This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The placebo response is a vexing problem for clinical trial design and drug development. Defined as a clinical improvement that occurs in participants treated with a physiologically inert substance, the placebo response has been largely ascribed to “expectation of clinical improvement and Pavlovian conditioning.”1 Other factors certainly play a role, however, including strict application of inclusion and exclusion criteria at study entry with subsequent reversion to the mean; that is, participants and investigators, knowing entry criteria for a trial, may subconsciously (or intentionally) overrate signs and symptoms to get into a trial, and then present at subsequent visits in their more typical state. Though this is not traditionally considered part of the true placebo response, it is likely that this phenomenon contributes to what is measured as the magnitude of the placebo response. Clinical trial design strategies such as central blinded ratings and avoiding the use of primary outcome measure criteria for screening can mitigate this phenomenon, but these are not routinely utilized.
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.
See page 2216
- © 2017 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
