By Clayton J. Baker, MD at Brownstone dot org.

When performing scientific studies of the effectiveness and safety of medical treatments, the gold-standard study design is widely considered to be the so-called "prospective, randomized, double-blinded, placebo-controlled clinical trial."

While this claim is not universally true for all types of medical investigation, when examining the effectiveness and safety of new - or existing - medical treatments, this rule applies very well indeed. For the purposes of this essay, we will focus on the placebo-controlled aspect of clinical trials.

There are two excellent reasons for a clinical trial to be placebo-controlled.

First, one does not want to perform a treatment on patients unless the treatment is more effective than leaving them alone.

Second, one does not want to perform a treatment on patients if the treatment is more harmful to them than leaving them alone.

Unless you are in the vaccine business, that is. The vaccine industry has a long, disgraceful history of shielding the ineffectiveness and toxicity of their products by using false placebos in the clinical trials of their products.

What Is a Placebo, and Why Are Placebo-Controlled Studies Important?

According to the Merriam-Webster Dictionary a placebo is defined as:

1a: a usually pharmacologically inert preparation prescribed more for the mental relief of the patient than for its actual effect on a disorder

b: an inert or innocuous substance used especially in controlled experiments testing the efficacy of another substance (such as a drug)

The first definition touches on the famous 'placebo effect,' which is the observed tendency for even inert or 'sham' treatments to produce positive effects in some patients.

The second definition is relevant to the clinical trial process. Here, a 'placebo' is the inert treatment that is used in the 'control group' of a clinical trial - that is, the group that doesn't get the active treatment. The control group provides a valid baseline for comparison with the 'treatment group' of the study - that is, the group of subjects that get the actual treatment in question. Note that the placebo must be both inert (inactive) and innocuous (harmless).

The reasons for using a true placebo comparison group in a clinical trial are straightforward. By comparing the active therapy under investigation to a true placebo, several vital determinations can be made about the therapy.

First, since a true placebo is harmless, one can identify, by comparing harmful effects seen in the group that got the treatment with harmful effects seen in the group that got the placebo, any and all harms caused by the treatment.

For example, if a harmful effect is seen equally in both the treatment group and the placebo group of the study, that harmful effect is not attributed to the treatment, but rather to other factors. However, if a harmful effect appears only in the treatment arm of the study (or appears with significantly higher frequency or intensity), it is attributed to the treatment.

Second, since a true placebo is inactive, one can determine, by comparing the intended or beneficial effects seen in the treatment group with beneficial effects seen in the placebo, any and all benefits caused by the treatment.

For example, if a beneficial effect is seen equally in both the treatment group and the placebo group of the study, that beneficial effect is not attributed to the treatment, but rather to other factors. (In such cases, the beneficial effect seen in the treatment group is often described as 'no better than placebo.') However, if a beneficial effect - especially if it was intended - appears only in the treatment arm (or appears with significantly higher frequency or intensity), it is attributed to the treatment.

It should be obvious how the proper use of true placebo control is essential to arriving at the truth in clinical studies of medical treatments. However, one can also see why a dishonest researcher woul...