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Posted by andrewturner on 23 Dec 2010 at 13:36 GMT
This is a neat trial which provides further evidence showing the diverse aspects of a treatment that can be therapeutically relevant; namely, for example: "warm patient-provider relationship... frequency and duration of contact time... persuasive rationale".
And so consequently the authors claim: "Our data suggest that harnessing placebo effects without deception is possible in the context of 1) an accurate description of what is known about placebo effects, 2) encouragement to suspend disbelief, 3) instructions that foster a positive but realistic expectancy, and 4) directions to adhere to the medical ritual of pill taking."
But why – as Robin Nunn has argued [1,2] – frame this in terms of 'placebos' at all? - An explanation of these results simply in terms of time spent with the patients, encouragement, expectation, and ritual is not only sufficient but clearer and more precise than an explanation in terms of 'placebos' and 'placebo effects'. Moreover it provides a much more programmatic guide to further research.
Perhaps talk about 'placebos' and lack of deception in this paper obscures, rather than constitutes, the interesting results.
[1] Nunn R. It’s time to put the placebo out of its misery. British Medical Journal. 2009;338:1015.
[2] Nunn R. Preparing for a Post-Placebo Paradigm: Ethics and Choice of Control in Clinical Trials. The American Journal of Bioethics. 2009;9(9):51-52.