False placebo

{{science}}
A '''false placebo''' is a non-[[placebo]] factor that appears to cause an improvement of a disease. False placebos differ from actual placebos in that they occur regardless of whether the patient is treated or not. False placebos are the "other" things controlled for in the placebo arms of clinical trials.

==Natural improvement==
===Spontaneous remission===
'''Spontaneous remission''' (also known as '''spontaneous improvement''' or '''spontaneous regression''') is a phenomenon in which an untreated disease or condition suddenly disappears for no apparent reason. This is one of the ways in which [[alternative medicine]] can seem to cure diseases such as [[cancer]] (along with [[misdiagnosis]], in which case the person is "cured" of a disease they don't actually have).<ref>[http://www.acampbell.org.uk/essays/skeptic/miraculouscures.html Apparently Miraculous Cures: What Do They Tell Us?]</ref>

The spontaneous remission rates for cancer depend on the type: according to studies done, basal cell carcinoma and breast cancer disappear in about 20% of cases, while the rates for melanoma haven't been studied, but have been estimated to be around 10%-20%.<ref>[http://jnci.oxfordjournals.org/content/93/14/1047.full Spontaneous Regression of Melanoma May Offer Insight Into Cancer Immunology], Carrie Printz, JNCI J Natl Cancer Inst (2001) 93 (14):  1047-1048.</ref><ref>[http://dartmed.dartmouth.edu/spring09/html/disc_remission.php Study reveals surprising cancer remission rate], Dartmouth Medicine Magazine.</ref>
Autoimmune hepatitis goes into spontaneous remission in 13%-20% of cases.<ref>[http://www.mdguidelines.com/hepatitis-chronic Hepatitis Chronic - Medical Disability Guidelines]</ref> Untreated tuberculosis goes away in approximately 29% of cases.<ref>[http://www.biomedcentral.com/1471-2334/9/87 How to optimize tuberculosis case finding: explorations for Indonesia with a health system model], BMC Infectious Diseases 2009, 9:87 doi:10.1186/1471-2334-9-87.</ref><ref>[http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0017601 Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review], PLoS ONE 6(4): e17601. doi:10.1371/journal.pone.0017601.</ref> About 65%-75% of people with invasive group A streptococcal infections live.<ref>[http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListDate/Page/1202487092166?p=1202487092166  HPA - FAQs - Group A streptococcal infections]</ref>

===Misdiagnosis===
Malaria misdiagnosis is a problem in [[Asia]] and [[Africa]].<ref name=bmj>[http://www.bmj.com/content/345/bmj.e4389 Overdiagnosis and mistreatment of malaria among febrile patients at primary healthcare level in Afghanistan: observational study], Toby Leslie, Amy Mikhail, Ismail Mayan, Mohammed Anwar, Sayed Bakhtash, Mohammed Nader, Clare Chandler, Christopher J M Whitty, Mark Rowland, BMJ 2012;345:e4389.</ref><ref>[http://www.ncbi.nlm.nih.gov/pubmed/15177148 Symptom overlap for malaria and pneumonia--policy implications for home management strategies], Källander K, Nsungwa-Sabiiti J, Peterson S., Acta Trop. 2004 Apr;90(2):211-4.</ref><ref>[http://www.news-medical.net/news/20120726/Malaria-misdiagnosis-an-interview-with-Dr-Toby-Leslie.aspx Malaria misdiagnosis: an interview with Dr Toby Leslie], July 26, 2012.</ref> In one study, out of 414 patients going to hospitals using clinical diagnosis, 412 were prescribed anti-malarial drugs, even though 413 tested negative for malaria.<ref name=bmj/>

===Regression to the mean===
{{main|Regression to the mean}}
Regression to the mean is just a fancy way of saying things tend to revert to normal given a set period of time. Many diseases are self-limiting. Time heals. So, most people will return to normal even if they have no treatment. Regression to the mean, however, can also mask actual efficacy of a treatment, and it's one of the many reasons anecdotes aren't reliable sources of information.

==See also==
*[[Alternative medicine]]
*"[[Sin]]", a well-known made-up disease that is often the subject of the false placebo effect.

==References==
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{{stub|Medicine}}

[[Category:Medicine]]

Categories: Medicine