Novel study designs to investigate the placebo response

<p>Abstract</p> <p>Background</p> <p>Investigating the size and mechanisms of the placebo response in clinical trials have relied on experimental procedures that simulate the double-blind randomized placebo-controlled design. However, as the conventional design is thoug...

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Main Authors: Klosterhalfen Sibylle, Enck Paul, Zipfel Stephan
Format: Article
Language:English
Published: BMC 2011-06-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:http://www.biomedcentral.com/1471-2288/11/90
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author Klosterhalfen Sibylle
Enck Paul
Zipfel Stephan
author_facet Klosterhalfen Sibylle
Enck Paul
Zipfel Stephan
author_sort Klosterhalfen Sibylle
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Investigating the size and mechanisms of the placebo response in clinical trials have relied on experimental procedures that simulate the double-blind randomized placebo-controlled design. However, as the conventional design is thought to elucidate drug rather than placebo actions, different methodological procedures are needed for the placebo response.</p> <p>Methods</p> <p>We reviewed the respective literature for trials designs that may be used to elucidate the size of the placebo response and the mechanisms associated with it.</p> <p>Results</p> <p>In general, this can be done by either manipulation the information provided to the subjects, or by manipulation the timing of the drug applied. Two examples of each strategy are discussed: the "balanced placebo design" (BDP) and the "balanced cross-over design" (BCD) and their variants are based on false information, while the "hidden treatment" (HT) and the ""delayed response test" (DRT) are based on manipulating the time of drug action. Since most such approaches include deception or incomplete information of the subjects they are suitable for patient only with authorized deception.</p> <p>Conclusion</p> <p>Both manipulating the information provided to subjects (BDP, DCD) or manipulating the timing of drug application (HT, DRT) allows overcoming some of the restrictions of conventional drug trials in the assessment of the placebo response, but they are feasible mostly in healthy subjects for ethical reasons.</p>
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spelling doaj.art-cf2d681f5d5a410f879644dd3b443b112022-12-22T02:47:17ZengBMCBMC Medical Research Methodology1471-22882011-06-011119010.1186/1471-2288-11-90Novel study designs to investigate the placebo responseKlosterhalfen SibylleEnck PaulZipfel Stephan<p>Abstract</p> <p>Background</p> <p>Investigating the size and mechanisms of the placebo response in clinical trials have relied on experimental procedures that simulate the double-blind randomized placebo-controlled design. However, as the conventional design is thought to elucidate drug rather than placebo actions, different methodological procedures are needed for the placebo response.</p> <p>Methods</p> <p>We reviewed the respective literature for trials designs that may be used to elucidate the size of the placebo response and the mechanisms associated with it.</p> <p>Results</p> <p>In general, this can be done by either manipulation the information provided to the subjects, or by manipulation the timing of the drug applied. Two examples of each strategy are discussed: the "balanced placebo design" (BDP) and the "balanced cross-over design" (BCD) and their variants are based on false information, while the "hidden treatment" (HT) and the ""delayed response test" (DRT) are based on manipulating the time of drug action. Since most such approaches include deception or incomplete information of the subjects they are suitable for patient only with authorized deception.</p> <p>Conclusion</p> <p>Both manipulating the information provided to subjects (BDP, DCD) or manipulating the timing of drug application (HT, DRT) allows overcoming some of the restrictions of conventional drug trials in the assessment of the placebo response, but they are feasible mostly in healthy subjects for ethical reasons.</p>http://www.biomedcentral.com/1471-2288/11/90study designexperimental researchplacebo
spellingShingle Klosterhalfen Sibylle
Enck Paul
Zipfel Stephan
Novel study designs to investigate the placebo response
BMC Medical Research Methodology
study design
experimental research
placebo
title Novel study designs to investigate the placebo response
title_full Novel study designs to investigate the placebo response
title_fullStr Novel study designs to investigate the placebo response
title_full_unstemmed Novel study designs to investigate the placebo response
title_short Novel study designs to investigate the placebo response
title_sort novel study designs to investigate the placebo response
topic study design
experimental research
placebo
url http://www.biomedcentral.com/1471-2288/11/90
work_keys_str_mv AT klosterhalfensibylle novelstudydesignstoinvestigatetheplaceboresponse
AT enckpaul novelstudydesignstoinvestigatetheplaceboresponse
AT zipfelstephan novelstudydesignstoinvestigatetheplaceboresponse