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Review: placebo is better than no treatment for subjective continuous outcomes and for treatment of pain

Data sources
Trials published before the end of 1998 were identified by searching Medline, EMBASE/Excerpta Medica, PsycLIT, Biological Abstracts, and the Cochrane Controlled Trials Register. Reference lists were reviewed and experts were contacted.

Study selection
Studies were selected if patients were randomly allocated to a placebo group or an untreated group. Exclusion criteria were unconcealed randomisation, a sample of paid or healthy volunteers, non-blinding of assessors of objective outcomes, a > 50% dropout rate, or if the alleged placebo had a clinical effect not associated with the treatment ritual alone.

Data extraction
The primary outcome was that defined by the trial author or, if not defined, the most clinically relevant outcome.

Main results
114 trials were included. The typical pharmacological placebo was a lactose tablet, the typical physical placebo was a procedure done with a machine turned off, and the typical psychological placebo was an attention placebo (a non-directional neutral discussion). 40 clinical conditions were investigated.

Placebo did . . . [Full text of this article]

Toshi A Furukawa, MD, PhD

Nagoya City University Nagoya, Japan