The Importance of Placebo Effects

Edzard Ernst, MD, PhD; Karl-Ludwig Resch, MD, PhD
JAMA. 1995;273(4):283. doi:10.1001/jama.1995.03520280027020.
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To the Editor.  —The recent publication by Dr Turner and colleagues1 is a laudable effort to understand the placebo response. The authors confirm that the placebo effect is often misperceived as the unwanted "noise" in a clinical trial that one ought to eliminate. Apart from being only part of the story (the placebo response is also a potentially desirable element that can and should be used for the benefit of the patient), this notion in itself is often interpreted incorrectly.A computerized search (MEDLINE, 1987 through 1993) was conducted identifying all clinical trials that contained the terms "placebo" and "untreated" in their abstracts. Three hundred eighteen such publications were retrieved and studied in detail. In the majority of cases (n=188), the term "untreated" did not refer to an untreated control group, but to the conditions studied (ie, untreated hypertension). Of the remaining 130, 52 had used the term "untreated"


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