Choice and the Placebo Effect: A Meta-analysis

Background Choice has been proposed as a method of enhancing placebo effects. However, there have been no attempts to systematically evaluate the magnitude, reliability, and moderators of the influence of choice on the placebo effect. Purpose To estimate the effect size of choice on the placebo effect and identify any moderators of this effect. Methods Web of Science, PsycINFO, EMBASE, and PubMed were systematically searched from inception to May 2021 for studies comparing placebo treatment with any form of choice over its administration (e.g., type, timing) to placebo treatment without choice, on any health-related outcome. Random-effects meta-analysis was then used to estimate the effect size associated with the influence of choice on the placebo effect. Meta-regression was subsequently employed to determine the moderating effect of factors such as type of choice, frequency of choice, and size of the placebo effect without choice. Results Fifteen independent studies (N = 1,506) assessing a range of conditions, including pain, discomfort, sleep difficulty, and anxiety, met inclusion criteria. Meta-analysis revealed that choice did significantly enhance the placebo effect (Hedges’ g = 0.298). Size of the placebo effect without choice was the only reliable moderator of this effect, whereby a greater effect of choice was associated with smaller placebo effects without choice. Conclusions Treatment choice can effectively facilitate the placebo effect, but this effect appears more pronounced in contexts where the placebo effect without choice is weaker. Because most evidence to date is experimental, translational studies are needed to test whether providing choice in clinical scenarios where placebo effects are weaker may help boost the placebo effect and thereby improve patient outcomes.

Systematic review and meta-analysis of the placebo effect in panic disorder: Implications for research and clinical practice

Objective: This review aimed to measure the degree of placebo response in panic disorder. Data Sources: We searched major databases up to 31 January 2021, for randomized pharmacotherapy trials published in English. Study Selection: A total of 43 studies met inclusion criteria to be in the analysis (with 174 separate outcome measurements). Data Extraction: Changes in outcome measures from baseline in the placebo group were used to estimate modified Cohen’s d effect size. Results: A total of 43 trials (2392 subjects, 174 outcomes using 27 rating scales) were included in the meta-analysis. Overall placebo effect size was 0.57 (95% confidence interval = [0.50, 0.64]), heterogeneity ( I2: 96.3%). Higher placebo effect size was observed among clinician-rated scales compared to patient reports (0.75 vs 0.35) and among general symptom and anxiety scales compared to panic symptoms and depression scales (0.92 and 0.64 vs 0.56 and 0.54, respectively). There was an upward trend in effect size over the publication period ( r = 0.02, p = 0.002) that was only significant among clinician-rated scales ( r = 0.02, p = 0.011). There was no significant publication bias, Egger’s test ( p = 0.08). Conclusion: We observed a substantial placebo effect size in panic disorder. This effect was more prominent for some aspects of panic disorder psychopathology than for others and was correlated with the source of the assessment and publication year. This finding has implications both for research design, to address the heterogeneity and diversity in placebo responses, and for clinical practice to ensure optimal quality of care. Systematic review registration number: PROSPERO, CRD42019125979.

CAM Use From Western and Asian Perspectives

This chapter will discuss the impact on the provision and integration of complementary and alternative medicine (CAM) into the patient's medical pathway and in turn, the prevalence of usage, not only for treatment but also prevention. Similarities and differences of these issues between Western and Asian perspectives will be presented. The authors will provide an overview of regulatory organisations which influence this provision, as well as advertising within the cultures which will have impact on belief of efficacy, which in turn will increase the placebo effect (thereby increasing efficacy). Due to a lack of evidence for CAM advertising in Asian cultures, further research is needed.

The 2005 Lancet review proved superior quality of homeopathy trials: what's next?

Several former reviews showed positive effects of homeopathy, but in 2005 The Lancet published a review which claimed that homeopathy is a placebo effect. This review was criticised for not revealing essential information. A reconstruction of post-publication data challenges the negative conclusion. The only conclusion that was rectified by the methodology of the 2005 review was that the quality of homeopathy trials, and especially of smaller trials, is better than quality of conventional trials. The comparison of the effect of 110 homeopathy trials with 110 matched conventional trials was flawed by selection bias, different publication bias, different quality, and different safety. Nevertheless, there is no significant difference of effects between both methods. Discussions about proof for homeopathy are in fact discussions about science. The prior assumption that homeopathy cannot work pervades all aspects of this discussion and is not properly evaluated in the introduction of most analyses.

Plants: a unique model for research on high diluted substances

Introduction: High efficiency and low cost of homeopathic drugs, lack of side effects and accumulation of toxins in animal farming products made homeopathy one of the priority developments in veterinary medicine. However, opponents of homeopathy have intensified their activity in the recent years. The attacks of the opponents of homeopathy, with their unfounded claims that it is totally explained by the placebo effect, can largely be explained by complexity of understanding the mechanism of action of these remedies which does not fit into the established concepts the effect of drugs on the body. That is why further study of homeopathic phenomenon is especially important in these days. In order to disproof the opinion that homeopathic phenomenon is explained by placebo effect, we have been studying the effect homeopathic remedies on vegetable growth and ripening. This choice was based on the hope that the opponents of homeopathy would not be able to accuse plants of self-suggestion under the effect of potentiated remedies. There are many publications about application of homeopathic remedies on plants. For example, in this direction such researchers as Stephan Baumgartner, Carneiro SMTPG, Rossi F, Carvalho LM, Bonato CM, Betti L, Lazzarato L V. Majewsky, and other researchers worked. Methods: Our first experiments that we performed during two years demonstrated a significant improvement of growth and ripening variables when homeopathic remedies were added to fertilizing mixtures, as compared with conventional plant care. Tomatoes of Typhoon F1 and Titan breeds were sued to study the effect of homeopathic remedies on plant growth and ripening. The studies were performed in greenhouse conditions in summer 2009 and 2010, on fertile soils of an experimental farm in the Krasnoselskiy district of the Leningrad region. Every study group of a certain tomato breed contained 20 plants. When the young plants were planted in the soil they were watered with adding Coca 1000 СН remedy, and then in one month the upper part of the plant was sprayed with Echinacea 30 СН. The same amounts of similar plants of the same breeds treated according to conventional agricultural technology were used as a control group. Results: As a result earlier ripening was found in the Typhoon F1 tomato breed: it occurred by 19 days earlier: that is by 18.3% than in the control group. The Titan tomatoes group ripened by 14.3% faster than in the control one. Every plant of the Typhoon breed produced an average of 45 tomato fruits, while in the control group the average number amounted to 14 (i.e. there was an increase of 221.4% in the test group). An average of 78 tomato fruits were produced by the Titan breed plants, while in the control group this number was only 20 (increase by 290%). Mean weight of the Typhoon tomato fruit increased by 59.5 g from the control values, i.e. by 180.8%. Mean weight of the Titan tomato fruit increased by 128.5 i.e. by 208.9%. A notable difference was found by all observers in the taste of experimental and control vegetables. The experimental plants had significantly better taste characteristics and they were also more resistant to buck eye rot. Conclusion: In such a way, the studies performed confirm the existence of homeopathic phenomenon in live organisms in the absence of the placebo effect. It has been demonstrated that the use of homeopathic remedies is effective in improvement of agricultural productivity. Plants are unique model for research of ultrahigh dilutions of substances.

New stage of scientific understanding of homeopathic phenomenon

Statements that homeopathy failed scientific testing and that it is a mock-science based on placebo effect are frequent in modern mass media. Their authors disregard not only results of many studies but also the effect of homeopathy in coma patients, infants, animals, germs and plants. Homeopathy is criticised due to lack of statistically acceptable studies and an accepted effect mechanism laid out in principles of modern science. However, homeopathy not only stood the time test but also showed potential for further implementation. Scientific studies, active use of homeopathy in medical practice help to resolve crisis in modern therapy by of treatment and prevention cost efficiency

REVIEW STUDY ON THE EFFICIENCY OF THE USE OF KINESIOLOGICTAPE IN PERFORMANCE ATHLETES

Introduction. In Asia, in the early 1970s, a new concept was developed -kinesiological tape.Physiotherapists use the kinesiological band in both performance or amateur athletes and patients who are in a kinetic recovery program. The exact mechanisms by which the kinesiological band acts on the body have not yet been fully elucidated .Aim. The aim of the study was to identify in the literature the information about the potential positive or negative effects offered by the use of kinesiological tape inperformance athletes that had suffered injuries and also to identify potential prophylactic effects inhealthy athletes.Material and method. The selection of articles was made using the Google Scholar search engine, where 98 studies were found in the databasesof ResearchGate, PubMed, MinervaMedica, Journal of Athletic Training, Journal of Orthopedic & Sports Physical Therapy. Only studies on groups of performance athletes were included.Results. Of the 28 selected articles, 12 studies showed results in which there were increases in performance and improvements in some parameters, in 12 studies it was concluded that there were no beneficial or significant effects, and in 4 articles the results of applying the bands kinesiological and placebo effect had relatively similar positive effects.Conclusions.Kinesiology tapes do not seem to bringmajor benefits in terms of the performance inhealthy athletes. Regarding the potential prophylactic effect of kinesiological bands, several complex and longer studies need tobe performed. But the kinesiological bands could be considered as an adjuvant method in rehabilitation.