--- title: "Reconsider placebo controls in clinical research? | Sutter Health" description: "Choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of common non-specific therapeutic benefits." url: "https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Reconsider placebo controls in clinical research? # Should we reconsider the routine use of placebo controls in clinical research? Avins AL, Cherkin DC, Sherman KJ, Goldberg H, & Pressman A. _Trials. 13:44. doi: 10.1186/1745-6215-13-44._ 2012-04-27 ## Abstract BACKGROUND: Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. METHODS: We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. RESULTS: We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. CONCLUSIONS: Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/?term=22540350) ## Research topics - [Comparative Effectiveness](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Comparative+Effectiveness%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Effectiveness of a group-based lifestyle change program versus usual care: an electronic health record, propensity score-matched cohort study](https://www.sutterhealth.org/research/publications/effectiveness-of-a-group-based-lifestyle-change-program-1055312802) Robert J. Romanelli, Hsiao-Ching Huang, Sylvia Sudat, Alice R. Pressman, Kristen M. J. Azar Am J Prev Med. 2020 Dec;59(6):850-859. doi: 10.1016/j.amepre.2020.07.002. Epub 2020 Nov 18 - Publication ### [Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive compulsive disorder: a systematic review and meta-analysis of head-to-head randomized controlled trials.](https://www.sutterhealth.org/research/publications/behavior-tx-and-sris-in-tx-of-ocd-review-of-trials-1055312711) Romanelli RJ, Wu FM, Gamba R, Mojtabai R, Segal JB. Depress Anxiety. 31(8):641-52. doi: 10.1002/da.22232. Epub 2014 Jan 3. 2014 Aug 01 - Publication ### [Minimran: a robust online system to implement minimization in randomized clinical trials.](https://www.sutterhealth.org/research/publications/minimran-online-do-minimization-rct-1055312971) Xiao L, Ma J. JSM Proc Biopharm Section. Alexandria VA: American Statistical Association 2014; 1094-1100. 2014 Aug 06 - Publication ### [Selection bias modeling using observed data augmented with imputed record-level probabilities.](https://www.sutterhealth.org/research/publications/selection-bias-modeling-using-observed-data-1055312921) Thompson CA, Arah OA. Ann Epidemiol. pii: S1047-2797(14)00364-0. doi: 10.1016/j.annepidem.2014.07.014. \[Epub ahead of print\] 2014 Aug 12 - Publication ### [Meta-analysis 101: what you want to know in the era of comparative effectiveness.](https://www.sutterhealth.org/research/publications/understand-meta-analyses-in-comparative-effectiveness-1055312642) Jones JB, Blecker S, Shah NR. Am Health Drug Benefits. 1(3):38-43. 2008 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Reconsider placebo controls in clinical research?"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728#medicalscholarlyarticle","name":"Should we reconsider the routine use of placebo controls in clinical research?","headline":"Reconsider placebo controls in clinical research?","abstract":"BACKGROUND: Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. METHODS: We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. RESULTS: We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. CONCLUSIONS: Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.","description":"Choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of common non-specific therapeutic benefits.","keywords":["Comparative Effectiveness"],"datePublished":"2012-04-27","url":"https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1186/1745-6215-13-44"}],"sameAs":["https://doi.org/10.1186/1745-6215-13-44"],"isPartOf":{"@type":"Periodical","name":"Trials"},"author":[{"@type":"Person","name":"Avins AL"},{"@type":"Person","name":"Cherkin DC"},{"@type":"Person","name":"Sherman KJ"},{"@type":"Person","name":"Goldberg H"},{"@type":"Person","name":"Pressman A"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Comparative Effectiveness","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Comparative+Effectiveness%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728#breadcrumblist"}}} ```