Program in Placebo Studies
For many years, the placebo effect was considered to be no more than a
nuisance variable that needed to be controlled in clinical trials. Only
recently have researchers redefined it as the key to understanding the
healing that arises from medical ritual, the context of treatment, the
patient-provider relationship and the power of imagination, hope and
Although our biomedical health care system often considers these dimensions
of care as secondary to the administration of pharmaceuticals and
procedures, the emerging field of placebo studies is producing scientific
evidence that these more humanistic elements of medicine may fundamentally
contribute to the improvement of patient care.
Over the past ten years an informal network of researchers at Harvard
Medical School has taken a leading role in establishing the field of
placebo studies. In July 2011, the Department of General Medicine and
Primary Care invited these researchers to create the world's first
interdisciplinary center for placebo research. The Harvard-wide Program in
Placebo Studies and the Therapeutic Encounter (PiPS) hosted at Beth Israel
Deaconess Medical Center pursues placebo studies through interdisciplinary,
translational research initiatives that bridge the basic, clinical and
social sciences, as well as the humanities.
PiPS draws its faculty from across Harvard Medical School's teaching
hospitals and the Faculty of Arts and Sciences at Harvard University. The
PiPS advisory board includes Fabrizio Benedetti, MD, of the University of
Turin, Italy; Tor Wager, PhD, of the University of Colorado; Emeran Mayer,
MD, of UCLA; and Pradrag Petrovic, MD, of the Karolinska Institute, Sweden.
PiPS is led by the following members of the Harvard faculty
Irving Kirsch, PhD
, Associate Director
Anthony Lembo, MD
, Director of Clinical Research
Randy Gollub, MD
, Director of Neuroscientific Research
Anne Harrington, PhD, Director of Initiatives in the Humanities
John Kelley, PhD
, Director of Psychological Research
Roger B. Davis, ScD
, Director of Statistics (BIDMC)
Efi Kokkoutou, MD, PhD, Director of Molecular Biological Research
One of the primary motivations for creating PiPS was to provide an
environment in which young researchers could develop careers in placebo
studies. As a result, a significant portion of our resources are dedicated
to providing post-doctoral fellowships and opportunities for mentorship and
collaboration between fellows and senior researchers. PiPS participates in
a Harvard-wide BIDMC NIH T-32 fellowship program.
Just as evidence-based scientific research drives the progress of medical
therapy, so too evidence-based research is needed to guide and enhance the
art of medicine. Traditionally, the art of medicine has been understood as
a humanistic orientation sequestered from medical science and technology.
Research on the placebo response provides a fruitful opportunity for
developing rigorous knowledge that can bridge this gap in the service of
Until PiPS researchers began contributing to the field of placebo studies,
there had been comparatively little patient-centered research aimed at
harnessing placebo responses in the treatment of common illnesses. PiPS has
addressed this gap by creating a comprehensive agenda for placebo research
that targets high-priority clinical challenges and their underlying
biological, psychosocial and cultural mechanisms.
Our Clinical research includes:
- Irritable Bowel Syndrome (IBS) studies investigating
whether placebo effects are dose dependent and how they can best be
utilized in clinical practice.
- Asthma physiological experiments delineating the
malleability of placebo responses.
- Chronic pain studies comparing two types of placebo
interventions - sham needles versus placebo pills -- for pain relief.
- Depression studies investigating novel uses of placebo
Our Neuroscience, Genetics and Molecular Biology research includes:
- Performing neuroimaging studies clarifying the brain mechanisms of
- Investigating the neurobiology of physicians while they treat patients.
- Elucidating genetic signatures of the placebo response.
Our research in the Social Sciences includes:
- Examining how patients' and practitioners' psychological profiles
influence their response to placebo.
- Investigating patients' cultural narratives while receiving placebo
- Analyzing social-demographic variables associated with placebo responses.
Our research in the Humanities and Bioethics includes:
- Ethical analyses surrounding the use of placebos in research and clinical
- Philosophic and theoretical papers that contribute new hypotheses and
insights about the
relationship between the mind and the body.
- Historical analyses of the history of placebo effects and placebo
Our Research Methodology includes:
- Analyses of bias and potential distortions in scientific research,
including placebo research.
- Analyses of potential limitations of the reliability of
- Investigations into more efficient methods for detecting drug-placebo
differences in clinical trials.
- Studies comparing the outcomes of clinical trials with and without
"placebo run in" periods.
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