Reframing placebo in research and practice.
The terms 'placebo' and 'placebo effects' cause confusion among patients, practitioners and scientists. This confusion results in both the adoption of practices that have no evidence of specificity yet considerable risk (such as surgery for low back pain) or the elimination of clinical practices proven to facilitate healing because they are not 'better than placebo' (such as acupuncture for low back pain). In this article, I discuss these issues and introduce the concept of optimal healing environment as a framework for disentangling what is useful from placebo research for adopting into clinical practice in a manner that is ethical and evidence-based.
Philos Trans R Soc Lond B Biol Sci. 2011 Jun 27;366(1572):1896-904. Jonas WB. Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314, USA.
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