Senin, 25 Juli 2011

Lower Back Pain, the "The Doctor Effect" and Patient Self-Reported Outcomes

The Doctor Effect is also known as the Placebo Effect.

Except, as pointed out in JournalWatch's Clinical Conversations Podcast #126, Placebos and Medical Meaning, a placebo is an inert substance that has no effect on a patient.

The Placebo Effect was raised by an article in the July 14th, 2011 New England Journal of Medicine Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma. The authors found that patients' self-reported breathing after sham acupucture improved while their Forced Expiratory Volume in 1 second (FEV-1) did not improve. The authors concluded that the self-report measures were therefore unreliable.

Dr. Daniel Moreman, author of Deconstructing the Placebo Effect and Finding the Meaning Response, argues that real, therapeutic effects can be measured in patients who take "inert" substances and that the patient experience (eg: feeling better) may be more important than "instrumental', or objective data, like the FEV-1.

At 11:38 min. in the podcast, Dr. Moreman (an anthropologist) directly speaks to the difficulty of lower back pain, patient self-report outcome measures and physician care.

Physical therapists should think about the Doctor Effect because of evidence that the Doctor Effect, or the process-of-care, may provide at least as large a therapeutic benefit as that provided by pharaceuticals with dangerous or deadly side effects.

Lower Back Pain, the "The Doctor Effect" and Patient Self-Reported Outcomes Rating: 4.5 Diposkan Oleh: Elvina dara

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