How do they add up? The interaction between the placebo and treatment effect: A systematic review.
clinical trials
drug effect
evidence-based practice
placebo
therapeutic alliance
treatment outcome
Journal
British journal of clinical pharmacology
ISSN: 1365-2125
Titre abrégé: Br J Clin Pharmacol
Pays: England
ID NLM: 7503323
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
25
03
2022
received:
29
09
2021
accepted:
27
03
2022
pubmed:
7
4
2022
medline:
20
7
2022
entrez:
6
4
2022
Statut:
ppublish
Résumé
The placebo effect and the specific effect are often thought to add up (additive model). Whether additivity holds can dramatically influence the external validity of a trial. This assumption of additivity was tested by Kleijnen et al in 1994 but the data produced since then have not been synthetized. In this review, we aimed to systematically review the literature to determine whether additivity held. We searched Medline and PsychInfo up to 10 January 2019. Studies using the balanced placebo design (BPD), testing two different strengths of placebos, were included. The presence of interaction was evaluated by comparing each group in the BPD with analysis of variance or covariance. Thirty studies were included and the overall risk of bias was high: four found evidence of additivity and 16 studies found evidence of interaction (seven had evidence of positive additivity). Evidence of additivity between placebo and specific features of treatments was rare in included studies. We suggest interventions for placebo-sensitive ailments should be tested in trials designed to take interactions seriously once an exploratory RCTs has proven their efficacy with sufficient internal validity.
Identifiants
pubmed: 35384004
doi: 10.1111/bcp.15345
pmc: PMC9545282
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3638-3656Subventions
Organisme : Medical Research Council
ID : MR/V020706/1
Pays : United Kingdom
Informations de copyright
© 2022 British Pharmacological Society.
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