'Much of medicine is based on what is considered the strongest possible evidence: The placebo-controlled trial. A paper published in the October 19 issue of Annals of Internal Medicine -- entitled "What's In Placebos: Who Knows?" calls into question this foundation upon which much of medicine rests, by showing that there is no standard behind the standard -- no standard for the placebo.
The thinking behind relying on placebo-controlled trials is this: to be sure a treatment itself is effective, one needs to compare people whose only difference is whether or not they are taking the drug. Both groups should equally think they are on the drug -- to protect against effects of factors like expectation. So study participants are allocated "randomly" to the drug or a "placebo" -- a pill that might be mistaken for the active drug but is inert.'
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