Current Pain and Headache Reports

, Volume 15, Issue 1, pp 35–38

Managing the Placebo Effect: Enhancing the Signal-to-Noise Ratio



Confirming the absence of the placebo response has been the bane of researchers throughout the ages. Thus, the gold standard of research methodology is the evidence for a treatment modality provided by a prospective randomized controlled trial. The “control” arm of a trial is the arm in which the placebo has been administered. Increasing evidence from basic science and clinical research is pointing to the fact that the placebo response may have some biological basis that can translate into enduring therapeutic benefit. Have our placebo-controlled trials simply compared one treatment effect to the treatment effect of the “placebo”? Thus, the “δ” is relative treatment effect; perhaps this may provide some insight as to why some treatment response is low compared to a relatively strong placebo response. How can we use this knowledge to create more robust clinical designs that help establish true treatment effect? This article aims to provide an overview of the contemporary insight into the placebo response.


Placebo effect Treatment signal Treatment noise 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical Care Medicine, Division of Pain MedicineJohns Hopkins School of MedicineBaltimoreUSA
  2. 2.Center for Pain StudiesRehabilitation Institute of ChicagoChicagoUSA
  3. 3.Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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