Evidence map›Paper›PMID 24658930›Full record

SynthesisNeurology2014

Another face of placebo: the lessebo effect in Parkinson disease: meta-analyses.

Tiago A Mestre, Prakesh Shah, Connie Marras, George Tomlinson, Anthony E Lang

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Subjective cognition and mood in persistent chemotherapy-related cognitive impairment.Journal of cancer survivorship : research and practice · 2022
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  6. Double-Blind, Randomized, Placebo-Controlled Trial of DA-9701 in Parkinson's Disease: PASS-GI Study.Movement disorders : official journal of the Movement Disorder Society · 2020
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  9. Nicotinic treatment of post-chemotherapy subjective cognitive impairment: a pilot study.Journal of cancer survivorship : research and practice · 2019
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Tiago A MestreFrom the Movement Disorders Centre and Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Division of Neurology (T.A.M., C.M., A.E.L.), the Department of Paediatrics and Institute of Health Policy, Management and Evaluation (P.S.), the Department of Public Health Sciences (G.T.), and the Department of Medicine (T.A.M., C.M., G.T., A.E.L.), University of Toronto; and the Department of Pediatrics (P.S.), Mount Sinai Hospital, Toronto. T.A.M. is currently with the Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, Ottawa Hospital, University of Ottawa.
Prakesh Shah
Connie Marras
George Tomlinson
Anthony E Lang

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo study the impact of negative expectation related to receiving a placebo (the "lessebo effect") on efficacy outcome measures of symptomatic treatments in Parkinson disease (PD).

methodsWe conducted meta-analyses of double-blind randomized controlled trials (RCTs) of dopamine agonists in PD and compared the pooled mean score change of the motor section of the Unified Parkinson's Disease Rating Scale (mUPDRS) across active treatment arms according to the presence of a placebo arm or the probability of placebo assignment (0%, <50%, and 50%) of the original RCT. A mixed-effects model was used. Heterogeneity was assessed by subgroup analyses and meta-regression modeling.

resultsA total of 28 study arms were extracted from active-controlled trials (3,277 patients) and 42 from placebo-controlled trials (4,554 patients). The overall difference between groups in the pooled mean score change in the mUPDRS was 1.6 units (95% confidence interval [CI] 0.2, 3.0; p = 0.023), in favor of the active-controlled group. In subgroup analyses, this difference was of higher magnitude in the early PD group without motor fluctuations (3.3 mUPDRS units, 95% CI 1.1, 5.4; p = 0.003) and for study duration ≤ 12 weeks (4.1 mUPDRS units, 95% CI 1.0, 7.2; p = 0.009). There was no between-group difference using probability of placebo assignment as criterion.

conclusionsThis study shows that the use of a placebo can be associated with a clinically significant reduction in the magnitude of change of the mUPDRS after an active treatment in RCTs for PD. These new findings have potential implications in the development of new treatments and appraisal of current treatment options for PD and possibly for other neurologic disorders.

Indexed as

Placebo EffectAgedAntiparkinson AgentsDopamine AgonistsDouble-Blind MethodFemaleHumansMaleMiddle AgedMotor SkillsNeurologic ExaminationParkinson DiseaseRandomized Controlled Trials as TopicAntiparkinson AgentsDopamine Agonists

Identifiers

PMID24658930
PMCPMC4001195

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.