Health Aff (Millwood). 2013 Jun;32(6):1116-25. doi: 10.1377/hlthaff.2012.1353.
Decline in placebo-controlled trial results suggests new directions for comparative effectiveness research.
SourceColumbia University, New York, NY, USA. firstname.lastname@example.org
The Affordable Care Act offers strong support for comparative effectiveness research, which entails comparisons among active treatments, to provide the foundation for evidence-based practice. Traditionally, a key form of research into the effectiveness of therapeutic treatments has been placebo-controlled trials, in which a specified treatment is compared to placebo. These trials feature high-contrast comparisons between treatments. Historical trends in placebo-controlled trials have been evaluated to help guide the comparative effectiveness research agenda. We investigated placebo-controlled trials reported in four leading medical journals between 1966 and 2010. We found that there was a significant decline in average effect size or average difference in efficacy (the ability to produce a desired effect) between the active treatment and placebo. On average, recently studied treatments offered only small benefits in efficacy over placebo. A decline in effect sizes in conventional placebo-controlled trials supports an increased emphasis on other avenues of research, including comparative studies on the safety, tolerability, and cost of treatments with established efficacy.
KEYWORDS:Evidence-Based Medicine, Health Reform, Research And Technology
- Placebo-controlled trials. [Health Aff (Millwood). 2013]
- [PubMed - in process]