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Suncheon, South Korea

Koog Y.H.,Honam Research Center
Complementary Therapies in Medicine | Year: 2016

Conventionally in controlled trials of drugs or modalities, the placebo and nocebo effects have been determined separately and understood to be the difference between the placebo and no-treatment groups. Recently, the effect of placebo acupuncture over no-treatment was found to be associated with the placebo and nocebo effects together. If these two effects are inseparable in acupuncture treatment, the conventional method of determining placebo and nocebo effects at the trial level will not reflect pure placebo or nocebo effects. Furthermore, if these effects are inseparable, observations about the efficacy of acupuncture will be biased when considering only the placebo effect. A simple mathematical model incorporating both the placebo and nocebo effects will be provided to see how the efficacy of acupuncture is affected. © 2015 Elsevier Ltd. Source


We S.R.,Honam Research Center | Jeong E.-O.,Kyung Hee University | Koog Y.H.,Honam Research Center | Min B.-I.,Kyung Hee University
African Journal of Biotechnology | Year: 2012

Knee osteoarthritis is the most common form of joint disease and is a major cause of pain and physical disability among the elderly. Although, numerous treatments have been developed to treat osteoarthritis, no definitive treatments with high efficacy and low risk have been identified until now. In recent years, it has been reported that nutraceuticals may be good candidates for the management of knee osteoarthritis. This paper describes the efficacy of nutraceuticals for treating knee osteoarthritis in terms of pain and structural change. To accomplish this, this paper reports on the analysis of randomized, placebo-controlled, clinical trials that were published prior to December 2011. © 2012 Academic Journals. Source


Koog Y.H.,Honam Research Center | We S.R.,Honam Research Center | Min B.-I.,Kyung Hee University
PLoS ONE | Year: 2011

Background: It has been argued that placebos may not have important clinical impacts in general. However, there is increasing evidence of a publication bias among trials published in journals. Therefore, we explored the potential for publication bias in randomized trials with active treatment, placebo, and no-treatment groups. Methods: Three-armed randomized trials of acupuncture, acupoint stimulation, and transcutaneous electrical stimulation were obtained from electronic databases. Effect sizes between treatment and placebo groups were calculated for treatment effect, and effect sizes between placebo and no-treatment groups were calculated for placebo effect. All data were then analyzed for publication bias. Results: For the treatment effect, small trials with fewer than 100 patients per arm showed more benefits than large trials with at least 100 patients per arm in acupuncture and acupoint stimulation. For the placebo effect, no differences were found between large and small trials. Further analyses showed that the treatment effect in acupuncture and acupoint stimulation may be subject to publication bias because study design and any known factors of heterogeneity were not associated with the small study effects. In the simulation, the magnitude of the placebo effect was smaller than that calculated after considering publication bias. Conclusions: Randomized three-armed trials, which are necessary for estimating the placebo effect, may be subject to publication bias. If the magnitude of the placebo effect is assessed in an intervention, the potential for publication bias should be investigated using data related to the treatment effect. © 2011 Koog et al. Source


We S.R.,Honam Research Center | Koog Y.H.,Honam Research Center | Park M.S.,Kyung Hee University | Min B.-I.,Kyung Hee University
Complementary Therapies in Medicine | Year: 2012

Objectives: We investigated the relationship between the placebo effect and the trial or patient characteristics. Data sources: We identified randomized clinical trials with acupuncture, sham and no-treatment groups in which no-treatment or conventional therapy was applied to the no-treatment group. Thirty-one trials in which no treatment was applied in the no-treatment group were categorised as 'strict' trials. Thirty-nine trials in which no-treatment or conventional therapy was applied to the no-treatment group were categorised as 'less strict' trials. We calculated the treatment effect, defined as the difference in the effect size between the acupuncture and no-treatment groups, and the placebo effect, defined as the difference in the effect size between the sham and no-treatment groups. Then, a random effect meta-regression analysis was performed on the two effects with respect to trial or patient characteristics. Results: The treatment effect was not found to be associated with any factors in both the strict and less strict trials. However, the placebo effect was found to be associated with the publication year in both the strict and less strict trials (P=. 0.009 and 0.005, respectively). The placebo effect increased by 0.05 in effect size per year in trials that were published more recently. Conclusion: While the treatment effect was not influenced by any trial or patient characteristics, the placebo effect was associated with the publication year. © 2011 Elsevier Ltd. Source


We S.R.,Honam Research Center | Koog Y.H.,Honam Research Center | Jeong K.-I.,Korea Atomic Energy Research Institute | Wi H.,Honam Research Center
Rheumatology (United Kingdom) | Year: 2013

Objective: Many reviews have been previously published on the efficacy of pulsed electromagnetic field (PEMF) in the management of knee OA. However, their results regarding pain and function yielded conflicting conclusions: Therefore this study was conducted to determine the efficacy of PEMF as compared with a placebo. Methods: We reviewed randomized, placebo-controlled trials using electronic databases. We also manually reviewed sources to identify additional relevant studies. Results: Fourteen trials were analysed, comprising 482 patients in the treatment group and 448 patients in the placebo group. When the efficacy of PEMF in treating pain was investigated, no significant effects were observed at any of the time points considered. However, when trials employing high-quality methodology were analysed, PEMF was significantly more effective at 4 and 8 weeks than the placebo. When the efficacy of PEMF was evaluated for function, a significant improvement was observed 8 weeks after the treatment initiation, with a standardized mean difference of 0.30 (95% CI 0.07, 0.53). No significant association was found between the use of PEMF and the occurrence of adverse events, as indicated by a relative risk of 1.47 (95% CI 0.67, 3.20). However, three (21.4%) trials applied electromagnetic field intensity over the levels recommended by the International Commission on Non-Ionizing Radiation Protection. Conclusion: The present study provided suggestive evidence supporting PEMF efficacy in the management of knee OA. Our results further raise the need for more well-controlled trials, employing adequate methodology, to conclusively evaluate the efficacy of PEMF. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Source

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