geoffrey modest medical blogs

  A recent systematic review and meta-analysis evaluated the placebo  response and adverse event rates in treatments for gastroparesis (see placebo response rate in gastroparesis ClinGastroHep2023 in dropbox, or  doi.org/10.1016/j.cgh.2022.09.033 )     Details : -- the medical literature was reviewed through August 2022 to identify RCTs comparing active drug with placebo in patients with gastroparesis -- placebo response rates were assessed for at least one of nausea, vomiting, abdominal pain, bloating, or fullness (typical gastroparesis symptoms), as well as for adverse events. -- 22 articles reported on the placebo response rates, with a total of 1011 patients -- Primary outcome: magnitude of the placebo response as well as adverse events associated with placebo (i.e. the nocebo effect: adverse events associated with the belief that the placebo will cause harm)   Results : -- overall pooled placebo response rate: 29.3% (23.7%-35.2%) ...

  A recent interesting article suggested that physical therapy for knee osteoarthritis (OA) was no better than placebo (see   knee arthritis PT not better than placebo AnnRheumDis2022  in dropbox, or 10.1136/annrheumdis2021-221129)   Details: -- 206 Danish adults at least 50 years old in an open label, RCT who had symptomatic and radiologically-confirmed knee osteoarthritis in Denmark were randomized to an eight week exercise and education program versus four intra-articular saline injections, from July 2019 to September 2020 -- average knee pain was at least 4 on a 10-point scale, radiologically verified to be tibiofemoral OA (Kellgren-Lawrence  grade   at least 2) -- those with prior intra-articular treatments within three months were excluded -- participants receiving saline injections were so informed, and all patients were told that the “active ingredients” of both interventions were unverified -- those in the education/exercise program had two 1.5-hou...