Overall, the albuterol inhaler improved exhaling by 20 percent. Each of the other approaches (including no treatment) improved it by just 7 percent overall.
So what did the patients think? Overall, they thought both inhalers (the real and fake ones) and the sham acupuncture improved their breathing by about the same amount (the albuterol inhaler by 50 percent, the fake inhaler by 45 percent, and the sham acupuncture by 46 percent). They thought doing nothing only improved it by 21 percent.
The research raises plenty of questions, said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. For one, he said, "how reliable are patients in terms of their subjective reporting of their symptoms? When a patient tells you that they feel better, and you think they really need more than what you're doing, should you stop? It really calls into question what we're doing, whether it's good enough to help the patients feel better."
The study authors had a similar view of the placebo effect. Due to the wide gap between asthma patients' self-reports and their actual lung function, the researchers concluded that for optimal asthma care, health providers should test lung function rather than rely on patients' self-assessments.
And in clinical trials in general, the authors added, "reliance solely on subjective outcomes may be inherently unreliable."
The study appears in the July 14 issue of The New England Journal of Medicine. It was funded by the National Center for Complementary and Alternative Medicine.
For more on the placebo effect, try the U.S. National Library of Medicine.
SOURCES: Ted J. Kaptchuk, O.M.D., as
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