Research: Could studying the placebo effect change the way we think about medicine?

The Pow­er of Noth­ing: Could study­ing the place­bo effect change the way we think about med­i­cine? (The New Yorker):

For years, Ted Kaptchuk per­formed acupunc­ture at a tiny clin­ic in Cam­bridge, a few miles from his cur­rent office, at the Har­vard Med­ical School. He opened for busi­ness in 1976, hav­ing just returned from Asia, where he had spent four years hon­ing his craft. Not long after he arrived in Boston, he treat­ed an Armen­ian woman for chron­ic bron­chi­tis. A few weeks lat­er, the woman returned with her hus­band and told Kaptchuk that he had “cured” her.”“It had to be some kind of place­bo,” Kaptchuk stat­ed. “I’ve always believed there is an impor­tant com­po­nent of med­i­cine that involves sug­ges­tion, rit­u­al, and belief.” This year, Har­vard cre­at­ed an insti­tute ded­i­cat­ed whol­ly to the study of place­bos, the Pro­gram in Place­bo Stud­ies and the Ther­a­peu­tic Encounter. It is based at the Beth Israel Dea­coness Med­ical Cen­ter and Kaptchuk was named its director.”

Link to Study: Place­bo inter­ven­tions for all clin­i­cal con­di­tions (PubMed)


  • BACKGROUND: Place­bo inter­ven­tions are often claimed to sub­stan­tial­ly improve patient-report­ed and observ­er-report­ed out­comes in many clin­i­cal con­di­tions, but most reports on effects of place­bos are based on stud­ies that have not ran­domised patients to place­bo or no treat­ment. Two pre­vi­ous ver­sions of this review from 2001 and 2004 found that place­bo inter­ven­tions in gen­er­al did not have clin­i­cal­ly impor­tant effects, but that there were pos­si­ble ben­e­fi­cial effects on patient-report­ed out­comes, espe­cial­ly pain. Since then sev­er­al rel­e­vant tri­als have been published.
  • OBJECTIVES: Our pri­ma­ry aims were to assess the effect of place­bo inter­ven­tions in gen­er­al across all clin­i­cal con­di­tions, and to inves­ti­gate the effects of place­bo inter­ven­tions on spe­cif­ic clin­i­cal con­di­tions. Our sec­ondary aims were to assess whether the effect of place­bo treat­ments dif­fered for patient-report­ed and observ­er-report­ed out­comes, and to explore oth­er rea­sons for vari­a­tions in effect.
  • AUTHORS’ CONCLUSIONS: We did not find that place­bo inter­ven­tions have impor­tant clin­i­cal effects in gen­er­al. How­ev­er, in cer­tain set­tings place­bo inter­ven­tions can influ­ence patient-report­ed out­comes, espe­cial­ly pain and nau­sea, though it is dif­fi­cult to dis­tin­guish patient-report­ed effects of place­bo from biased report­ing. The effect on pain var­ied, even among tri­als with low risk of bias, from neg­li­gi­ble to clin­i­cal­ly impor­tant. Vari­a­tions in the effect of place­bo were part­ly explained by vari­a­tions in how tri­als were con­duct­ed and how patients were informed.

To learn more: read Mind Hacks and the Place­bo Effect.

Source of pic: Big­Stock­Photo


  1. mike on December 18, 2011 at 8:18

    I’ve always won­dered if the place­bo effect could be used to actu­al­ly treat ill­ness­es. It real­ly does seem that in some cas­es, the belief that you will get bet­ter actu­al­ly aids in ones recovery.

    It real­ly comes down to how you define recov­ery. Has a per­son recov­ered when they feel bet­ter, or when their body has actu­al­ly repaired itself?

    • Alvaro Fernandez on December 30, 2011 at 3:54

      It also depends on how you define “ill­ness” and “treat­ment”. I’d say “treat­ment” means a durable recov­ery and solu­tion of the root prob­lem, so place­bos should­n’t be seen as a treat­ment — they should be seen as (pow­er­ful) enhancers/ accel­er­a­tors of evi­dence-based treatments.

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