What is the placebo worth?

doi:10.1136/bmj.39535.344201.BE

BMJ, doi: 10.1136/bmj.39535.344201.BE, (Published 3 April 2008)

Editorials

What is the placebo worth?

The doctor-patient relationship is a crucial part of its value

The first 150 words of the full text of this article appear below.

George Bernard Shaw described a miracle as "an event that createsfaith." Belief is a powerful tool, and many factors influenceit. A recent study testing pain relief from analgesics showedthat merely telling people that a novel form of codeine theywere taking (actually a placebo) was worth $2.50 (£1.25; ${euro}$ 1.58) rather than 10 cents increased the proportion of peoplewho reported pain relief from 61% to 85.4%.¹ When the "price"of the placebo was reduced, so was the pain relief. A meta-analysisof decades of clinical trials proposed that the placebo effectwas more hype than reality.² However, the resulting backlashagainst it has had the implicit effect of clarifying what isbest practice with regard to the placebo.³

Hovering over much of the research is a practical question forclinicians—what does all this mean for patient care? Inthe accompanying randomised controlled trial, Kaptchuk and colleaguesundertake . . . [Full text of this article]

David Spiegel, Willson professor ¹, Anne Harrington, professor and chair²

¹ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5718, USA, ² Department of the History of Science, Science Center 371, Harvard University, Cambridge, MA 02138, USA

dspiegel@stanford.edu

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