Although it has been recognized for centuries,1 the concept of the placebo effect was brought to professional consciousness with the 1955 publication of “The Powerful Placebo.”2 In this seminal work, Beecher used a quasi–meta-analysis approach to estimate that 35.2% of patients had a satisfactory response to placebo for relief of pain. Despite limitations in design and more recent analyses calling these results into question, the study by Beecher is largely responsible for the commonly held perception that approximately one-third of patients respond to placebos.3 In this issue of JAMA Pediatrics, Paul et al4 report the results of a randomized clinical trial comparing the efficacy of agave nectar (the study intervention), placebo, or no treatment for acute nighttime cough in children 2 to 47 months old. Although the study intervention provided no more relief from cough symptoms than placebo, both treatments were statistically superior to no treatment. The investigators contend that these findings are indicative of a placebo effect. Perhaps more provocatively, they suggest that knowingly using a placebo to treat cold symptoms in young children may constitute good medicine.
Taylor JA, Opel DJ. Using the Placebo Effect to Treat Cold Symptoms in Children. JAMA Pediatr. 2014;168(12):1091-1092. doi:10.1001/jamapediatrics.2014.2355