Editorials

Confusion over use of placebos in clinical trials

"Medicine the science" is gradually replacing "medicine the art," and demands for treatments to be evidence based have given the process a recent fillip.¹ The key to this transition has been the controlled clinical trial, which, for drugs at least, is now an essential component for assessing interventions. But the clinical trial is more than a scientific instrument, for in addition to meeting the needs of the scientist it must also satisfy licensing authorities, marketing departments, prescribers, consumers, ethicists, lawyers, and often all of these in many countries. With such diverse interests, disagreements over the design of trials are inevitable, and one area in which conflict arises is in the use of the placebo.

On page 844 of this week's journal Aspinall and Goodman, who have analysed trials of ondansetron for postoperative nausea and vomiting, argue that placebos have been used so excessively that patients have been . . . [Full text of this article]

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