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One group is given a newly developed medication X, and the other group placebo. If X has noticeable side effects, like extra sleepiness, change in appetite, tremors, etc, wouldn't the participates in group 1 realize that they're given the real medication? How would it affect the study?

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    not necessarily: even placebo has "noticeable" side effects. every symptom you describe can also occur in a placebo group. under some circumstances, it could be an issue. if it is, then they would consider using an active placebo. this is uncommon, however. you can test for what you're describing: you ask the participants what group they were in. a properly-blinded study will have the same rate of wrong/correct belief. – faustus Feb 12 '18 at 11:48

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