文章基本信息

标题：Should we reconsider the routine use of placebo controls in clinical research?
本地全文：下载
作者：Andrew L Avins ; Daniel C Cherkin ; Karen J Sherman 等
期刊名称：Trials
印刷版ISSN：1745-6215
电子版ISSN：1745-6215
出版年度：2012
卷号：13
期号：1
页码：44
DOI：10.1186/1745-6215-13-44
语种：English
出版社：BioMed Central
摘要：Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.
关键词：Clinical trials ; Blinding ; Masking ; Placebos ; Placebo effect ; Placebo controls