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Frederik Feys graduated as a dentist in 1997. He studied medicine for several years and holds a master’s degree in family and sexological sciences (2002). In 2015 he became Doctor in Medical Sciences. In the clinical field he has been working since 12 years as a sex- and couple therapist. He applies the principles of autosuggestion in the form of self-help. His mission is to further explore how we can openly use the ‘vehicle’ behind the powerful placebo effect. So that clinicians can incorporate such effects in treatment decisions and patient counselling information. Ultimately improving the health and wellbeing of people.
Book Summary Medication side-effects can unblind randomized clinical trials (RCTs) that may result in misleading treatment effect estimates. Enhanced intervention blinding of people participating in an RCT can be achieved by using active placebo’s, a placebo that mimics side-effects of the intervention.
In the realm of sexual medicine, we found that such blinding-enhanced controlled RCTs for erection pills are absent. We also found a consistent failure to report on RCT blinding in journal publications. Clearly, the blinding efforts for almost all trials remain unclear. Our study found no conclusive evidence that unblinding leads to underestimating placebo effects or to the overestimation for intervention effects by investigators. Secondary analyses provided evidence that RCT participants with prior experience with the intervention reported substantially lowered placebo scores. It may be that participants with prior experience determine their allocation to placebo more efficiently and consequently engender lower expectancies as to their benefits.
After critical appraisal of the blinding status in studies for an ejaculation-delaying pill (dapoxetine), we found no evidence that dapoxetine is more effective than placebo. And dapoxetine comes with harmful effects. The blinding adequacy of almost all the studies remained unknown. The
methodology used in most studies was problematic due to incomplete data reporting, conflict of interests and selective reporting.
We conclude that methodological rigour in the conduct and reporting of RCTs is especially imperative for those health conditions that are evaluated
subjectively, such as depression, erectile dysfunction, low back pain, and many other symptom driven complaints.