Moseley, J.B. et al. (July 2002). A Controlled Trial of Arthoscopic Surgery for Osteoarthritis of the Knee, The New England Journal of Medicine, Volume 347, Number 2, 81-88.
Over 650,000 knee surgeries are performed each year to relieve the pain of osteoarthritis. However, there is no evidence to support that arthroscopy cures or arrests osteoarthritis. Amazingly though, about half of the patients report relief from pain. This paper set out to see if the surgeries were being successful due to some direct medical benefit being received or whether they were equivalent to placebo, and thus successful for other, psychological reasons. The outcomes showed that arthroscopic lavage and arthroscopic debridement were in fact no better than a placebo procedure. Therefore, the successes being witnessed were likely related to placebo effect. (Ergo, researchers should not underestimate the power of placebo.)
Showing posts with label Placebo. Show all posts
Showing posts with label Placebo. Show all posts
Wednesday, January 16, 2008
Sunday, January 13, 2008
The Placebo Effect
Brown, W.A. (January 1998). The Placebo Effect, Scientific American, p. 90-95.
The placebo effect, where the very act of undergoing treatment helps the patient to recover, has been known for some time. However, its neural correlates still remain elusive. A wide range of afflictions seem to respond to placebo, especially those in which stress directly affects the symptoms. Animal and human studies have shown that the functioning of the immune system falters under stressful conditions, stymied by release of the stress hormone cortisol. Therefore, reducing fear and anxiety by restoring some sense of control might help to prevent exacerbation of symptoms.
To practitioners, the article recommends a good bedside manner, a proper diagnosis and prognosis, and presentation of different treatment options for the patient to choose from whenever possible. While the author believes every effort should be made to understand and harness this powerful phenomena to affect treatment outcomes, he cautions doctors against prescribing placebos deceptively on ethical grounds.
The placebo effect, where the very act of undergoing treatment helps the patient to recover, has been known for some time. However, its neural correlates still remain elusive. A wide range of afflictions seem to respond to placebo, especially those in which stress directly affects the symptoms. Animal and human studies have shown that the functioning of the immune system falters under stressful conditions, stymied by release of the stress hormone cortisol. Therefore, reducing fear and anxiety by restoring some sense of control might help to prevent exacerbation of symptoms.
To practitioners, the article recommends a good bedside manner, a proper diagnosis and prognosis, and presentation of different treatment options for the patient to choose from whenever possible. While the author believes every effort should be made to understand and harness this powerful phenomena to affect treatment outcomes, he cautions doctors against prescribing placebos deceptively on ethical grounds.
Subscribe to:
Posts (Atom)