Review

Why do ineffective treatments seem helpful? A brief review

Steve E Hartman

Department of Anatomy, College of Osteopathic Medicine, University of New England, Biddeford, Maine 04005, USA

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Chiropractic & Osteopathy 2009, 17:10doi:10.1186/1746-1340-17-10

Published:	12 October 2009

Abstract

After any therapy, when symptoms improve, healthcare providers (and patients) are tempted to award credit to treatment. Over time, a particular treatment can seem so undeniably helpful that scientific verification of efficacy is judged an inconvenient waste of time and resources. Unfortunately, practitioners' accumulated, day-to-day, informal impressions of diagnostic reliability and clinical efficacy are of limited value. To help clarify why even treatments entirely lacking in direct effect can seem helpful, I will explain why real signs and symptoms often improve, independent of treatment. Then, I will detail quirks of human perception, interpretation, and memory that often make symptoms seem improved, when they are not. I conclude that healthcare will grow to full potential only when judgments of clinical efficacy routinely are based in properly scientific, placebo-controlled, outcome analysis.