Simon Katherine E, Russell Katharine, Mondino Alejandra, Yang Chin-Chieh, Case Beth C, Anderson Zachary, Whitley Christine, Griffith Emily, Gruen Margaret E, Olby Natasha J
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
Department of Statistics, North Carolina State University, Raleigh, NC, USA.
Geroscience. 2025 Aug 11. doi: 10.1007/s11357-025-01822-3.
The placebo effect, or the positive effects observed after an inert treatment which result from patients' expectations for the therapy, is well documented in human medicine. However, in veterinary medicine, where owner's expectations serve as a proxy for their pets, it remains underexplored, particularly for elderly dogs with cognitive decline. To address this gap, we examined 21 dogs (mean age: 12.85 years, SD: 1.46) from a placebo group in a randomized controlled trial (RCT) and compared their results to 17 dogs (mean age: 13.24 years, SD:1.56) from an observational, longitudinal study to distinguish placebo effect from trial participation effect. Both populations had statistically comparable baseline data. Cognitive changes were evaluated with two remotely administered owner questionnaires (Canine Cognitive Dysfunction Scale (CCDR) and Canine Dementia Scale (CADES)) and three in-house cognitive assessments (Cylinder Task, Detour and Sustained Gaze). We hypothesized that placebo effect would be greater than trial participation effect, particularly in owner-reported measures. Matched pairs T-tests and effect size calculations (Hedge's g) were used to calculate changes across 6 months. A strong (g = 0.76), significant (p = 0.021) improvement in CADES was observed in the placebo cohort after 6 months, while no changes were detected with CCDR. Conversely, the observational cohort showed a small (g = 0.35) and significant (p = 0.03) deterioration on CCDR, and no change in CADES. No significant changes were noted on the in-house cognitive assessments in either cohort. We conclude that study context influences remotely delivered owner assessments and CCDR is more robust against caregiver placebo effect in RCTs than CADES.
安慰剂效应,即患者对治疗的期望导致在接受无效治疗后观察到的积极效果,在人类医学中有充分的文献记载。然而,在兽医学中,由于宠物主人的期望可作为其宠物的替代指标,这一效应仍未得到充分研究,尤其是对于认知能力下降的老年犬。为了填补这一空白,我们在一项随机对照试验(RCT)中检查了安慰剂组的21只狗(平均年龄:12.85岁,标准差:1.46),并将它们的结果与一项观察性纵向研究中的17只狗(平均年龄:13.24岁,标准差:1.56)进行比较,以区分安慰剂效应和试验参与效应。两组的基线数据在统计学上具有可比性。通过两份由主人远程填写的问卷(犬认知功能障碍量表(CCDR)和犬痴呆量表(CADES))以及三项内部认知评估(圆柱体任务、迂回任务和持续注视)来评估认知变化。我们假设安慰剂效应将大于试验参与效应,尤其是在主人报告的测量中。配对样本T检验和效应量计算(Hedge's g)用于计算6个月内的变化。6个月后,安慰剂组的CADES有显著(g = 0.76,p = 0.021)的改善,而CCDR未发现变化。相反,观察队列在CCDR上有轻微(g = 0.35)且显著(p = 0.03)的恶化,CADES没有变化。两个队列的内部认知评估均未发现显著变化。我们得出结论,研究背景会影响主人远程进行的评估,并且在随机对照试验中,CCDR比CADES更能抵抗照顾者的安慰剂效应。