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)

Abstract:

• 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

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