Placebo effect in research related to surgery and technical procedures

Development of new technology has led to the introduction of many new high-tech surgical treatment modalities. It has been claimed that the use of high-tech medicine is a potent inductor of placebo effect; in fact, many new treatment modalities have been established before they have been evaluated in placebo-controlled trials. However, there are several ways to minimize the confounding effects of placebo in surgical trials. This is a review based on a thoroughly performed search on Medline of Norwegian and English language publications published up until August 2000. Several studies have demonstrated that surgical treatment induces significant placebo effect. To minimize the confounding effects of placebo in trials evaluating new surgical modalities, it is important to use adequate blinding, neutral patient information, objective end-points, and correction for estimated placebo effects. The use of placebo surgery has been a source of lively controversy; many consider it ethically unacceptable.