scholarly journals Paracetamol and the Placebo Effect in Osteoarthritis Trials: A Missing Link?

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Henning Zeidler
Keyword(s):  
Placebo Effect ◽  
Rescue Medication ◽  
Meta Analysis ◽  
Symptom Relief ◽  
Placebo Response ◽  
Potential Contribution ◽  
Missing Link ◽  
Starting Dose ◽  
Positive Effect

This paper addresses the role of paracetamol in placebo-controlled osteoarthritis (OA) trials and the potential contribution to the large placebo response in such trials. Paracetamol is used as rescue medication in nearly all OA placebo-controlled trials. Triggered by the discussion about the placebo effect in general and because of the lack of systematic reviews of placebo effect in OA trials, a recent meta-analysis examined the placebo effect and its potential determinants in the treatment of OA, as the main result came out that placebo is very effective in the treatment of OA, especially for pain, stiffness, and self-reported function. However, mostly limited data are available from published OA trials on the starting dose, final dose, dose over time of paracetamol use, and the percentage of patients who used rescue medication during the study. Paracetamol may be an important additional simulated effect of placebo administration mimicking the true placebo effect and thus a missing link contributing partially to the large placebo response in OA trials. Therefore, the positive effect of paracetamol on symptom relief as well as the need for standardized recording of rescue medication should be taken into account when designing, executing, and interpreting placebo-controlled OA studies.

scholarly journals IPR Law Protection and Enforcement and the Effect on Horizontal Productivity Spillovers from Inward FDI to Domestic Firms: A Meta-analysis

2021 ◽  
Author(s):  
Danai Christopoulou ◽  
Nikolaos Papageorgiadis ◽  
Chengang Wang ◽  
Georgios Magkonis
Keyword(s):  
Intellectual Property ◽  
Property Rights ◽  
Intellectual Property Rights ◽  
Meta Analysis ◽  
Host Countries ◽  
Productivity Spillovers ◽  
Domestic Firms ◽  
The Relationship ◽  
Positive Effect

AbstractWe study the role of the strength of Intellectual Property Rights (IPR) law protection and enforcement in influencing horizontal productivity spillovers from inward FDI to domestic firms in host countries. While most WTO countries adopted strong IPR legislation due to exogenous pressure resulting from the signing of the Trade-Related Aspects of IPR (TRIPS) agreement, public IPR enforcement strength continues to vary significantly between countries. We meta-analyse 49 studies and find that public IPR enforcement strength has a direct positive effect on horizontal productivity spillovers from inward FDI to domestic firms and a negative moderating effect on the relationship between IPR law protection strength and horizontal productivity spillovers from inward FDI to domestic firms.

scholarly journals Placebo response in treatment resistant depression: a systematic review and meta-analysis of multiple treatment modalities

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S261-S262
Author(s):  
Brett D M Jones ◽  
Cory R. Weissman ◽  
Jewel Karbi ◽  
Tya Vine ◽  
Louise S. Mulsant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Stimulation ◽  
Placebo Effect ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Placebo Response ◽  
Treatment Modalities ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

AimsThe placebo response in depression clinical trials is a major contributing factor for failure to establish the efficacy of novel and repurposed treatments. However, it is not clear as to what the placebo response in treatment-resistant depression (TRD) patients is or whether it differs across treatment modalities. Our objective was to conduct a systematic review and meta-analysis of the magnitude of the placebo response in TRD patients across different treatment modalities and its possible moderators.MethodSearches were conducted on MEDLINE and PsychInfo from inception to January 24, 2020. Only studies that recruited TRD patients and randomization to a placebo (or sham) arm in a pharmacotherapy, brain stimulation, or psychotherapy study were included (PROSPERO 2020 CRD42020190465). The primary outcome was the Hedges’ g for the reported depression scale using a random-effects model. Secondary outcomes included moderators assessed via meta-regression and response and remission rate. Heterogeneity was evaluated using the Egger's Test and a funnel plot. Cochrane Risk of Bias Tool was used to estimate risks.Result46 studies met our inclusion criteria involving a total of 3083 participants (mean (SD) age: 45.7 (6.2); female: 52.4%). The pooled placebo effect for all modalities was large (N = 3083, g = 1.08 ,95% CI [0.95-1.20)I 2 = 0.1). The placebo effect in studies of specific treatment modalities did not significantly differ: oral medications g = 1.14 (95%CI:0.99-1.29); parenteral medications g = 1.32 (95%CI:0.59-2.04); ayahuasca g = 0.47 (95%CI:-0.28-1.17); rTMS g = 0.93 (95%CI:0.63-1.23); tDCS g = 1.32 (95%CI:0.52-2.11); invasive brain stimulation g = 1.06 (95%CI:0.64-1.47). There were no psychotherapy trials that met our eligibility criteria. Similarly, response and remission rates were comparable across modalities. Heterogeneity was large. Two variables predicted a lager placebo effect: open-label prospective design (B:0.32, 95%CI: 0.05-0.58; p:0.02) and sponsoring by a pharmaceutical or medical device company (B:0.39, 95%CI:0.13-0.65, p:0.004)). No risk of publication bias was found.ConclusionThe overall placebo effect in TRD studies was large (g = 1.08) and did not differ among treatment modalities. A better understanding of the placebo response in TRD will require: standardizing the definition of TRD, head-to-head comparisons of treatment modalities, an assessment of patient expectations and experiences, and standardized reporting of outcomes.

Systematic review and meta-analysis of the placebo effect in panic disorder: Implications for research and clinical practice

2022 ◽  
pp. 000486742110687
Author(s):  
Masoud Ahmadzad-Asl ◽  
Farnoush Davoudi ◽  
Safoura Mohamadi ◽  
Fatemeh Hadi ◽  
Seyed Aria Nejadghaderi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Panic Disorder ◽  
Placebo Effect ◽  
Effect Size ◽  
Rating Scales ◽  
Data Extraction ◽  
Meta Analysis ◽  
Placebo Response ◽  
Patient Reports

Objective: This review aimed to measure the degree of placebo response in panic disorder. Data Sources: We searched major databases up to 31 January 2021, for randomized pharmacotherapy trials published in English. Study Selection: A total of 43 studies met inclusion criteria to be in the analysis (with 174 separate outcome measurements). Data Extraction: Changes in outcome measures from baseline in the placebo group were used to estimate modified Cohen’s d effect size. Results: A total of 43 trials (2392 subjects, 174 outcomes using 27 rating scales) were included in the meta-analysis. Overall placebo effect size was 0.57 (95% confidence interval = [0.50, 0.64]), heterogeneity ( I2: 96.3%). Higher placebo effect size was observed among clinician-rated scales compared to patient reports (0.75 vs 0.35) and among general symptom and anxiety scales compared to panic symptoms and depression scales (0.92 and 0.64 vs 0.56 and 0.54, respectively). There was an upward trend in effect size over the publication period ( r = 0.02, p = 0.002) that was only significant among clinician-rated scales ( r = 0.02, p = 0.011). There was no significant publication bias, Egger’s test ( p = 0.08). Conclusion: We observed a substantial placebo effect size in panic disorder. This effect was more prominent for some aspects of panic disorder psychopathology than for others and was correlated with the source of the assessment and publication year. This finding has implications both for research design, to address the heterogeneity and diversity in placebo responses, and for clinical practice to ensure optimal quality of care. Systematic review registration number: PROSPERO, CRD42019125979.

scholarly journals The Role of Public Defenders Within the American Justice System

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Brianna Fisher ◽  
Patti Thompson
Keyword(s):  
Work Ethic ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Weighted Mean ◽  
Public Defenders ◽  
Weighted Means ◽  
Negative Effect ◽  
American Cities ◽  
Positive Effect

This paper examines the inner workings of the legal system in connection with public defenders and their duties. The factors of total caseload, plea deals, waivers, and bench verdicts were implemented to create a comprehensive means of measuring work ethic, due to their significant presence in the everyday workings of public defenders. Through a meta-analysis of the five most densely populated African American cities within the state of Michigan, the combined and individual weighted mean effect sizes were calculated to determine if there was a strong positive or negative effect of the four factors mentioned above on work ethic. Additionally, both the upper and lower credibility levels were calculated to analyze their proximity to the weighted means. For all four factors tested, the weighted mean effect sizes relate a positive effect of the factors on work ethic, with all means falling closer to their upper credibility levels. These results confirm that the factors of total caseload, plea deals, waivers, and bench verdicts affect how cases are being handled and how clients are being treated.

The Role of Information Technology in Learning

2005 ◽  
pp. 14-36 ◽  
Author(s):  
Klarissa T.T. Chang ◽  
John Lim
Keyword(s):  
Information Technology ◽  
Task Performance ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Knowledge Retention ◽  
Research And Practice ◽  
Course Characteristics ◽  
Positive Effect ◽  
Role Of Information

This study provides an updated meta-analysis on the effects of information technology (IT) in education. Sixty-eight experimental studies conducted on the application of IT in the classrooms were integrated and analyzed. Positive effect sizes were found for learning outcomes, including academic achievement, knowledge retention, task performance, self-reported learning, and self-efficacy. Further analysis revealed the primary effects to be significantly moderated by several factors, categorized under learner and course characteristics. These findings have important implications for both research and practice.

scholarly journals Differential power of placebo across major psychiatric disorders: a preliminary meta-analysis and machine learning study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bo Cao ◽  
Yang S. Liu ◽  
Alessandro Selvitella ◽  
Diego Librenza-Garcia ◽  
Ives Cavalcante Passos ◽  
...  
Keyword(s):  
Machine Learning ◽  
Psychiatric Disorders ◽  
Mood Disorders ◽  
Placebo Effect ◽  
Rating Scales ◽  
Meta Analysis ◽  
Placebo Response ◽  
Pharmacological Intervention ◽  
Placebo Effects ◽  
Meta Regression

AbstractThe placebo effect across psychiatric disorders is still not well understood. In the present study, we conducted meta-analyses including meta-regression, and machine learning analyses to investigate whether the power of placebo effect depends on the types of psychiatric disorders. We included 108 clinical trials (32,035 participants) investigating pharmacological intervention effects on major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SCZ). We developed measures based on clinical rating scales and Clinical Global Impression scores to compare placebo effects across these disorders. We performed meta-analysis including meta-regression using sample-size weighted bootstrapping techniques, and machine learning analysis to identify the disorder type included in a trial based on the placebo response. Consistently through multiple measures and analyses, we found differential placebo effects across the three disorders, and found lower placebo effect in SCZ compared to mood disorders. The differential placebo effects could also distinguish the condition involved in each trial between SCZ and mood disorders with machine learning. Our study indicates differential placebo effect across MDD, BD, and SCZ, which is important for future neurobiological studies of placebo effects across psychiatric disorders and may lead to potential therapeutic applications of placebo on disorders more responsive to placebo compared to other conditions.

scholarly journals Meta-analysis on the role of exercise in the treatment of constipation

2021 ◽  
Vol 1 ◽  
pp. 210001
Author(s):  
Thomas Weiser ◽  
Sabine Landes
Keyword(s):  
Exercise Therapy ◽  
Life Style ◽  
Chronic Constipation ◽  
Meta Analysis ◽  
Exercise Programme ◽  
Sodium Picosulfate ◽  
Current Guidelines ◽  
Positive Effect

Current guidelines recommend life-style adjustment (including more exercise) as the first measure for treating constipation. This meta-analysis investigated the influence of exercise therapy on the symptoms of patients with chronic constipation. About half of participants in a exercise programme lasting several weeks experienced a positive effect on their symptoms. Studies with the laxatives bisacodyl and sodium picosulfate showed that these generally alleviated symptoms even within the first day of treatment.

Internationalization and family firm performance

2020 ◽  
Vol 27 (1) ◽  
pp. 1-25
Author(s):  
Bart J. Debicki ◽  
Chao Miao ◽  
Shanshan Qian
Keyword(s):  
Firm Performance ◽  
Family Firms ◽  
Meta Analysis ◽  
Family Firm ◽  
Future Research ◽  
Content Type ◽  
Potential Impact ◽  
The Impact ◽  
Positive Effect

Purpose The purpose of this paper is to evaluate the effect of internationalization on performance in family firms, as well as the potential impact of moderators on this relationship. Design/methodology/approach This paper is a meta-analysis of the impact of internationalization on performance in family firms, as well as the role of several moderators shaping this relationship, based on 29 studies. Findings The findings indicate a significant positive effect of internationalization on family firm performance. This relationship was stronger in family firms with lower family ownership. Several methodological moderators were significant, such as the means of measuring performance and internationalization. The results also point to several cultural moderators, such as individualism, masculinity, low uncertainty avoidance and short-term orientation, which positively influence the main effect. Originality/value The authors provide discussions of the results, their practical and theoretical implications, as well as avenues for future research.

Multiple sclerosis and nutrition

2005 ◽  
Vol 11 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Stefan Schwarz ◽  
Hans Leweling
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Unsaturated Fatty Acids ◽  
Early Stage ◽  
Meta Analysis ◽  
Saturated Fat ◽  
Epidemiological Studies ◽  
Linoleic Acid Intake ◽  
Positive Effect

Benefits from any particular diet in multiple sclerosis (MS) have not yet been proven. It is, however, frequent that malnutrition may potentially exacerbate the symptoms of MS. There is some evidence that a high intake of saturated fat increases the incidence of MS. Epidemiological studies imply that unsaturated fatty acids may have a positive effect on the course of MS. However, the results of controlled studies are ambiguous. A meta-analysis of three small controlled clinical trials suggests a benefit from linoleic acid. Intake of Vitamin D is associated with a lower incidence of MS. In MS, the risk of osteoporosis is high, and prophylactic vitamin D and calcium should be considered at an early stage. The role of minerals, trace elements, antioxidants, vitamins or fish oil is unclear. The possible relationships between diet and MS have not been subjected to adequate study. It seems possible that in the future, diets or dietary supplements may become recommended forms of treatment for MS.

Meta-analytic studies in depression and the role of placebo response

2011 ◽  
Vol 26 (S2) ◽  
pp. 2081-2081
Author(s):  
K. Fountoulakis
Keyword(s):  
Active Drug ◽  
Drug Effect ◽  
Meta Analysis ◽  
Placebo Response ◽  
Data Sets ◽  
Depression Severity ◽  
Distinct Mechanism ◽  
The Difference ◽  
The Relationship

During the last few years there is a growing concern about the increasing response to placebo seen in trials of antidepressants and the ever increasing difficulty in detecting the therapeutic signal. Even worse, recently there was much debate on the true usefulness of antidepressant therapy itself, especially after the publication of a meta-analysis by Kirsch et al in 2008. However the re-analysis of these data suggested that the correct drug-placebo difference is 2.18 or 2.68 instead of 1.80. Kirsch et al failed to report that that the change in HDRS score was 3.15 or 3.47 points for venlafaxine and 3.12 or 3.22 for paroxetine, which are above the NICE threshold. It is of prime importance that although a large percentage of the placebo response is due to expectancy this is not true for the active drug and effects are not additive. This might mean a distinct mechanism underlying the placebo and the drug effect. Also, the drug effect is always present and is unrelated to depression severity, while this is not true for placebo. It is interesting that by passing the years there seems to be an increasing absolute both placebo and drug effect but the effect size of the difference remains stable. Meta-analytic studies in larger data sets are necessary in order to further elucidate the relationship between the drug and the placebo response and the nature of the latter.

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