Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011;2011:842767.
doi: 10.1093/ecam/neq074. Epub 2011 Apr 14.

Revisiting the Sham: Is It All Smoke and Mirrors?

Affiliations
Free PMC article

Revisiting the Sham: Is It All Smoke and Mirrors?

Brandon Horn et al. Evid Based Complement Alternat Med. .
Free PMC article

Abstract

The misuse of sham controls in examining the efficacy or effectiveness of Complementary and Alternative Medicine has created numerous problems. The theoretical justification for incorporating a sham is questionable. The sham does not improve our control of bias and leads to relativistic data that, in most instances, has no appropriate interpretation with regards to treatment efficacy. Even the concept of a sham or placebo control in an efficacy trial is inherently paradoxical. Therefore, it is prudent to re-examine how we view sham controls in the context of medical research. Extreme caution should be used in giving weight to any sham-controlled study claiming to establish efficacy or safety.

Figures

Figure 1
Figure 1
Possible effects of a sham control.
Figure 2
Figure 2
Placebo effect paradox in an efficacy trial.

Similar articles

See all similar articles

Cited by 1 article

References

    1. van Spall HG, Toren A, Kiss A, Fowler RA. Eligibility criteria of randomized controlled trials published in high-impact general medical journals: a systematic sampling review. Journal of the American Medical Association. 2007;297:1233–1240. - PubMed
    1. Stedman’s medical dictionary. Lippincott Williams & Wilkins, 2006.
    1. Miriam Webster dictionary. September 2009, http://www.merriam-webster.com/medical/sham.
    1. Sutherland ER. Sham procedure versus usual care as the control in clinical trials of devices: which is better? Proceedings of the American Thoracic Society. 2007;4:574–576. - PubMed
    1. Simon SD. Is the randomized clinical trial the gold standard of research? Andrology lab corner. Journal of Andrology. 2001;22(6):938–943. - PubMed

LinkOut - more resources

Feedback