebo and assumptions and consequences of

these. Principal among these is the assumption that the placebo is inert

when it is not, which introduces bias against the tested medical procedures

and devices. To illustrate the problem, the author examines the use of sham

procedures in clinical trials of the medical procedures surgery and

acupuncture in which the sham was assumed to be inert but was not. Trials of

surgery and acupuncture should be re-examined in light of this.

 

PMID: 16646730 [PubMed - in process]