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Placebo-adjusted effect: difference between revisions

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Revision 1 — 09:00, 7 Oct 2024
DiagramDelphine (talk)
create article — trial programme stub
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Revision 2 — 05:45, 15 Oct 2024
DrTitration (talk)
add the PMID
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10The active-arm change alone conflates the treatment effect with everything else operating during the trial: regression to the mean, the natural course of the condition, the lifestyle intervention both arms received, and the effects of being observed.{{r|hrobjartsson2010}}10The active-arm change alone conflates the treatment effect with everything else operating during the trial: regression to the mean, the natural course of the condition, the lifestyle intervention both arms received, and the effects of being observed.{{r|hrobjartsson2010}}
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+12== What the comparator arm captures ==
+13A placebo arm in a modern obesity trial is not a no-treatment arm. Participants receive the same lifestyle counselling, the same visit schedule and the same measurement, and the difference between the arms is the treatment alone.{{r|hrobjartsson2010,ich_e10}}
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+15Several distinct phenomena contribute to the change in a placebo arm. Regression to the mean operates because participants are enrolled at a moment when their measurement was high enough to qualify. The trial's own intervention — diet advice, activity advice, regular weighing — has an effect. Observation changes behaviour. And the natural course of a condition may be towards improvement or deterioration.{{r|hrobjartsson2010}}
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12== References ==17== References ==
13{{reflist}}18{{reflist}}
14<ref name="ich_e9">International Council for Harmonisation, ''E9(R1): Estimands and Sensitivity Analysis in Clinical Trials'' (2019).</ref>19<ref name="ich_e9">International Council for Harmonisation, ''E9(R1): Estimands and Sensitivity Analysis in Clinical Trials'' (2019).</ref>
15<ref name="hrobjartsson2010">Hróbjartsson A, Gøtzsche PC. "Placebo interventions for all clinical conditions." ''Cochrane Database of Systematic Reviews'' (1):CD003974 (2010). PMID 20091554.</ref>20<ref name="hrobjartsson2010">Hróbjartsson A, Gøtzsche PC. "Placebo interventions for all clinical conditions." ''Cochrane Database of Systematic Reviews'' (1):CD003974 (2010). PMID 20091554.</ref>
+21<ref name="ich_e10">International Council for Harmonisation, ''E10: Choice of Control Group and Related Issues in Clinical Trials'' (2000).</ref>
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17{{DEFAULTSORT:Placebo-adjusted effect}}23{{DEFAULTSORT:Placebo-adjusted effect}}