The quality of manual therapy placebo techniques in randomised controlled trials: a systematic review
Item
- Title
- The quality of manual therapy placebo techniques in randomised controlled trials: a systematic review
- Title
- The quality of manual therapy placebo techniques in randomised controlled trials: a systematic review
- Author(s)
- Carne Roger
- Abstract
- Background: There are inherent problems using placebo techniques in trials evaluating the efficacy of manual therapy. These involve measuring the inertness of, and anticipating the expectancy from, placebo techniques. There is an absence of standard, verified placebo techniques used in randomised controlled trials (RCT). Objective: To assess the quality of placebo techniques used in RCTs of manual therapy. Method: Systematic computerised and hand literature searches of RCTs were evaluated using methodological quality criteria. RCTs were rated for risk of bias, and for the quality of placebo technique or placebo intervention used. These evaluations were cross-tabulated to show: risk of bias; and quality of placebo technique. Results: Of the ten papers reviewed: only two papers ranked “low” for risk of bias, and “good” for quality of placebo; four papers ranked “low “ for risk of bias, but “medium” for quality of placebo; two papers ranked “medium” for risk of bias and “moderate” for quality of placebo; one paper ranked “medium” for risk of bias but “poor” for quality of placebo; and one paper ranked “high” for risk of bias and “poor” for quality of placebo. Conclusion: The review finds that RCTs which rank as “low” risk of bias do not necessarily rank as “good” quality of manual therapy placebo technique. This may be, in part, due to the inherent problems of using placebos in manual therapy research. Overall, the complex interactions between subject expectation, inertness of placebo, and risk of unblinding, obfuscate a conclusive result.
- Abstract
- Background: There are inherent problems using placebo techniques in trials evaluating the efficacy of manual therapy. These involve measuring the inertness of, and anticipating the expectancy from, placebo techniques. There is an absence of standard, verified placebo techniques used in randomised controlled trials (RCT). Objective: To assess the quality of placebo techniques used in RCTs of manual therapy. Method: Systematic computerised and hand literature searches of RCTs were evaluated using methodological quality criteria. RCTs were rated for risk of bias, and for the quality of placebo technique or placebo intervention used. These evaluations were cross-tabulated to show: risk of bias; and quality of placebo technique. Results: Of the ten papers reviewed: only two papers ranked “low” for risk of bias, and “good” for quality of placebo; four papers ranked “low “ for risk of bias, but “medium” for quality of placebo; two papers ranked “medium” for risk of bias and “moderate” for quality of placebo; one paper ranked “medium” for risk of bias but “poor” for quality of placebo; and one paper ranked “high” for risk of bias and “poor” for quality of placebo. Conclusion: The review finds that RCTs which rank as “low” risk of bias do not necessarily rank as “good” quality of manual therapy placebo technique. This may be, in part, due to the inherent problems of using placebos in manual therapy research. Overall, the complex interactions between subject expectation, inertness of placebo, and risk of unblinding, obfuscate a conclusive result.
- presented at
- British School of Osteopathy
- Date Accepted
- 2011
- Date Submitted
- 3.2.2012 00:00:00
- Type
- osteo_thesis
- Language
- English
- Pub-Identifier
- 15043
- Inst-Identifier
- 780
- Keywords
- Manual therapy, osteopathy, physiotherapy, chiropractic, placebo, randomised controlled trial, clinical trial
- Recommended
- 0
- Item sets
- Thesis
Carne Roger, “The quality of manual therapy placebo techniques in randomised controlled trials: a systematic review”, Osteopathic Research Web, accessed May 13, 2024, https://www.osteopathicresearch.com/s/orw/item/1793