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• W2049778838 abstract "Avec l’utilisation du placebo au sein des essais cliniques contrôlés depuis 50 ans, il semble qu’on puisse objectiver et mesurer les effets psychophysiologiques liés à la thérapeutique regroupés sous le terme « effet placebo ». Depuis l’article de référence de Beecher en 1955, il est admis et mentionné dans de nombreux articles médicaux que son efficacité est de 35 % en moyenne dans la plupart des symptômes. Or, il apparaît que la signification de cette mesure est erronée. Elle ne prend pas en compte par exemple l’évolution spontanée des symptômes et des maladies. En fait, l’effet placebo n’est pas l’effet mesuré dans le groupe traité par le placebo. L’essai clinique contrôlé médicament contre placebo ne permet pas de mesurer ce qu’on appelle donc à tort « l’effet placebo ». Peut-on alors mesurer et objectiver ce qu’on appelle « l’effet placebo » ? Si cela est possible, de quelle manière ? Cet article remet en question l’ampleur de l’effet placebo évaluée au moyen des essais cliniques contrôlés sans pour autant nier son importance en pratique soignante. Il soulève d’une part, le problème épistémologique de la possibilité réelle d’objectiver les effets psychologiques de la thérapeutique, via l’expérimentation et d’autre part, il pose la question de l’intérêt pour la pratique soignante, à l’heure de la médecine fondée sur les preuves et de les objectiver. The use of placebos within controlled clinical trials for the last 50 years suggests that psycho-physiological effects can be objectified and measured. These are related to the therapeutic results covered by the term “placebo effect”. Since Beecher’s pioneer article in 1955, this effect is recognised and cited in medical articles as being on average 35% effective on the majority of symptoms. However, the meaning of these measurement is questionable. For example, it does not take into account the spontaneous evolution of symptoms and diseases. In fact, the placebo effect is not the effect measured in the group treated by the placebo. The clinical trial drug controlled against placebo does not make it possible to measure what is thus wrongly called “the placebo effect”. Is it possible then to measure and to objectify what is called the placebo effect? And if that is possible, how? This article calls into question the extent of the placebo effect evaluated by means of controlled clinical trials, without denying its importance in medical practice. Firstly it raises the epistemological problem of the real possibility, via experimentation, of objectifying psychological therapeutic effects. And secondly, the question is also raised of the interest for medical care of objectifying those effects." @default.
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• W2049778838 date "2006-05-01" @default.
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• W2049778838 title "La difficile mesure de l’effet placebo" @default.
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• W2049778838 doi "https://doi.org/10.2515/therapie:2006049" @default.
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