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Comment & Response |

Placebo Effects in Infants, Toddlers, and Parents

Joe Kossowsky, PhD1; Ted J. Kaptchuk, OMD2
[+] Author Affiliations
1Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA Pediatr. 2015;169(5):505. doi:10.1001/jamapediatrics.2014.3798.
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To the Editor The phenomenon that Paul et al1 describe in their study of acute cough, where active interventions and placebo showed no difference yet were both superior to the no treatment group,1 may be an example of what has been described previously as placebo by proxy.2 The idea that family members and physicians may have an emotional response to a patient’s treatment and perceived improvement on subjective complaints2 and that a patient’s response to therapy may be affected by the behavior of other people who know the patient is undergoing therapy3 seem to be especially prominent in pediatric conditions.2 This phenomenon is similar to the common occurrence in placebo-controlled randomized trials of animals (eg, lameness from osteoarthritis in dogs4 and headshaking in horses5), where owners and physicians detect significant improvements in both active and placebo interventions but objective measures show no change.

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May 1, 2015
Luana Colloca, MD, PhD
1Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore2Department of Anesthesiology, School of Medicine, University of Maryland, Baltimore
JAMA Pediatr. 2015;169(5):504-505. doi:10.1001/jamapediatrics.2014.3795.
May 1, 2015
Ian M. Paul, MD, MSc
1Division of Academic General Pediatrics, Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
JAMA Pediatr. 2015;169(5):505-506. doi:10.1001/jamapediatrics.2014.3801.
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