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In This Issue of JAMA Internal Medicine
November 25, 2013


JAMA Intern Med. 2013;173(21):1937-1939. doi:10.1001/jamainternmed.2013.6338

One of the underlying assumptions of placebo-controlled randomized trials is that the placebo effect is always constant; however, different types of placebo interventions may be associated with different responses. Meissner and coauthors investigated this question in a meta-analysis of 79 randomized clinical trials on migraine prophylaxis. Findings from univariate analyses showed that more patients responded with a significant reduction of attack frequency to sham acupuncture and sham surgery than to oral drug placebos. When controlling for possible confounders, only sham acupuncture and sham surgery were significantly associated with the placebo response. In an Editor’s Note, Redberg details the implications for future placebo-controlled studies.