当代医学中安慰剂效应差异的挑战：以脑刺激为例。
Challenges of differential placebo effects in contemporary medicine: The example of brain stimulation.
机构信息
Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
出版信息
Ann Neurol. 2019 Jan;85(1):12-20. doi: 10.1002/ana.25387. Epub 2019 Jan 8.
Abstract
‘Differential placebo effects’ is the concept that different types of placebos (e.g. inert pill versus sham device) may yield different magnitudes of placebo effects. This issue has been pushed into the spotlight by recent clinical trials of new technologies reporting unexpectedly large placebo effects from sham devices/procedures needed to maintain blinding integrity. In this Neurology Grand Rounds, we use transcranial magnetic stimulation as a model to explore the principles and implications of differential placebo effects. We highlight emerging research on the neurobiology of placebo effects and analyze fundamental questions of measuring efficacy in contemporary medicine.
摘要
“差异安慰剂效应”是指不同类型的安慰剂（例如惰性药丸与假设备）可能产生不同程度的安慰剂效应。最近一些新技术的临床试验报告称，为了保持盲法完整性而使用的假设备/程序产生了出乎意料的大的安慰剂效应，这一问题引起了人们的关注。在本次神经学大查房中，我们使用经颅磁刺激作为模型来探讨差异安慰剂效应的原理和意义。我们强调了安慰剂效应的神经生物学方面的新兴研究，并分析了当代医学中衡量疗效的基本问题。
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