Do patients with fibromyalgia syndrome and healthy people differ in their opinions on placebo effects in routine medical care? 2025 van Lennep et al

Abstract

Objectives
Placebo effects can relieve acute and chronic pain in both research and clinical treatments by learning mechanisms. However, the application of placebo-based treatment strategies in routine medical care is questioned. The current study investigated the opinions of patients with fibromyalgia and healthy controls regarding learning of placebo effects and their practical applications.

Method
An online survey asked 158 age- and sex-matched adult patients and controls (79 per group) to rate the perceived influence of various placebo learning mechanisms on pain relief, and the acceptability and perceived effectiveness of placebo-based strategies (open-label, closed-label, dose-extending, and treatment-enhancing strategies). Respondents' knowledge about placebo effects was obtained through a 7-item quiz.

Results
The groups did not differ in the perceived influence of placebo learning mechanisms on pain relief (p = 0.217). Controls considered closed-label and treatment-enhancing strategies more acceptable than patients (p = 0.003 and p < 0.001), whereas controls perceived all strategies more effective. In both groups, closed-label strategies were significantly less acceptable than any other strategy (p-values < 0.001), and treatment-enhancing or dose-extending strategies were most acceptable. Higher acceptability was predicted by higher perceived effectiveness ratings (p < 0.001). Also, increased placebo knowledge was related to higher acceptability (p = 0.03) and perceived effectiveness (p < 0.001).

Discussion
This survey suggests that both the medical history of patients and knowledge about placebo effects affect the acceptability and perceived effectiveness of placebo-based strategies. Furthermore, strategies that are transparent, assumed effective, or combined with existing medical treatments are deemed most acceptable. Keeping these factors in mind is essential for the clinical implementation of placebo-based strategies in routine medical care.

Open access

 

Oh my days. We’re researching the opinions of sick people now?

 

They are openly asking people how much they can get away with. Quite dystopian..

 

I can't see how this is any different than a study of the power of prayer asking about beliefs in whatever religion is used in those prayers.

Because it's the same thing, just a different set of beliefs. One that makes absurd pseudoscientific statements as this:

"Placebo effects" don't cause pain relief, rather it is fuzzy responses on biased questionnaires being influenced into reporting such relief even when there isn't any. This is a problem of instrumentation and difficulty of comparison, and no data exists to make causal attribution, which is always, always, made one way only.

The exact same effect exists in computer graphics. Put side-by-side screenshots comparing older graphics technology next to spanking new cutting edge wizardry graphical effects that are 4x better and 16x snazzier and you'll have a base % of people who will mix them up, point at the older, worse, graphics saying "wow so much better". But do the same experiment with the real output, with real-time video instead of screenshots, and that problem almost entirely disappears.

Medicine for sure will prefer to pretend to study the power of beliefs over admitting that this 'placebo' stuff is just a bunch of useless noise that they are creating and abusing themselves.