Nerdly aside: randomized controlled trials (RCTs) defined

The placebo effect is a well-known phenomenon in medicine. If a person is told they are being given an extremely powerful and effective new medication, a significant percentage will improve, even if they are not told the product they are being given actually has no benefit (it’s inert). The power of suggestion is so strong that they will actually improve, just because they believe they are supposed to.

To determine whether a particular approach is an effective intervention for a given medical condition it’s necessary to eliminate the placebo effect and reduce the variables to one:  the test product. The gold standard to accomplish this is called a randomized controlled trial, or RCT. Or to give it a more complete and descriptive title, the randomized, placebo-controlled, double blind, crossover trial.

To break it down:

• randomized means that a fairly large group of people with similar characteristics (age, sex, general health status, etc.) are divided at random into two groups. Every person in the trial must have exactly equal chances of being in either the test or the placebo group, so either a random number-generating computer program is used, or there are charts that do the same thing.
• A placebo is a substance or treatment meant to fool people into thinking it’s the same as the product or procedure being tested, but that has no benefit. So if it’s a medication being tested, a pill is made to look exactly the same as the test product, but is made of an inert substance, usually sugar.
• Double-blind means that neither the test subjects nor the people conducting the test know whether a given subject is in the product or placebo group, to avoid unconsciously causing a bias by anyone (testers or subjects).
• When the test begins, everyone is told the same thing and then given their coded product (again, neither the subjects nor the tester know which is the real McCoy and which is the placebo). Everyone follows the instructions carefully (hopefully) and extensive records are kept during the test period. Enough time is given to show some significant change, and then the groups are switched (the “crossover” part). Now the people who were taking the placebo are getting the test product, and those originally taking the test product are getting the placebo. If the product being tested has a benefit, the original group will show improvement while the placebo group does not (or less of an improvement, due to the “placebo effect.”) During the crossover portion of the trial, the former placebo group will now begin to improve (assuming the test product works), while the group that was taking the test product (but is now taking the placebo) will regress.

Anyhow, this process is supposed to weed out any possible placebo effect, and as I said is considered the Holy Grail of clinical tests.