Components of the placebo effect
Kaptchuk TJ, Kelley JM, Conboy LA, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ. 2008 May 3;336(7651):999-1003. PMID: 18390493
A fine benchmark study from investigators at Harvard Medical School. From the discussion:
In this large prospective study of placebo effects we found that such effects can be disentangled into three components that can then be recombined to produce incremental improvement in symptoms in a manner resembling a graded dose escalation of component parts. In the pairwise comparisons, we also found that an enhanced relationship with a practitioner, together with the placebo treatment, provides the most robust effect in terms of the four measures we used….
The magnitude of non-specific effects in the augmented arm is not only statistically significant but also clearly clinically significant in the management of irritable bowel syndrome…. the percentage of patients reporting adequate relief (62% and 61% at three and six weeks, respectively) is comparable with the responder rate in clinical trials of drugs currently used in the treatment of irritable bowel syndrome.
These results indicate that such factors as warmth, empathy, duration of interaction, and the communication of positive expectation might indeed significantly affect clinical outcome.
CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.
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