By: Phelix Peer
Placebo effect – what’s the first thought that comes to mind when you hear this? I am almost certain sirens are going off somewhere, equating placebo to the words “fake” and “sham”. In drug and treatment studies, placebo is often used as a baseline to mean “no effect”, and studied treatment or drug options are tested against placebo to see whether a statistical difference can be observed. However, the trend researchers are finding within the pharmaceutical and surgical realm is that it’s getting harder to harder to beat placebo. Does this mean these new treatments do not work? Fundamentally that’s what these studies are trying to find out. In recent years, a new idea is developing: is it fair to view placebo as a baseline? Is it fair to negate our mind’s impact on our body?
It may be surprising to some, but there’s actually a whole interdisciplinary program in placebo studies at Harvard Medical School looking at how we can harness placebo effect for the healing process. From Harvard Medical School’s website “The placebo effect is more than positive thinking – believing a treatment or procedure will work. It’s about creating a stronger connection between the brain and body and how they work together,”.1 This new concept is potentially shaking Health Authorities’ approach to treatment versus placebo across a whole variety of studied ailments, neurological diseases in particular. Researchers are realizing, that when assessing various drugs and surgical treatments, that many treatments actually do not have statistical difference versus placebo. Conditions such as Irritable Bowel Syndrome (IBS), neuropathic pain, bone spurs, are all conditions where results showed no statistical difference between placebo and actual treatment. However, individuals did experience an improvement to their quality of life. Additionally, symptoms did reduce in placebo groups as well, leading one to think
Dr. Kathryn Hall spoke in an episode of “Adam Ruins Everything”, “In fairness to these kind of surgical procedures, many of them have not been tested against placebo. You know, I think our belief around surgery is so strong, that we have not seen the need to submit patients to sham surgery.”2 In a study assessing osteoarthritis of the knee in 2002, it was found that sham surgery versus those who had standard arthroscopic procedure, there was no statistical difference between the groups.3 The individuals in both groups improved the same amount.
Thus, how do we define what is a sham and has no effect? Maybe we should revisit how we think about placebo, and how we can harness this and implement it into the way we do clinical trials and assess new treatment options for the growing ailments we face day by day.
- Harvard Health Publishing. “The Power of the Placebo Effect.” Harvard Health, Harvard Health Publishing, 9 Aug. 2019, www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect.
- MaximumFun.org, company. “Dr. Kathryn Hall on the Surprising Power of Placebos/” Adam Ruins Everything, Spotify, 9 Feb. 2019, https://open.spotify.com/show/31F64lcd12EXN2zJtqpFMT?si=2plkzu2URAenY8vYfRTxBQ
- Kirkley, Alexandra, et al. “A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee.” New England Journal of Medicine, vol. 359, no. 11, 2008, pp. 1097–1107., doi:10.1056/nejmoa0708333.