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May 12, 2004

Ethical Issues in Research in Complementary and Alternative Medicine—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(18):2192-2194. doi:10.1001/jama.291.18.2193-d

In Reply: Drs Cantor and Malani claim that placebo effects can be demonstrated by comparing a pair of 2-arm trials of active treatment vs placebo that have different proportions of participants randomized to receive active treatment. This is an interesting speculation; however, we are unaware of any data to support this claim or to indicate that this design is just as able, or more able, to discriminate placebo effects than would be a 3-arm trial comparing active treatment, placebo, and no treatment. Their alternative design may suggest placebo effects but still leaves open the critical question of whether either the active treatment or placebo-control is better than no treatment.

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