A Review of the Adverse Outcomes of Placebo-Controlled Pain Trials

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The purpose of this article is to help you understand the nature of placebo side effects and how they may affect your health or treatment. When we speak of a placebo, we are referring to any medication or treatment that contains the word ‘placebo’ in its name or design. Although there are many different types of medication and remedies, Placebo Designs, as they are referred to, have become popular in recent years. Their increasing popularity is due to the fact that their therapeutic claims seem to be supported by very strong scientific principles.

Placebo Designs Are Very Popular

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Although Placebo Designs is very popular with doctors, they are also increasingly used by homeopathic practitioners and herbalists. One of the primary nocebo effects is known as symptom misattribution. This is where the patient perceives a varying degree of benefit from a treatment, but the doctor or medical professional does not claim that there is any improvement in the patient’s condition. In theory, the patient believes that the treatment has been ineffective, but the practitioner has not revealed any evidence of this.

Primary No

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As stated above, one of the primary no-treatment control designs is when the practitioner withholding information, but there are also many other no-treatment control designs. A classic example would be the so-called double blind, or double control, studies. These studies involve only two parties and both are unaware of the real purpose of the testing, thus rendering the results null and void. However, most doctors believe that such studies produce unrealistic results due to the placebo effect.

Sure

There are many reasons why placebo effects may occur and there is no sure-fire method for avoiding misattribution. For instance, if the test subject believes that he/she is receiving a treatment that is actually worthless, the effects could be significant. Such misattribution is especially common in clinical trials where placebo effects are expected. The reason behind this phenomenon is that the subject is under the impression that a beneficial result has been received when it has not, and therefore will act in a way that is conducive to receiving a real treatment. It has also been found that some subjects, even after receiving placebo treatments, will still report an improvement to the therapist, indicating that there may be a placebo or no-treatment effect occurring.

Bottom Lines

When comparing between the control condition and the acupuncture group, the standard mean difference (SEMD) for the comparison should be taken. The SEMD will be derived by dividing the total number of patients experiencing unpleasant outcomes by the total number of patients in the placebo group who experienced no side effect. A value between zero and one is considered to be acceptable for a good result, where one to five would be acceptable for medium undesirable results, and ten or more is considered unacceptable. When evaluating whether a side effect occurred, it is important to look at the differences between the placebo and control group. If the pain ratings were high in the placebo condition but low in the control group, the difference may be due to the placebo. If the pain ratings were low in the control condition but very high in the placebo group, the difference may be due to the effectiveness of the acupuncture.