Cited by 389Statistical Methods in Clinical TrialsMeta-analysis and systematic reviewsPain Management and Placebo Effect

The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.

Reporting Methods of Blinding in Randomized Trials Assessing Nonpharmacological Treatments

Open access

Abstract

BACKGROUND: Blinding is a cornerstone of treatment evaluation. Blinding is more difficult to obtain in trials assessing nonpharmacological treatment and frequently relies on "creative" (nonstandard) methods. The purpose of this study was to systematically describe the strategies used to obtain blinding in a sample of randomized controlled trials of nonpharmacological treatment. METHODS AND FINDINGS: We systematically searched in Medline and the Cochrane Methodology Register for randomized controlled trials (RCTs) assessing nonpharmacological treatment with blinding, published during 2004 in high-impact-factor journals. Data were extracted using a standardized extraction form. We identified 145 articles, with the method of blinding described in 123 of the reports. Methods of blinding of participants and/or health care providers and/or other caregivers concerned mainly use of sham procedures such as simulation of surgical procedures, similar attention-control interventions, or a placebo with a different mode of administration for rehabilitation or psychotherapy. Trials assessing devices reported various placebo interventions such as use of sham prosthesis, identical apparatus (e.g., identical but inactivated machine or use of activated machine with a barrier to block the treatment), or simulation of using a device. Blinding participants to the study hypothesis was also an important method of blinding. The methods reported for blinding outcome assessors relied mainly on centralized assessment of paraclinical examinations, clinical examinations (i.e., use of video, audiotape, photography), or adjudications of clinical events. CONCLUSIONS: This study classifies blinding methods and provides a detailed description of methods that could overcome some barriers of blinding in clinical trials assessing nonpharmacological treatment, and provides information for readers assessing the quality of results of such trials.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pmed.0040061

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1 Flow of Records, Citations, and Articles through the Cross-Sectional Study
Figure 1 Flow of Records, Citations, and Articles through the Cross-Sectional StudyCC BY · PubMed Central
Figure 2 Sham Procedure Performed According to the Category of Treatment Assessed
Figure 2 Sham Procedure Performed According to the Category of Treatment AssessedCC BY · PubMed Central
Figure 3 Methods of Blinding Participants, Health Care Providers, or Other Caregivers That Rely on the Category of Treatment and Comparator Assessed
Figure 3 Methods of Blinding Participants, Health Care Providers, or Other Caregivers That Rely on the Category of Treatment and Comparator AssessedCC BY · PubMed Central
Figure 4 Methods of Blinding Outcome Assessors Depending on the Primary Outcome Considered
Figure 4 Methods of Blinding Outcome Assessors Depending on the Primary Outcome ConsideredCC BY · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 55 references

Research works printed but not linked: 55

  1. Gluud, 2006, Am J Epidemiol, 163, 493
  2. Schulz, 1995, JAMA, 273, 408
  3. Schulz, 2002, Ann Intern Med, 136, 254
  4. Schulz, 1996, BMJ, 312, 742
  5. Devereaux, 2001, JAMA, 285, 2000
  6. Montori, 2002, J Clin Epidemiol, 55, 787
  7. Hrobjartsson, 2002, J Clin Epidemiol, 55, 430
  8. Hrobjartsson, 2001, N Engl J Med, 344, 1594
  9. Noseworthy, 1994, Neurology, 44, 16
  10. Altman, 2001, Ann Intern Med, 134, 663
  11. Moher, 1998, Lancet, 352, 609
  12. Juni, 2001, BMJ, 323, 42
  13. Kjaergard, 2001, Ann Intern Med, 135, 982
  14. Fergusson, 2004, BMJ, 328, 432
  15. Sackett, 2004, BMJ, 328, 1136
  16. Boutron, 2005, J Clin Epidemiol, 58, 1220
  17. Hrobjartsson, 2004, 12th Cochrane Colloquium: Bridging the Gaps, 138
  18. Boutron, 2004, J Clin Epidemiol, 57, 543
  19. Boutron, 2003, JAMA, 290, 1062
  20. McCulloch, 2002, BMJ, 324, 1448
  21. Lilford, 2004, Br J Surg, 91, 6
  22. Devereaux, 2005, BMJ, 330, 88
  23. Bhandari, 2002, J Bone Joint Surg Am, 84-A, 388
  24. Jacquier, 2006, Ann Surg, 244, 677
  25. Ethgen, 2005, Ann Intern Med, 143, 20
  26. Lee, 2002, JAMA, 287, 2805
  27. Freed, 2001, N Engl J Med, 344, 710
  28. Balon, 1998, N Engl J Med, 339, 1013
  29. Baker, 2001, J Rheumatol, 28, 1655
  30. Wolsko, 2004, Altern Ther Health Med, 10, 36
  31. Quilty, 2003, J Rheumatol, 30, 1311
  32. Edinger, 2001, JAMA, 285, 1856
  33. Wang, 2004, Anesthesiology, 100, 1399
  34. Carbajal, 2003, BMJ, 326, 13
  35. Boutron, 2005, J Clin Epidemiol, 58, 1233
  36. Paterson, 2005, BMJ, 330, 1202
  37. Moseley, 2002, N Engl J Med, 347, 81
  38. Spigt, 2005, J Clin Epidemiol, 58, 350
  39. Zelen, 1992, Lancet, 340, 375
  40. Boter, 2004, BMJ, 329, 86
  41. Bishop, 2005, Complement Ther Med, 13, 144
  42. Devilly, 2000, J Behav Ther Exp Psychiatry, 31, 73
  43. Torgerson, 2005, JAMA, 294, 41
  44. Torgerson, 1998, BMJ, 316, 606
  45. McPherson, 1999, Eur J Cancer, 35, 1598
  46. McPherson, 2001, Qual Health Care 10 Suppl, 1, i61
  47. McPherson, 1997, J R Soc Med, 90, 652
  48. McPherson, 1998, BMJ, 317
  49. Halpern, 2003, J Clin Epidemiol, 56, 109
  50. Wood, 2006, 14th Cochrane Colloquium:Bridging the Gaps
  51. Gerritsen, 2002, JAMA, 288, 1245
  52. Altman, 2004, BMJ, 328, 1135
  53. Sackett, 1986, Clin Res, 34, 711A
  54. Senn, 2004, BMJ, 328, 1135
  55. Pildal, 2005, BMJ, 330, 1049

Cited by

Sorted by citations

Items 201–300 of 389

Metadata

Authors
Boutron, I., Guittet, L., Estellat, C., Moher, D., Hróbjartsson, A., & Ravaud, P.
Affiliations
  • Inserm (FR)
  • University of Ottawa (CA)
  • Rigshospitalet (DK)
Corresponding author
Boutron, Isabelle
Venue
PLoS Medicine
Published
2007-02-20
Volume
4
Issue
2
Pages
e61
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
OpenAlex
W2118789584
Cited by
389
References
55
Citations by year
2026: 34 · 2025: 27 · 2024: 14 · 2023: 21 · 2022: 20 · 2021: 27 · 2020: 27 · 2019: 24 · 2018: 36 · 2017: 17 · 2016: 16 · 2015: 24 · 2014: 20 · 2013: 20 · 2012: 18
FWCI
10.56
Type
journal article
Language
en
Open access
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
University of Ottawa
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords
blinding, randomization, non-pharmacological treatment, sham procedure, placebo, rehabilitation, psychotherapy, trial reporting quality
MeSH terms
Double-Blind Method, Humans, Research Design, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review