Placebo Effects and the Common Cold: A Randomized Controlled Trial

Bruce Barrett; Roger Brown; Dave Rakel; David Rabago; Lucille Marchand; Jo Scheder; Marlon Mundt; Gay Thomas; Shari Barlow

doi:10.1370/afm.1250

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Experiment Design
Weimin Guo

Published on: 02 November 2015
A Negative Study Can Provide Useful Information
Walter A Brown

Published on: 14 July 2011
Author's reply
Bruce P Barrett

Published on: 14 July 2011
Open label placebo may further elucidate placebo effects
Oliver R Frank

Published on: 12 July 2011

Published on: (2 November 2015)
Page navigation anchor for Experiment Design
Experiment Design
Weimin Guo, Researcher
One group of "placebo-labeled-as-echinacea" might be considered to be included in this study. Therefore, there will be total five groups in this study:
1. No pill; 2. Placebo - blind to the subjects; 3. Placebo - labeled as echinacea; 4. Echinacea - blind to the subjects; 5. Echinacea - labeled as echinacea.
Then, multiple comparison would be made to fully distinguish the placebo effects and echinacea eff...
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One group of "placebo-labeled-as-echinacea" might be considered to be included in this study. Therefore, there will be total five groups in this study:
1. No pill; 2. Placebo - blind to the subjects; 3. Placebo - labeled as echinacea; 4. Echinacea - blind to the subjects; 5. Echinacea - labeled as echinacea.
Then, multiple comparison would be made to fully distinguish the placebo effects and echinacea effects.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (14 July 2011)
Page navigation anchor for A Negative Study Can Provide Useful Information
A Negative Study Can Provide Useful Information
Walter A Brown, Tiverton, RI USA
This paper calls to mind a statement attributed to Senator Pete Domenici: "If you torture the numbers long enough they will confess to anything."
Despite the authors' strenuous effort to wrest something significant from the results this is essentially a negative study; none of the interventions, placebo or otherwise, had any appreciable impact on the cold. This is worth knowing. The cold may be among those con...
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This paper calls to mind a statement attributed to Senator Pete Domenici: "If you torture the numbers long enough they will confess to anything."
Despite the authors' strenuous effort to wrest something significant from the results this is essentially a negative study; none of the interventions, placebo or otherwise, had any appreciable impact on the cold. This is worth knowing. The cold may be among those conditions that show little improvement with placebo. If this finding is replicated it can guide clinical care. In particular, deliberate attempts to enhance the placebo response, worthwhile in many conditions, may not be warranted in the management of colds.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (14 July 2011)
Page navigation anchor for Author's reply
Author's reply
Bruce P Barrett, Madison WI
Responding to Dr Oliver Frank, Adelaide, Australia
Yes, I agree with these comments. The inclusion of no pill and open label arms in randomized trials could add substantively to the knowledge base, possibly in quite useful ways, and should be considered during the development and testing phases of new medications. The downside is of course the larger sample sizes that would be needed to achieve adequate statis...
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Responding to Dr Oliver Frank, Adelaide, Australia
Yes, I agree with these comments. The inclusion of no pill and open label arms in randomized trials could add substantively to the knowledge base, possibly in quite useful ways, and should be considered during the development and testing phases of new medications. The downside is of course the larger sample sizes that would be needed to achieve adequate statistical power. Whether or not doctors should prescribe placebo pills is controversial, but if so, full disclosure is recommended. Honesty is key to the doctor patient relationship and to effective shared decision- making.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (12 July 2011)
Page navigation anchor for Open label placebo may further elucidate placebo effects
Open label placebo may further elucidate placebo effects
Oliver R Frank, Adelaide, Australia
The inclusion of a 'no pill' group and of both blinded and open label echinacea groups in this study was valuable in increasing our understanding of the beneficial and adverse effects of taking medicines with or without ingredients that are or may be pharmacologically active.
To further increase our understanding, I would like to suggest that future trials of medicines could include not only blinded placebo group...
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The inclusion of a 'no pill' group and of both blinded and open label echinacea groups in this study was valuable in increasing our understanding of the beneficial and adverse effects of taking medicines with or without ingredients that are or may be pharmacologically active.
To further increase our understanding, I would like to suggest that future trials of medicines could include not only blinded placebo groups but also open label placebo groups. Patients assigned to the open label placebo group could be told: "This medicine contains no pharmacologically active ingredients. However, taking it can help you to feel better."
The beneficial and adverse effects of open label placebos may differ from those of blinded placebos. It would also be interesting to compare adherence to open label placebos with adherence to all other trial medicines or treatments including blinded placebos.
Open label placebos may be the nearest thing to putting the power of medical hypnosis into a pill.
Competing interests: None declared
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Competing Interests: None declared.