[Why control conditions are rarely without effect in clinical intervention research].
PubMed, vol. 170
Abstract
Randomized controlled trials (RCTs) often assume an unchanging control condition. When blinding is not feasible, waitlist or standard-care conditions can evoke negative expectations and nocebo effects. Differences between the intervention and control conditions are therefore determined not only therapeutically, but also contextually. Psychopathology and various somatic conditions are increasingly understood as disturbances of a complex dynamic system, in which small changes can trigger large shifts. Effects that may appear to be of little significance, such as the impact that assignment to a control condition has on people's expectations, may have major effects on the outcome.
Authors 2
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Erik J. Giltay Aachen
Leiden University Medical Center
Affiliation as printed
LUMC, Leiden. Afd. Psychiatrie
Contact: e.j.giltay@lumc.nl
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Saskia le Cessie Aachen
Leiden University Medical Center
Affiliation as printed
LUMC, Leiden. Afd. Klinische Epidemiologie