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Clinicians have long understood that many of the therapeutic benefits of our treatments have nothing to do with our therapies themselves, ie, a placebo or expectancy effect. Such effects are sometimes very powerful and may affect clinical outcome. In clinical trial design, extensive consideration, including scripted statements for oral instructions, validated questionnaires, and placebo-controlled arms in randomized trials are used to control for these extraneous effects. In clinical practice, these effects, both negative and positive, are ubiquitous and some authors have maintained could result in outcomes as drastic as patients dying “on cue.”¹

Recent studies by the Rochester group have provided new insights into the fascinating and novel field of patient expectancies. Data have been generated from clinical trials investigating how patients’ symptom relief may not simply vary with the intervention, but also with the way data are presented to them about the intervention. In this age of molecularly targeted therapies, it is at once instructive and sobering to be reminded in this way that the patient remains the final arbiter of their own symptom relief.

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Reference 

1. Meador CK . Hex death (voodoo magic or persuasion?) . South Med J . 1992;85:244–247
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