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• {"link"=>{"url"=>"http://www.citeulike.org/user/timsenior/article/12187269"}, "post_time"=>"2013-03-21 11:12:12", "tag"=>"placebo", "linkout"=>{"type"=>"DOI", "url"=>"http://dx.doi.org/10.1371/journal.pone.0058247"}, "username"=>"timsenior", "article_id"=>"12187269"}

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{"title"=>"Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners", "type"=>"journal", "authors"=>[{"first_name"=>"Jeremy", "last_name"=>"Howick", "scopus_author_id"=>"26221816200"}, {"first_name"=>"Felicity L.", "last_name"=>"Bishop", "scopus_author_id"=>"8572928700"}, {"first_name"=>"Carl", "last_name"=>"Heneghan", "scopus_author_id"=>"15020768600"}, {"first_name"=>"Jane", "last_name"=>"Wolstenholme", "scopus_author_id"=>"7006373221"}, {"first_name"=>"Sarah", "last_name"=>"Stevens", "scopus_author_id"=>"56354026200"}, {"first_name"=>"F. D.Richard", "last_name"=>"Hobbs", "scopus_author_id"=>"7005778918"}, {"first_name"=>"George", "last_name"=>"Lewith", "scopus_author_id"=>"7007030912"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84875166030", "doi"=>"10.1371/journal.pone.0058247", "pui"=>"368562510", "pmid"=>"23526969", "scopus"=>"2-s2.0-84875166030", "issn"=>"19326203", "isbn"=>"1932-6203"}, "id"=>"33a82f3b-9365-373b-93c4-9b308f5dc744", "abstract"=>"OBJECTIVES: Surveys in various countries suggest 17% to 80% of doctors prescribe 'placebos' in routine practice, but prevalence of placebo use in UK primary care is unknown.\\n\\nMETHODS: We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into 'pure' and 'impure'. 'Impure' placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. 'Pure' placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks.\\n\\nRESULTS: We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances.\\n\\nCONCLUSION AND IMPLICATIONS: Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.", "link"=>"http://www.mendeley.com/research/placebo-united-kingdom-results-national-survey-primary-care-practitioners-1", "reader_count"=>83, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>3, "Librarian"=>1, "Student > Doctoral Student"=>6, "Researcher"=>9, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>3, "Student > Master"=>18, "Other"=>5, "Student > Bachelor"=>14, "Lecturer"=>5}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>3, "Librarian"=>1, "Student > Doctoral Student"=>6, "Researcher"=>9, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>3, "Student > Master"=>18, "Other"=>5, "Student > Bachelor"=>14, "Lecturer"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Agricultural and Biological Sciences"=>6, "Philosophy"=>5, "Arts and Humanities"=>1, "Business, Management and Accounting"=>2, "Computer Science"=>2, "Nursing and Health Professions"=>2, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>36, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Sports and Recreations"=>2, "Psychology"=>15, "Social Sciences"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>36}, "Social Sciences"=>{"Social Sciences"=>2}, "Sports and Recreations"=>{"Sports and Recreations"=>2}, "Psychology"=>{"Psychology"=>15}, "Unspecified"=>{"Unspecified"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Neuroscience"=>{"Neuroscience"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>6}, "Computer Science"=>{"Computer Science"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Philosophy"=>{"Philosophy"=>5}}, "reader_count_by_country"=>{"United Kingdom"=>5, "Portugal"=>1, "Germany"=>1}, "group_count"=>5}

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• 3936024
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Journal Comments | Further Information

• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/d3c92ab6-9f43-47f7-8e8e-03efa2a2a041", "title"=>"Media Coverage of This Article", "body"=>"The following article represents some of the media coverage that has occurred for this paper:\n\nPublication: ABC.es \nTitle: “Los médicos también recetan placebo - Noticias de Salud | abc.es”\nhttp://www.abc.es/salud/noticias/medicos-tambien-recetan-placebo-14497.html\n\nPublication: Associated Press \nTitle: “Many UK doctors give useless drugs, treatments”\nhttp://bigstory.ap.org/article/many-uk-doctors-give-useless-drugs-treatments\n\nPublication: BBC Mundo \nTitle: “Recetar placebo es más común de lo que se cree - BBC Mundo - Noticias”\nhttp://www.bbc.co.uk/mundo/noticias/2013/03/130320_salud_placebo_medicos_gtg.shtml\n\nPublication: BBC News \nTitle: “BBC News - 'Most family doctors' have given a patient a placebo drug”\nhttp://www.bbc.co.uk/news/health-21834440\n\nPublication: Belfast Telegraph \nTitle: “Most doctors prescribe placebos - BelfastTelegraph.co.uk”\nhttp://www.belfasttelegraph.co.uk/news/local-national/uk/most-doctors-prescribe-placebos-29145391.html\n\nPublication: Channel 4 News \nTitle: “Placebo drugs in widespread use finds study - Channel 4 News”\nhttp://www.channel4.com/news/placebo-drugs-doctors-frequently-prescribed-stigma\n\nPublication: Daily Express \nTitle: “Doctors like to 'sugar the pill'”\nhttp://www.express.co.uk/news/health/385742/Doctors-like-to-sugar-the-pill\n\nPublication: Daily Mail \nTitle: “Nearly ALL doctors have given patients a placebo - either to keep them happy or reassure them”\nhttp://www.dailymail.co.uk/health/article-2296437/Nearly-ALL-doctors-given-patients-placebo-psychological-benefits.html\n\nPublication: Decoded Science \nTitle: “The Placebo Effect: Cures and Side Effects From Sugar Pills”\nhttp://www.decodedscience.com/the-placebo-effect-cures-and-side-effects-from-sugar-pills/27240\n\nPublication: EurekAlert \nTitle: “97 percent of UK doctors have given placebos to patients at least once”\nhttp://www.eurekalert.org/pub_releases/2013-03/uoo-9ou031813.php\n\nPublication: Everyday Health \nTitle: “U.K. Docs Often Prescribe Placebos To Patients, Study Finds”\nhttp://www.everydayhealth.com/healthy-living/uk-docs-often-prescribe-placebos-to-patients-study-finds-7173.aspx\n\nPublication: Express & Star \nTitle: “Most doctors prescribe placebos « Express & Star”\nhttp://www.expressandstar.com/news/2013/03/21/most-doctors-prescribe-placebos/\n\nPublication: Forbes \nTitle: “Is It Ethical For Doctors To Prescribe Placebo? - Forbes”\nhttp://www.forbes.com/sites/alicegwalton/2013/03/22/is-it-ethical-for-doctors-to-prescribe-placebo/\n\nPublication: Forskning.no \nTitle: “forskning.no > Nesten alle leger bruker placebo”\nhttp://www.forskning.no/artikler/2013/mars/351876\n\nPublication: Global Post \nTitle: “Many UK doctors have given a patient a placebo drug | GlobalPost”\nhttp://www.globalpost.com/dispatch/news/health/130321/many-uk-doctors-have-given-patient-placebo-drug\n\nPublication: Globe and Mail \nTitle: “Probing the power of placebos - The Globe and Mail”\nhttp://www.theglobeandmail.com/life/health-and-fitness/health-navigator/probing-the-power-of-placebos/article10014580/\n\nPublication: Health Canal \nTitle: “Health News - 97% of UK doctors have given placebos to patients at least once”\nhttp://www.healthcanal.com/drugs-approvals-trials/37172-doctors-have-given-placebos-patients-least-once.html\n\nIf you see any additional coverage of this paper in the press or blogosphere, please reply to this thread and add the link to the article. ", "isRemoved"=>false, "created"=>"2013-03-23T00:12:23Z", "lastModified"=>"2013-03-23T00:12:23Z", "creator"=>{"userId"=>"80539"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>true, "body"=>"PLOS ONE Staff"}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>2, "mostRecentActivity"=>"2013-04-01T19:07:26Z", "replies"=>[{"type"=>"REPLY", "parentID"=>63233, "annotationUri"=>"info:doi/10.1371/reply/ff4742f0-8985-4e18-8327-89706d4d17c8", "title"=>"RE: Media Coverage of This Article", "body"=>"The following article represents some of the media coverage that has occurred for this paper: \n\nPublication: Independent.ie \nTitle: “Most doctors prescribe placebos - Independent.ie”\nhttp://www.independent.ie/world-news/europe/most-doctors-prescribe-placebos-29145389.html\n\nPublication: JournalWatch \nTitle: “Placebo Prescribing High Among U.K. Primary Care Docs - Physician's First Watch”\nhttp://firstwatch.jwatch.org/cgi/content/full/2013/321/4\n\nPublication: Metro.co.uk \nTitle: “Sweetening the pill: 97 per cent of GPs give us placebos | Metro News”\nhttp://metro.co.uk/2013/03/20/sweetening-the-pill-97-per-cent-of-gps-give-us-placebos-3552644/\n\nPublication: Oxford Mail \nTitle: “Most doctors prescribe placebos (From Oxford Mail)”\nhttp://www.oxfordmail.co.uk/news/national/news/10303903.Most_doctors_prescribe_placebos/\n\nPublication: Pulse \nTitle: “Three quarters of GPs 'administer placebos once a week' | News Article | Pulse Today”\nhttp://www.pulsetoday.co.uk/clinical/three-quarters-of-gps-administer-placebos-once-a-week/20002366.article\n\nPublication: Round News \nTitle: “Several Family Doctors Admit To Giving Patients Placebo Drugs”\nhttp://www.roundnews.com/health/medicine/1166-several-family-doctors-admit-to-giving-patients-placebo-drugs.html\n\nPublication: Science 2.0 \nTitle: “UK Doctors Who Have Given Placebos: 97 Percent”\nhttp://www.science20.com/news_articles/uk_doctors_who_have_given_placebos_97_percent-107081\n\nPublication: Scinexx \nTitle: “scinexx | Placebos vom Hausarzt sind kein Einzelfall: Studie: 97 Prozent der Mediziner geben zu, schon Scheinbehandlungen durchgeführt oder verordnet zu haben - Placebo, Arzt, Patient, Scheinbehandlung, Psychologie, Arzneimittel, Scheinmedikament, Placebo”\nhttp://www.scinexx.de/wissen-aktuell-15811-2013-03-21.html\n\nPublication: Southern Daily Echo \nTitle: “Most doctors have prescribed placebo (From Daily Echo)”\nhttp://www.dailyecho.co.uk/news/10303784.Most_doctors_have_prescribed_placebo/\n\nPublication: The Independent \nTitle: “The placebo effect: doctors admit prescribing unproven treatments, unnecessary tests and pills with no active ingredient - Health News - Health & Families - The Independent”\nhttp://www.independent.co.uk/life-style/health-and-families/health-news/the-placebo-effect-doctors-admit-prescribing-unproven-treatments-unnecessary-tests-and-pills-with-no-active-ingredient-8542666.html\n\nPublication: The Standard \nTitle: “Unethical British doctors prescribe dummy drugs - The Standard”\nhttp://www.thestandard.com.hk/breaking_news_detail.asp?id=33720&icid=a&d_str=\n\nPublication: The Times \nTitle: “Placebos work. Is that so hard to swallow? | The Times”\nhttp://www.thetimes.co.uk/tto/opinion/columnists/article3718750.ece\n\nPublication: The Times \nTitle: “Most doctors admit to using sugar pills or other placebos | The Times”\nhttp://www.thetimes.co.uk/tto/health/news/article3718861.ece\n\nPublication: The Washington Post \nTitle: “Many UK doctors give patients useless drugs, treatments; authorities say that's unethical - The Washington Post”\nhttp://www.washingtonpost.com/world/europe/many-uk-doctors-give-patients-useless-drugs-treatments-authorities-say-thats-unethical/2013/03/20/da5f1376-9194-11e2-9173-7f87cda73b49_story.html\n\nIf you see any additional coverage of this paper in the press or blogosphere, please reply to this thread and add the link to the article.", "isRemoved"=>false, "created"=>"2013-03-23T00:13:02Z", "lastModified"=>"2013-03-23T00:13:02Z", "creator"=>{"userId"=>"80539"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>true, "body"=>"PLOS ONE Staff"}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-03-23T00:13:02Z", "replies"=>[]}, {"type"=>"REPLY", "parentID"=>63233, "annotationUri"=>"info:doi/10.1371/reply/f1adab8d-3b94-4aec-b7eb-b5b9d1ce0663", "title"=>"RE: Media Coverage of This Article", "body"=>"The following article represents some of the media coverage that has occurred for this paper:\n\nPublication: The Miami Herald \nTitle: “LONDON: Many UK doctors give useless drugs, treatments”\nhttp://www.miamiherald.com/2013/03/21/3297984/many-uk-doctors-give-useless-drugs.html\n\nPublication: Health Hub \nTitle: “Most GPs admit giving placebos: UK study”\nhttp://health.msn.co.nz/healthnews/8631790/most-gps-admit-giving-placebos-uk-study\n\nPublication: The Guardian \nTitle: “The ethicality of prescribing placebos”\nhttp://www.guardian.co.uk/science/sifting-the-evidence/2013/mar/25/ethicality-of-prescribing-placebos\n\nIf you see any additional coverage of this paper in the press or blogosphere, please reply to this thread and add the link to the article. \n", "isRemoved"=>false, "created"=>"2013-04-01T19:07:26Z", "lastModified"=>"2013-04-01T19:07:26Z", "creator"=>{"userId"=>"80539"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>true, "body"=>"PLOS ONE Staff"}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-04-01T19:07:26Z", "replies"=>[]}]}
• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/c723ce2c-cd6a-4ed0-b936-63731f52fb9f", "title"=>"Impure placebo as an unsound concept and other problems in the paper by Howick et al. ", "body"=>"Howick et al. have reported the findings of a survey that addressed the use of placebos among primary care practitioners in the United Kingdom. (1) They adopted methodology similar to that used in previous studies performed in other countries; however, the use of this approach also means that they repeated the conceptual confusion of the previous surveys. (2,3,4) Therefore the findings are not useful. \n\nFirst, although the authors acknowledge the conceptual problems related to placebos and placebo effects, they fail to consider the fundamental importance of these problems in their paper. They write for example: “... placebos are often characterized as inactive and nonspecific when in fact they can be active, and have specific effects, especially for relieving pain.” The essential difference between “giving a placebo” and “the placebo effect” (3,4) is not considered in their paper. By definition, a “placebo” means an inert substance. (5) The “placebo effect” is produced by other factors involved, such as expectancy, behavioral conditioning and the quality of the patient–physician relationship, (6) but not by the inert placebo. Inert substances and methods cannot have “specific” – or “unspecific” – effects by themselves. Because of the misleading nature of the term “placebo effect”, other terms have been proposed to describe the phenomenon in clinical practice, including “care effect”, (3) “contextual healing”, (7) and “meaning response”. (8) \n\nSecond, the authors wrote that they “adopted a pragmatic approach and asked physicians whether they used various treatments described as placebos in other similar surveys.” They justified this approach by claiming that their “approach has the advantage of being useful: patients, doctors, and policy makers care more about whether particular treatments are effective and ethical than whether these treatments carry the label ‘placebo’”. What the authors did, however, was to survey the frequency of the usage of placebos. Frequency of usage does not tell us anything about effectiveness, and it cannot act as a guide for policy makers about whether the “use of placebos” should be increased or decreased.\n\nThird, the authors introduced a novel concept “ethical placebo” but did not elaborate it in any respect. At the end of their paper, they concluded that “further investigations are warranted to develop ethical and cost-effective placebos.” Given that, by definition, a “placebo” is inert, (5) it is not clear what the authors mean with their comment. Concealed use of inert substances or methods is deceiving and unethical. For example, the Council on Ethical and Judicial Affairs of the American Medical Association states that it “may undermine trust, compromise the patient–physician relationship, and result in medical harm to the patient”. (9)\n\nA few studies on the open-label use of placebos have indicated that a beneficial response is not necessarily limited to settings in which patients are deceived. (10,11,12) However, open-label use of pure placebos remains a special case, and no general recommendations can yet be given. Problems related to so-called impure placebos are described below.\n\nFourth, the only findings of the survey that make any sense are the figures describing the use of “pure placebos”. However, even in this respect the findings leave many questions open. The authors wrote that pure placebos mean “interventions such as sugar pills ... or saline injections without direct pharmacologically active ingredients for the condition being treated.” The questionnaire asked “respondents to note how frequently (if at all) they used placebo interventions”. According to the results, 12% of the respondents reported using pure placebos at least once in their career. It is not clear what the term “using” covered. Did the respondents mean 1) writing a formal prescription for a pure placebo without informing the patient that the physician believed it to be pharmacologically ineffective, 2) giving the patient pure placebos directly from the physician’s office, 3) verbally suggesting that the patient might test a treatment the physician considered ineffective, or 4) allowing the patient to use, for example, alternative medicine treatments that the physician considered useless. All of these four options are very different types of situations, and some are clearly unethical, whereas some are less so. (2) Furthermore, even though 12% of the respondents reported using pure placebos at least once in their career, only 0.9% reported using them frequently. Since the use of pure placebos implies the misleading of patients, and misleading patients is unethical, (9) we conclude that less than 1% of general practitioners in the UK are frequently unethical in this sense.\n\nFifth, the authors adopted the concept “impure placebo” uncritically from earlier research, and they ignored the confusion created by the use of this concept in empirical studies. (2) They defined impure placebos as “substances, interventions or ‘therapeutic’ methods which have known pharmacological, clinical or physical value for some ailments but lack specific therapeutic effects or value for the condition for which they have been prescribed”. They gave examples of impure placebos, such as positive suggestions, probiotics for diarrhea, antibiotics for suspected viral infections, off-label uses of potentially effective therapies, conventional medicine whose effectiveness is not evidence-based, non-essential physical examinations, and non-essential technical examinations of the patient (blood tests, X-rays). Their list had a few more items, and, at the bottom of Table 2, they gave 11 more items that they classified as “impure placebos”.\n\nWe cannot see any justification for classifying all the preceding examples under the singular heading of “impure placebo”, let alone classifying all of them together with the “pure placebos” under the higher level heading “placebos”. All of their examples are problematic in some sense. To save space, we will not comment on all two dozen items in the authors' lists, but a few examples follow: \n\na) Positive suggestions\nUtterances like “you will certainly feel better in a few days” belong to normal good physician–patient relationships and do not “lack ... value for the condition for which they have been prescribed”. \n\nb) Probiotics for diarrhea \nThere is evidence that probiotics have preventive, as well as curative, effects on some types of diarrhea (13,14). Why have the authors ignored this evidence?\n\nc) Antibiotics for suspected viral infections\nMost respiratory infections are viral in origin, but laboratory tests are seldom made to confirm the etiology. Many patients have both viruses and bacteria simultaneously, and it is usually not possible to determine for certain whether antibiotics are ineffective. (4,15,16) A decision to prescribe antibiotics is often based on the probability of bacterial infection, and the duration of symptoms is one of the associated factors that physicians consider. Thus the use of antibiotics for acute respiratory tract infections cannot be classified uniformly as placebo treatment.\n\nd) Off-label uses of potentially effective therapies\nThe official process of approving pharmaceuticals has legal and commercial components, and it is only partly based on scientific evidence. Off-label use – prescribing for an unapproved indication or an unapproved age group – is common practice, for example, in pediatrics and intensive care. There is no justification to classify off-label treatments as placebo interventions. \n\ne) Conventional medicine whose effectiveness is not evidence-based \n“Evidence-based medicine” (EBM) is a problematic term that dichotomizes medicine artificially into two fields: EBM and non-EBM. There are many definitions of EBM, but they are vague and do not provide an unambiguous demarcation line between the EBM and non-EBM sectors of medicine. We agree with Timmermans and Mauck, who noted that “The term is loosely used and can refer to anything from conducting a statistical meta-analysis of accumulated research, to promoting randomized clinical trials, to supporting uniform reporting styles for research, to a personal orientation toward critical self-evaluation.” (17) Thus the EBM or non-EBM division is irrelevant to the question of what is or is not a placebo.\n\nf) Non-essential physical examinations and non-essential technical examinations of a patient (blood tests, X-rays)\nIt is often not obvious what physical or technical examinations are useful for a particular patient. All experienced physicians recall cases in which an examination that originally seemed non-essential unexpectedly revealed important findings. In some cases, it is the pressure of the patient that leads to an examination or X-ray being made. It is not reasonable to classify such examinations as placebo interventions.\n\nIn conclusion, the paper’s main finding “placebos are commonly used in UK primary care” is not correct. Only 0.9% of the responding general practitioners reported using pure placebos frequently. The frequency with which impure placebos are used is irrelevant because the concept is useless, as described above. \nMisleading a patient by administering inert substances without the explicit consent of the patient is unethical. The authors' proposal to “develop ethical and cost-effective placebos” is not possible because saving money by misleading patients is unethical. There is substantial conceptual confusion in the area of placebo and placebo-effect research, and the paper by Howick et al. does not help to reduce this confusion. \n\n\nReferences: \n\n1. Howick J, Bishop FL, Heneghan C, Wolstenholme J, Stevens S, et al. (2013) Placebo use in the United Kingdom: results from a national survey of primary care practitioners. PLoS ONE 8(3): e58247.\nhttp://dx.doi.org/10.1371/journal.pone.0058247\n\n2. Louhiala P (2012) What do we really know about the deliberate use of placebos in clinical practice? J Med Ethics 38:403-405. \nhttp://dx.doi.org/10.1136/medethics-2011-100420\n\n3. Louhiala P, Puustinen R (2008) Rethinking the placebo effect. Med Humanities 34:107-109. http://dx.doi.org/10.1136/jmh.2008.000307\n\n4. Louhiala P (2009) The ethics of the placebo in clinical practice revisited. J Med Ethics 35: 407-409.\nhttp://dx.doi.org/10.1136/jme.2008.028225\n\n5. Placebo. In: Oxford English Dictionary.\n http://www.oed.com\n\n6. Enck P, Bingel U, Schedlowski M, Rief W (2013) The placebo response in medicine: minimize, maximize or personalize? Nat Rev Drug Discov 12:191-204. \nhttp://dx.doi.org/10.1038/nrd3923\n\n7. Miller F, Kaptchuk T (2008) The power of context: reconceptualizing the placebo effect. J R Soc Med 101:222-225.\nhttp://dx.doi.org/10.1258/jrsm.2008.070466\n\n8. Moerman D (2002) Meaning, medicine and the ’placebo effect’. Cambridge: Cambridge University Press.\n\n9. American Medical Association Council on Ethical and Judicial Affairs. Placebo use in clinical practice [internet]. \nhttp://www.ama-assn.org/ama1/pub/upload/mm/369/ceja_recs_2i06.pdf\n\n10. Park LC, Covi U (1965) Nonblind placebo trial: an exploration of neurotic patients’ responses to placebo when its inert content is disclosed. Arch Gen Psychiatry 12:36–45.\nhttp://dx.doi.org/10.1001/archpsyc.1965.01720340008002\n\n11. Aulas JJ, Rosner I (2003) Effets de la prescription d’un placebo “annoncé”. [Efficacy of a\nnon-blind placebo prescription; in French]. Encephale 29:68-71.\nhttp://www.ncbi.nlm.nih.gov/pubmed/12640329\n\n12. Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, et al. (2010) Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE 5(12): e15591.\n http://dx.doi.org/10.1371/journal.pone.0015591\n\n\n13. de Vrese M, Marteau PR (2007) Probiotics and prebiotics: effects on diarrhea. J Nutr 137: 803S-811S.\nhttp://jn.nutrition.org/content/137/3/803S\n\n14. Allen SJ, Martinez EG, Gregorio GV, Dans LF (2010) Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev (11): CD003048.\nhttp://dx.doi.org/10.1002/14651858.CD003048.pub3\n\n15. Young J, De Sutter A, Merenstein D, et al. (2008) Antibiotics for adults with clinically diagnosed acute rhinosinusitis: a meta-analysis of individual patient data. Lancet 371:908-14.\nhttp://dx.doi.org/10.1016/S0140-6736(08)60416-X\n\n16. Kaiser L, Lew D, Hirschel B, et al. (1996) Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions. Lancet 347:1507-10.\nhttp://dx.doi.org/10.1016/S0140-6736(96)90670-4\n\n17. Timmermans S, Mauck A (2005) The promises and pitfalls of evidence-based medicine. Health Affairs 24:18-28.\nhttp://dx.doi.org/10.1377/hlthaff.24.1.18\n\n\nAuthors:\n\nPekka Louhiala, Department of Public Health, University of Helsinki, Finland, pekka.louhiala@helsinki.fi \n\nRaimo Puustinen, Department of General Practice, Medical School, University of Tampere, Finland, raimo.puustinen@uta.fi \n\nHarri Hemilä, Department of Public Health, University of Helsinki, Finland, pekka.louhiala@helsinki.fi ", "isRemoved"=>false, "created"=>"2013-04-18T05:13:16Z", "lastModified"=>"2013-04-18T05:13:16Z", "creator"=>{"userId"=>"23731"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-04-18T05:13:16Z", "replies"=>[]}
• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/fe9cca57-f551-419b-aa67-1983611ba25d", "title"=>"Howick et al. beg the question", "body"=>"The distinction in Howick et al. between \"pure\" and \"inert\" placebos leads the authors to conclude that the use of placebos is widespread. The term \"inert placebo\" as employed by Howick et al. is paradoxical since they use it to refer to treatments that are not pharmacologically inert. Hitherto, by definition, a placebo has been understood to be a pharmacologically inert substance employed as a treatment for psychological reasons or as a control in clinical trials.\n\nThe authors do not justify their new terminology, they adopt it by fiat. Their study does not present evidence of widespread use of \"pure\" placebos: Which is to say, placebos as hitherto understood are not in widespread use. It is their new category of \"inert\" placebos that are not inert, which are found to be in widespread use: Treatments not hitherto considered to be placebos at all.\n\nThe authors must justify the paradoxical extension of the term \"placebo\" to include pharmacologically active treatments, in order to justify their claim that placebos are in widespread medical use.", "isRemoved"=>false, "created"=>"2013-07-21T09:22:21Z", "lastModified"=>"2013-07-21T09:22:21Z", "creator"=>{"userId"=>"355185"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-07-21T09:22:21Z", "replies"=>[]}
• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/e84a1a9b-9318-4ac0-a099-2749c6f109b4", "title"=>"Howick et al. beg the question", "body"=>"For \"inert\" read \"impure\".", "isRemoved"=>false, "created"=>"2013-07-21T09:35:30Z", "lastModified"=>"2013-07-21T09:35:30Z", "creator"=>{"userId"=>"355185"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-07-21T09:35:30Z", "replies"=>[]}
• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/9182d304-3cfa-4ea2-9af4-22ac6ecd3089", "title"=>"Problems with the concept \"impure placebo\"", "body"=>"Our 18 April 2013 comments were formulated to a regular paper:\nLouhiala P1, Hemilä H, Puustinen R. \nImpure placebo is a useless concept. \nTheor Med Bioeth. 2015 Aug;36(4):279-89\nhttp://www.ncbi.nlm.nih.gov/pubmed/26215744\nhttp://dx.doi.org/10.1007/s11017-015-9336-6\n", "isRemoved"=>false, "created"=>"2015-08-30T21:07:53Z", "lastModified"=>"2015-08-30T21:07:53Z", "creator"=>{"userId"=>"23731"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0058247", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2015-08-30T21:07:53Z", "replies"=>[]}

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• {"id"=>"1036263948935258112", "text"=>"RT @AbelNovoa: @limoia @el_pais https://t.co/6lqRh6C5sQ la utilizaci?n de productos con intenci?n de activar el efecto placebo es muy frecu…", "created_at"=>"2018-09-02T14:45:52Z", "user"=>"Firefly_fan", "user_name"=>"Marc Casa?as Escarr?", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1009364643377229824/S1_-OtbZ_normal.jpg"}
• {"id"=>"314504129454161921", "text"=>"@PeteDeveson http://t.co/WoGAYYEgkc", "created_at"=>"2013-03-20T22:30:02Z", "user"=>"clarercgp", "user_name"=>"Clare Gerada", "user_profile_image"=>"http://a0.twimg.com/profile_images/2826305871/c277f3a4885adaa3118f7a507a7fb027_normal.png"}
• {"id"=>"314504316692070400", "text"=>"@tuwituwo @jackiecassell @PeteDeveson @BBCr4today @mgtmccartney http://t.co/WoGAYYEgkc", "created_at"=>"2013-03-20T22:30:46Z", "user"=>"clarercgp", "user_name"=>"Clare Gerada", "user_profile_image"=>"http://a0.twimg.com/profile_images/2826305871/c277f3a4885adaa3118f7a507a7fb027_normal.png"}
• {"id"=>"314632025883701248", "text"=>".@mgtmccartney @clarercgp @janedreaper Here’s the paper http://t.co/jb7QeOcugk They call antibiotics ‘impure’ placebos", "created_at"=>"2013-03-21T06:58:15Z", "user"=>"mellojonny", "user_name"=>"Jonathon Tomlinson", "user_profile_image"=>"http://a0.twimg.com/profile_images/361890051/support_nhs_normal.png"}
• {"id"=>"314632641007738880", "text"=>"RT @mellojonny: .@mgtmccartney @clarercgp @janedreaper Here’s the paper http://t.co/jb7QeOcugk They call antibiotics ‘impure’ placebos", "created_at"=>"2013-03-21T07:00:41Z", "user"=>"eczemasupport", "user_name"=>"Nottingham Eczema", "user_profile_image"=>"http://a0.twimg.com/profile_images/522162557/N_normal.jpg"}
• {"id"=>"314639668031401984", "text"=>"英国の医師の97パーセントが、医師になってから少なくとも一回は患者にプラセボを与えたことがあると答えた。\n【Eurek Alert!】http://t.co/RFFH1SwSNh　\n【PLoS ONE】\nhttp://t.co/gMwI7MuwWP", "created_at"=>"2013-03-21T07:28:37Z", "user"=>"kojima_aponet", "user_name"=>"小嶋 慎二＠アポネット", "user_profile_image"=>"http://a0.twimg.com/profile_images/1864221167/aponet_profile_normal.jpg"}
• {"id"=>"314640989123915776", "text"=>"Table from the @PLOSMedicine placebo paper, note numbers for sugar pills and touch http://t.co/jb7QeOcugk @clarercgp @janedreaper", "created_at"=>"2013-03-21T07:33:52Z", "user"=>"mellojonny", "user_name"=>"Jonathon Tomlinson", "user_profile_image"=>"http://a0.twimg.com/profile_images/361890051/support_nhs_normal.png"}
• {"id"=>"314647931942735872", "text"=>"RT @mellojonny: Table from the @PLOSMedicine placebo paper, note numbers for sugar pills and touch http://t.co/jb7QeOcugk @clarercgp @ja ...", "created_at"=>"2013-03-21T08:01:27Z", "user"=>"SpencerProf", "user_name"=>"Professor Spencer", "user_profile_image"=>"http://a0.twimg.com/profile_images/3117093117/ec5822ccf805501d6dd6479f203c50b3_normal.jpeg"}
• {"id"=>"314648729217011712", "text"=>"#PLOSONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/9Wk1kPQnBk", "created_at"=>"2013-03-21T08:04:37Z", "user"=>"curtrice", "user_name"=>"Curt Rice", "user_profile_image"=>"http://a0.twimg.com/profile_images/2344105032/jvzhjoq08txm3rv1etb8_normal.jpeg"}
• {"id"=>"314656004090499072", "text"=>"97 Percent of UK Doctors Have Given Placebos to Patients at Least Once (faut-il s'en réjouir) http://t.co/p6wvCopvlP", "created_at"=>"2013-03-21T08:33:32Z", "user"=>"GosnatM", "user_name"=>"Muriel Gosnat", "user_profile_image"=>"http://a0.twimg.com/sticky/default_profile_images/default_profile_1_normal.png"}
• {"id"=>"314667331915751424", "text"=>"This is the paper on placebo use by GPs in UK @PLOSMedicine http://t.co/kxUyqzR5YW", "created_at"=>"2013-03-21T09:18:32Z", "user"=>"SwanSessGPs", "user_name"=>"SwanseaSessionalGPs", "user_profile_image"=>"http://a0.twimg.com/profile_images/1457536789/SSGP4_normal.jpg"}
• {"id"=>"314672954090856450", "text"=>"97% of UK doctors have prescribed 'pure' placebo at least once; but only 1% do so once a week: http://t.co/3iRf8puzXK via @Psych_Writer", "created_at"=>"2013-03-21T09:40:53Z", "user"=>"StuartJRitchie", "user_name"=>"Stuart Ritchie", "user_profile_image"=>"http://a0.twimg.com/profile_images/3321369651/fdac9826c8b0cdb4f58ad417f5e71717_normal.jpeg"}
• {"id"=>"314672998336561152", "text"=>"What do you think are the potential implications of this, outcome and/or ethics-wise? http://t.co/ciHXcOq1Hd", "created_at"=>"2013-03-21T09:41:03Z", "user"=>"DMpohlmann", "user_name"=>"DMpohlmann", "user_profile_image"=>"http://a0.twimg.com/profile_images/1337860936/image_normal.jpg"}
• {"id"=>"314680653021057024", "text"=>"97% of GPs in UK have given sugar pill or other placebo to patients http://t.co/VqZXeO6xuH but they only want to help http://t.co/6y5m9TY3lJ", "created_at"=>"2013-03-21T10:11:28Z", "user"=>"IvorGoodbody", "user_name"=>"Ivor Goodbody", "user_profile_image"=>"http://a0.twimg.com/profile_images/1762170479/IvorG_PictoPaint_normal.jpg"}
• {"id"=>"314683470582530048", "text"=>"Placebo Use in the UK: Results from a National Survey of Primary Care Practitioners http://t.co/HTMIN93Vrz", "created_at"=>"2013-03-21T10:22:40Z", "user"=>"silParacchini", "user_name"=>"Silvia Paracchini", "user_profile_image"=>"http://a0.twimg.com/profile_images/1419510064/DSC_8726_normal.JPG"}
• {"id"=>"314687022482731008", "text"=>"Must avoid the 0.6% of GPs who think sugar pill \"is not a placebo\". Even Mary Poppins used medicine with her sugar.\nhttp://t.co/ZbziRi98TW", "created_at"=>"2013-03-21T10:36:47Z", "user"=>"cambo81", "user_name"=>"Camilla Halewood", "user_profile_image"=>"http://a0.twimg.com/profile_images/1337214265/_UNSET__normal.jpg"}
• {"id"=>"314697294907858944", "text"=>"77% of GPs use impure placebos on a weekly basis - take that Evidenced Based Medicine! http://t.co/Ad1jOydlHO", "created_at"=>"2013-03-21T11:17:36Z", "user"=>"in_psych", "user_name"=>"Dr JH", "user_profile_image"=>"http://a0.twimg.com/profile_images/1671176713/joe_normal.jpg"}
• {"id"=>"314700616930820096", "text"=>"Come on doc own up! You never did give me anything for that rash did you? via@PlosOne 97% of UK drs give placebos http://t.co/RZ2mTsCRAK", "created_at"=>"2013-03-21T11:30:48Z", "user"=>"JournoLil", "user_name"=>"Lilian Anekwe", "user_profile_image"=>"http://a0.twimg.com/profile_images/2855868617/db59bb6b3fb0afdf6daf199d30df6128_normal.jpeg"}
• {"id"=>"314716707736391682", "text"=>"Every doc uses placebos. Cuz they work, on some level. Time for real discussion around this http://t.co/0W5ZXUVQse", "created_at"=>"2013-03-21T12:34:44Z", "user"=>"gforbes", "user_name"=>"gforbes", "user_profile_image"=>"http://a0.twimg.com/profile_images/2268728960/7qm0st0csf0rn76r3uoo_normal.jpeg"}
• {"id"=>"314725674931859456", "text"=>"MT @mellojonny: Table from the @PLOSMedicine placebo paper, note numbers for sugar pills and touch http://t.co/xaNgY27Wcn", "created_at"=>"2013-03-21T13:10:22Z", "user"=>"medskep", "user_name"=>"Medicalskeptic", "user_profile_image"=>"http://a0.twimg.com/profile_images/1394688432/IMAG0474-1_normal.jpg"}
• {"id"=>"314729837615001601", "text"=>"Placebo Use in the United Kingdom: 77% of docs use some placebo treatment every week. http://t.co/7aOA6TncML", "created_at"=>"2013-03-21T13:26:55Z", "user"=>"dominof", "user_name"=>"dominof", "user_profile_image"=>"http://a0.twimg.com/profile_images/2566084927/image_normal.jpg"}
• {"id"=>"314736034711736320", "text"=>"#UK Primary Care Docs Prescribing #Placebo @PLOS ONE http://t.co/jjnDFMWZUh", "created_at"=>"2013-03-21T13:51:32Z", "user"=>"ba_steinberg", "user_name"=>"Benjamin Steinberg", "user_profile_image"=>"http://a0.twimg.com/profile_images/582390609/images_normal.jpg"}
• {"id"=>"314737925512376321", "text"=>"Headline gist: ‘Most GPs have given placebo drugs’\nExample news report: http://t.co/ZcTaNliE9X\nResearch: http://t.co/CFuxMOCFPM", "created_at"=>"2013-03-21T13:59:03Z", "user"=>"ThePapersBehind", "user_name"=>"The Papers Behind…", "user_profile_image"=>"http://a0.twimg.com/profile_images/2585898049/image_normal.jpg"}
• {"id"=>"314750121269141505", "text"=>"Did you hear the news story today about placebos? Here's the study they were talking about: Placebo use in the UK: http://t.co/NvEivAG7am", "created_at"=>"2013-03-21T14:47:31Z", "user"=>"LULHealthTeam", "user_name"=>"LUL Health Team", "user_profile_image"=>"http://a0.twimg.com/profile_images/2609247387/19c9alvs9bvp9m3ccmve_normal.jpeg"}
• {"id"=>"314750639890640897", "text"=>"Links to today's media stories: Placebos and Autism on our Facebook page http://t.co/nS5veUlwKX", "created_at"=>"2013-03-21T14:49:34Z", "user"=>"bedshertslmcs", "user_name"=>"bedshertslmcs", "user_profile_image"=>"http://a0.twimg.com/profile_images/2780455007/3ec58f294eef253a46be7cd0c2cc835f_normal.png"}
• {"id"=>"314782318814457857", "text"=>"97% of GPs in #Britain use \"impure placebos\" like \"non-essential physical exams\" & unnecessary antibiotics http://t.co/g1mvipFXjy", "created_at"=>"2013-03-21T16:55:27Z", "user"=>"biggpix", "user_name"=>"Bigg", "user_profile_image"=>"http://a0.twimg.com/profile_images/2778909718/2d198e61491185b62cbd04fd707ed506_normal.jpeg"}
• {"id"=>"314783821558054913", "text"=>"The power & controversy over #placebos. 3 out of 4 British #doctors use them at least once a week. #healthcare http://t.co/I3W7B0HoLk", "created_at"=>"2013-03-21T17:01:26Z", "user"=>"JimmyChungMD", "user_name"=>"Jimmy Chung, M.D.", "user_profile_image"=>"http://a0.twimg.com/profile_images/2179430958/210679_1__normal.jpg"}
• {"id"=>"314791669524492288", "text"=>"Very interesting study in #PLOSONE on placebo use in UK #nhs #primarycare RP http://t.co/cXCcvHe873", "created_at"=>"2013-03-21T17:32:37Z", "user"=>"cchsr", "user_name"=>"CCHSR", "user_profile_image"=>"http://a0.twimg.com/profile_images/2987018179/90af8d3563668302d91f17150109ec7c_normal.png"}
• {"id"=>"314798717964255232", "text"=>"@ilocinetweet @ami89_pharma La prescription de placebo par les médecins britanniques http://t.co/rn0jXbiwDr", "created_at"=>"2013-03-21T18:00:37Z", "user"=>"Fraslin", "user_name"=>"Jean-Jacques Fraslin", "user_profile_image"=>"http://a0.twimg.com/profile_images/3348796032/d2d00275d03553d41e952b11e47cd8f3_normal.jpeg"}
• {"id"=>"314818293158526976", "text"=>"PLOS ONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practiti http://t.co/jpEicdDfe8", "created_at"=>"2013-03-21T19:18:24Z", "user"=>"michaelscally", "user_name"=>"Michael Scally", "user_profile_image"=>"http://a0.twimg.com/profile_images/1408389009/scally_image_normal.png"}
• {"id"=>"314818783342637056", "text"=>"PLOS ONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/JtB53t1iwy", "created_at"=>"2013-03-21T19:20:21Z", "user"=>"13_tatari", "user_name"=>"悶絶たたりちゃん。", "user_profile_image"=>"http://a0.twimg.com/profile_images/1808008523/2406_normal.gif"}
• {"id"=>"314833172758147073", "text"=>"'Most family doctors' have given a patient a placebo drug http://t.co/d3wPDkOzMs article by @cebmblog here http://t.co/BmakFLz30p", "created_at"=>"2013-03-21T20:17:32Z", "user"=>"peterjgill", "user_name"=>"Peter Gill", "user_profile_image"=>"http://a0.twimg.com/profile_images/2759215851/8f03bf47dd6a936a4fe9a45c838f3494_normal.png"}
• {"id"=>"314852040285237250", "text"=>"17-80% van Britse huisartsen schrijven placebo's voor. Echter, wel een bizarre definitie van placebo. http://t.co/J3TF8a723t", "created_at"=>"2013-03-21T21:32:30Z", "user"=>"JochenCals", "user_name"=>"JochenCals", "user_profile_image"=>"http://a0.twimg.com/profile_images/3113874138/679a258f5f83faadb44e91c9693e0c85_normal.jpeg"}
• {"id"=>"314931286890393600", "text"=>"Survey found placebo use is up to 97% among UK general practitioners. http://t.co/oSrp9e7PSU #Journal #PLoSONE", "created_at"=>"2013-03-22T02:47:24Z", "user"=>"pawinpawin", "user_name"=>"Pawin Numthavaj", "user_profile_image"=>"http://a0.twimg.com/profile_images/2630745885/24953c5fe5976046e8c3f97fe27028c0_normal.png"}
• {"id"=>"314933408956575745", "text"=>"RT @pawinpawin: Survey found placebo use is up to 97% among UK general practitioners. http://t.co/oSrp9e7PSU #Journal #PLoSONE", "created_at"=>"2013-03-22T02:55:50Z", "user"=>"fonlac24", "user_name"=>"ฝนวรา", "user_profile_image"=>"http://a0.twimg.com/profile_images/3404804591/ad27938ea160b4c639c6cbf770b8d54e_normal.jpeg"}
• {"id"=>"314938989297676288", "text"=>"RT @pawinpawin: Survey found placebo use is up to 97% among UK general practitioners. http://t.co/oSrp9e7PSU #Journal #PLoSONE", "created_at"=>"2013-03-22T03:18:00Z", "user"=>"Maymupmip", "user_name"=>"May Parinya", "user_profile_image"=>"http://a0.twimg.com/profile_images/3405742998/ce6b01b0bd4bbd1aac7335adb657b7fe_normal.jpeg"}
• {"id"=>"314940738150465537", "text"=>"#PLOSONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/hCdl40cnDI", "created_at"=>"2013-03-22T03:24:57Z", "user"=>"gd21a7", "user_name"=>"Hasan ZEYTIN", "user_profile_image"=>"http://a0.twimg.com/profile_images/2534454869/image_normal.jpg"}
• {"id"=>"314993504566788097", "text"=>"@GabrielScally @kerryhood The paper being discussed uses an expansive definition of placebo http://t.co/jb7QeOcugk", "created_at"=>"2013-03-22T06:54:38Z", "user"=>"mellojonny", "user_name"=>"Jonathon Tomlinson", "user_profile_image"=>"http://a0.twimg.com/profile_images/361890051/support_nhs_normal.png"}
• {"id"=>"314993860738703360", "text"=>"@Katiissick @clarercgp @leach_mick @NeilOConnell @mgtmccartney see the paper we’re discussing definition of placebo http://t.co/jb7QeOcugk", "created_at"=>"2013-03-22T06:56:03Z", "user"=>"mellojonny", "user_name"=>"Jonathon Tomlinson", "user_profile_image"=>"http://a0.twimg.com/profile_images/361890051/support_nhs_normal.png"}
• {"id"=>"315021170598617088", "text"=>"#PLOSONE: #Placebo Use in UK: National Survey of Primary Care Practitioners http://t.co/QQQc1OGGbj < causing quite a stir in the media...!", "created_at"=>"2013-03-22T08:44:34Z", "user"=>"lilylai", "user_name"=>"Lily Lai", "user_profile_image"=>"http://a0.twimg.com/profile_images/2670860717/c1bd6d3cee1b31cd41c8e33813b127d5_normal.jpeg"}
• {"id"=>"315036577334169600", "text"=>"#Placebo National GP survey article is open access here: http://t.co/rvldCp4TSN", "created_at"=>"2013-03-22T09:45:47Z", "user"=>"Acuandherbs", "user_name"=>"Lily Lai", "user_profile_image"=>"http://a0.twimg.com/profile_images/628441478/5_Element_Herb_Pots_normal.jpg"}
• {"id"=>"315045191314731010", "text"=>"How frequently do UK doctors give out placebos? You can find out thanks to this #OpenAccess @PLOSONE study http://t.co/BAEyiMbzq7", "created_at"=>"2013-03-22T10:20:01Z", "user"=>"crucifixkiss", "user_name"=>"Simon Li", "user_profile_image"=>"http://a0.twimg.com/profile_images/29451922/tux_normal.jpg"}
• {"id"=>"315047893289549824", "text"=>"@vancalmthout 17-80% van Britse huisartsen schrijven placebo's voor. Echter, wel een bizarre definitie van placebo. http://t.co/J3TF8a723t", "created_at"=>"2013-03-22T10:30:45Z", "user"=>"JochenCals", "user_name"=>"JochenCals", "user_profile_image"=>"http://a0.twimg.com/profile_images/3113874138/679a258f5f83faadb44e91c9693e0c85_normal.jpeg"}
• {"id"=>"315057940883202048", "text"=>"#PLOSONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/Kt3lA2Qmmn", "created_at"=>"2013-03-22T11:10:41Z", "user"=>"ml_int", "user_name"=>"MediLexicon Int", "user_profile_image"=>"http://a0.twimg.com/profile_images/1133842534/ml_int_twitter_normal.jpg"}
• {"id"=>"315104998558162945", "text"=>"@PennySarchet http://t.co/jr7oqRRiY1 (PLoS One) via http://t.co/MXudpsAcH0 (BBC).", "created_at"=>"2013-03-22T14:17:40Z", "user"=>"Zephyris", "user_name"=>"Richard Wheeler", "user_profile_image"=>"http://a0.twimg.com/profile_images/2855848193/b0cbfe832362f7eee17409c84da26798_normal.png"}
• {"id"=>"315117155463077888", "text"=>"Never happen here?\nPlacebo use and cost of the lie.\n\nhttp://t.co/BL63b6Y4TY", "created_at"=>"2013-03-22T15:05:59Z", "user"=>"DrBattistoni", "user_name"=>"Henry Battistoni", "user_profile_image"=>"http://a0.twimg.com/profile_images/2852399553/6b59e5312e735b8efde6184ded1e2217_normal.jpeg"}
• {"id"=>"315157891386589184", "text"=>"RT @JochenCals: 17-80% van Britse huisartsen schrijven placebo's voor. Echter, wel een bizarre definitie van placebo. http://t.co/J3TF8a723t", "created_at"=>"2013-03-22T17:47:51Z", "user"=>"sibylanthierens", "user_name"=>"sibyl anthierens", "user_profile_image"=>"http://a0.twimg.com/profile_images/1812898966/image_normal.jpg"}
• {"id"=>"315212377236836352", "text"=>"RT @DrBattistoni: Never happen here?\nPlacebo use and cost of the lie.\n\nhttp://t.co/BL63b6Y4TY", "created_at"=>"2013-03-22T21:24:21Z", "user"=>"RelyLocalAVL", "user_name"=>"RelyLocal Asheville", "user_profile_image"=>"http://a0.twimg.com/profile_images/3080618694/a941f9717953869828e4823322b3b035_normal.png"}
• {"id"=>"315214514800971777", "text"=>"RT @JochenCals: 17-80% van Britse huisartsen schrijven placebo's voor. Echter, wel een bizarre definitie van placebo. http://t.co/J3TF8a723t", "created_at"=>"2013-03-22T21:32:51Z", "user"=>"nsiriwardena", "user_name"=>"Niroshan Siriwardena", "user_profile_image"=>"http://a0.twimg.com/profile_images/1298122579/Niro_HF_20072_copy_normal.jpg"}
• {"id"=>"315260655777234944", "text"=>"From PLoS: UK Study reveals 97% of 783 doctors surveyed gave placebos - most thought it was ethical in some cases @ http://t.co/lf5oqIy3td", "created_at"=>"2013-03-23T00:36:12Z", "user"=>"ebvma", "user_name"=>"EBVMA Members", "user_profile_image"=>"http://a0.twimg.com/sticky/default_profile_images/default_profile_3_normal.png"}
• {"id"=>"315275599155445761", "text"=>"#PLOSONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/QODWbudykj", "created_at"=>"2013-03-23T01:35:35Z", "user"=>"homosaka", "user_name"=>"友坂真彩", "user_profile_image"=>"http://a0.twimg.com/profile_images/2239559130/1321532138938_normal.jpg"}
• {"id"=>"315614195297185793", "text"=>"Placebo Use in UK; 77% Used every Week http://t.co/7EcY7icGr8 http://t.co/Gh9wuQWZej", "created_at"=>"2013-03-24T00:01:02Z", "user"=>"medmore23", "user_name"=>"carlos alberto", "user_profile_image"=>"http://a0.twimg.com/profile_images/1088306650/9hZvGo151247-02_1__normal.jpg"}
• {"id"=>"315771901291143169", "text"=>"【AFPBB News】英開業医のほぼ全員「気休めの薬」処方経験あり　http://t.co/wojhnCNqbs \n 【Eurek Alert!】　http://t.co/RFFH1SwSNh\n 【PLoS ONE】 http://t.co/gMwI7MuwWP", "created_at"=>"2013-03-24T10:27:42Z", "user"=>"kojima_aponet", "user_name"=>"小嶋 慎二＠アポネット", "user_profile_image"=>"http://a0.twimg.com/profile_images/1864221167/aponet_profile_normal.jpg"}
• {"id"=>"315969966505590784", "text"=>"The original PlosONE article that caused all the furore last week on GP's prescribing placebo http://t.co/FAxy4zR2I6", "created_at"=>"2013-03-24T23:34:45Z", "user"=>"RamFernando1", "user_name"=>"Ram Fernando", "user_profile_image"=>"http://a0.twimg.com/profile_images/3349845428/cb26a31fada8c026204096ee37357ba8_normal.jpeg"}
• {"id"=>"315990865673875458", "text"=>"PLOS ONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/7pPLiIrTIs", "created_at"=>"2013-03-25T00:57:47Z", "user"=>"Nagapiii", "user_name"=>"ながぴい", "user_profile_image"=>"http://a0.twimg.com/profile_images/1096217489/nami4_normal.jpg"}
• {"id"=>"316194548042825728", "text"=>"@mgtmccartney @garwboy but according to their findings most doctors rated those things as placebo http://t.co/cKnSPlZDng see table 2.", "created_at"=>"2013-03-25T14:27:09Z", "user"=>"soozaphone", "user_name"=>"Suzi Gage", "user_profile_image"=>"http://a0.twimg.com/profile_images/2606113757/xgl7y4dzzyotcfqfvwod_normal.jpeg"}
• {"id"=>"316217995779264512", "text"=>"今日の英語：できればこれ。\nPlacebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners\nhttp://t.co/7eNt1PmUz6", "created_at"=>"2013-03-25T16:00:19Z", "user"=>"chiruru", "user_name"=>"Hiroko Yoshida", "user_profile_image"=>"http://a0.twimg.com/profile_images/3348833851/ce25c775a2f94dbf4e4161278b6bad30_normal.jpeg"}
• {"id"=>"316235905910321152", "text"=>"#PLOSONE: Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners http://t.co/7hD5DuR2iV", "created_at"=>"2013-03-25T17:11:30Z", "user"=>"BocaGrupo", "user_name"=>"grupo boca", "user_profile_image"=>"http://a0.twimg.com/profile_images/2731561513/a6e4dec410da1df64ced55a811f4e12c_normal.jpeg"}
• {"id"=>"316652072395210752", "text"=>"http://t.co/8TxMv0inBW So Drs are the baddies for prescribing placebo meds, but don't all interventions have some element of placebo?", "created_at"=>"2013-03-26T20:45:11Z", "user"=>"PeakCityPhysio", "user_name"=>"Peak City Physio", "user_profile_image"=>"http://a0.twimg.com/profile_images/2549899913/zsqf6c6o7l9tks0lg6yj_normal.jpeg"}
• {"id"=>"317000150751014912", "text"=>"Placebos may represent one of the more commonly used treatments in UK primary care http://t.co/UJ0x8A3zmr #PLOSONE", "created_at"=>"2013-03-27T19:48:20Z", "user"=>"plosc_disasters", "user_name"=>"disasters@plos.org", "user_profile_image"=>"http://a0.twimg.com/profile_images/2430001471/ds4uflh93eobzrntcrjf_normal.jpeg"}
• {"id"=>"317000388471570434", "text"=>"Placebos may represent one of the more commonly used treatments in UK primary care http://t.co/VUO5LYdg6v #PLOSONE:", "created_at"=>"2013-03-27T19:49:16Z", "user"=>"lizflavall", "user_name"=>"Liz Flavall", "user_profile_image"=>"http://a0.twimg.com/profile_images/2386287016/mpf943rjsbmdeyiv2syq_normal.jpeg"}
• {"id"=>"317194112568807424", "text"=>"#PLOSONE: Zdravotníctvo je fakt čierna diera: Placebo Use in the United Kingdom http://t.co/Ih5U9eUk0f", "created_at"=>"2013-03-28T08:39:04Z", "user"=>"daimonion", "user_name"=>"daimonion", "user_profile_image"=>"http://a0.twimg.com/profile_images/847670208/dvc_normal.png"}
• {"id"=>"322854286855917568", "text"=>"Formulación de placebo en el Reino Unido por médicos generales, está en el 12% http://t.co/aaqAGbBYLK", "created_at"=>"2013-04-12T23:30:34Z", "user"=>"luisfcifuentes", "user_name"=>"Luis F Cifuentes, MD", "user_profile_image"=>"http://a0.twimg.com/profile_images/3474059473/d3db7ecf871c4371faa97efe2ccd3b3c_normal.jpeg"}
• {"id"=>"334254277402951680", "text"=>". @Rocking_Infidel incidentally, most doctors disagree with you wife: http://t.co/LRdiqDNxfm", "created_at"=>"2013-05-14T10:30:04Z", "user"=>"ProfMike_M", "user_name"=>"Michael Merrifield", "user_profile_image"=>"http://a0.twimg.com/profile_images/2947630987/61ccb56ed9aaa2b4e16c30336ce94bf5_normal.jpeg"}
• {"id"=>"334255025104752640", "text"=>". @Rocking_Infidel incidentally, most doctors disagree with your wife: http://t.co/LRdiqDNxfm", "created_at"=>"2013-05-14T10:33:02Z", "user"=>"ProfMike_M", "user_name"=>"Michael Merrifield", "user_profile_image"=>"http://a0.twimg.com/profile_images/2947630987/61ccb56ed9aaa2b4e16c30336ce94bf5_normal.jpeg"}
• {"id"=>"339498031491735552", "text"=>"@javierpadillab Ahí va otro de los mismos autores http://t.co/Q1oIU2FAcl", "created_at"=>"2013-05-28T21:46:52Z", "user"=>"eparquiodelgado", "user_name"=>"Eparquio Delgado", "user_profile_image"=>"http://a0.twimg.com/profile_images/3654239521/8240dfc07ae843fc62fd48892c9a7dc8_normal.jpeg"}
• {"id"=>"341169007111581696", "text"=>"#placebo usato a man bassa nella #medicina : http://t.co/WOVAlIr79x", "created_at"=>"2013-06-02T12:26:44Z", "user"=>"eucondrio", "user_name"=>"eucondrio", "user_profile_image"=>"http://a0.twimg.com/sticky/default_profile_images/default_profile_5_normal.png"}
• {"id"=>"364779771000922113", "text"=>"Placebo use in the UK: http://t.co/dnVDYPeMF6 #medicalethics", "created_at"=>"2013-08-06T16:07:29Z", "user"=>"nilshoppe", "user_name"=>"Nils Hoppe", "user_profile_image"=>"http://a0.twimg.com/profile_images/3468309025/7b5707621796612b6e044c10e21bc0db_normal.jpeg"}
• {"id"=>"442739320559255553", "text"=>"@RichardDawkins http://t.co/eOpSWPwCBi", "created_at"=>"2014-03-09T19:10:54Z", "user"=>"thenumber2goose", "user_name"=>"thenumber2goose", "user_profile_image"=>"http://pbs.twimg.com/profile_images/432064411017441280/VSYKFIMc_normal.png"}
• {"id"=>"454196023372824576", "text"=>"@spignal ain't flavoured water a better way of triggering a placebo effect than using antibiotics?\n\nhttp://t.co/cAEs1gpsaW", "created_at"=>"2014-04-10T09:55:45Z", "user"=>"Shane_Conneely", "user_name"=>"Shane Conneely", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000862570248/6CNN1FEy_normal.jpeg"}
• {"id"=>"671107150526160897", "text"=>"Would placebos be better than antibiotics?@kenjimartinez_ @KapTestNews\n\nhttps://t.co/7ZPoGEJx6z\n#meded #FOANed", "created_at"=>"2015-11-29T23:23:07Z", "user"=>"PodcastLib", "user_name"=>"Sheryl Ramer Gesoff", "user_profile_image"=>"http://pbs.twimg.com/profile_images/610964290305163265/S3aTcrPb_normal.jpg"}
• {"id"=>"748828931625717760", "text"=>"@Solof1sincirco @LadyPau_ @illborregos Mira el 97% de los m?dicos de UK usan placebo para curar https://t.co/ew9wUCKiT2 quimica, quimica!!", "created_at"=>"2016-07-01T10:41:44Z", "user"=>"JordiFlynn", "user_name"=>"Jordi Flynn", "user_profile_image"=>"http://pbs.twimg.com/profile_images/638758395240153089/KfHsRGa6_normal.jpg"}

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• {"month"=>"2", "year"=>"2014", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"295"}
• {"month"=>"3", "year"=>"2014", "pdf_views"=>"52", "xml_views"=>"5", "html_views"=>"553"}
• {"month"=>"4", "year"=>"2014", "pdf_views"=>"21", "xml_views"=>"3", "html_views"=>"354"}
• {"month"=>"5", "year"=>"2014", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"247"}
• {"month"=>"6", "year"=>"2014", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"195"}
• {"month"=>"7", "year"=>"2014", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"169"}
• {"month"=>"8", "year"=>"2014", "pdf_views"=>"16", "xml_views"=>"2", "html_views"=>"155"}
• {"month"=>"9", "year"=>"2014", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"191"}
• {"month"=>"10", "year"=>"2014", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"325"}
• {"month"=>"11", "year"=>"2014", "pdf_views"=>"24", "xml_views"=>"1", "html_views"=>"302"}
• {"month"=>"12", "year"=>"2014", "pdf_views"=>"22", "xml_views"=>"2", "html_views"=>"234"}
• {"month"=>"1", "year"=>"2015", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"252"}
• {"month"=>"2", "year"=>"2015", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"209"}
• {"month"=>"3", "year"=>"2015", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"234"}
• {"month"=>"4", "year"=>"2015", "pdf_views"=>"22", "xml_views"=>"1", "html_views"=>"234"}
• {"month"=>"5", "year"=>"2015", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"140"}
• {"month"=>"6", "year"=>"2015", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"113"}
• {"month"=>"7", "year"=>"2015", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"109"}
• {"month"=>"8", "year"=>"2015", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"126"}
• {"month"=>"9", "year"=>"2015", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"162"}
• {"month"=>"10", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"185"}
• {"month"=>"11", "year"=>"2015", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"276"}
• {"month"=>"12", "year"=>"2015", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"288"}
• {"month"=>"1", "year"=>"2016", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"234"}
• {"month"=>"2", "year"=>"2016", "pdf_views"=>"4", "xml_views"=>"0", "html_views"=>"191"}
• {"month"=>"3", "year"=>"2016", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"205"}
• {"month"=>"4", "year"=>"2016", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"199"}
• {"month"=>"5", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"135"}
• {"month"=>"6", "year"=>"2016", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"116"}
• {"month"=>"7", "year"=>"2016", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"113"}
• {"month"=>"8", "year"=>"2016", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"119"}
• {"month"=>"9", "year"=>"2016", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"237"}
• {"month"=>"10", "year"=>"2016", "pdf_views"=>"48", "xml_views"=>"0", "html_views"=>"310"}
• {"month"=>"11", "year"=>"2016", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"504"}
• {"month"=>"12", "year"=>"2016", "pdf_views"=>"28", "xml_views"=>"2", "html_views"=>"490"}
• {"month"=>"1", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"563"}
• {"month"=>"2", "year"=>"2017", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"554"}
• {"month"=>"3", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"539"}
• {"month"=>"4", "year"=>"2017", "pdf_views"=>"18", "xml_views"=>"1", "html_views"=>"467"}
• {"month"=>"5", "year"=>"2017", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"527"}
• {"month"=>"6", "year"=>"2017", "pdf_views"=>"29", "xml_views"=>"0", "html_views"=>"307"}
• {"month"=>"7", "year"=>"2017", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"147"}
• {"month"=>"8", "year"=>"2017", "pdf_views"=>"9", "xml_views"=>"2", "html_views"=>"157"}
• {"month"=>"9", "year"=>"2017", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"148"}
• {"month"=>"10", "year"=>"2017", "pdf_views"=>"21", "xml_views"=>"2", "html_views"=>"292"}
• {"month"=>"11", "year"=>"2017", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"295"}
• {"month"=>"12", "year"=>"2017", "pdf_views"=>"19", "xml_views"=>"1", "html_views"=>"234"}
• {"month"=>"1", "year"=>"2018", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"163"}
• {"month"=>"2", "year"=>"2018", "pdf_views"=>"42", "xml_views"=>"1", "html_views"=>"127"}
• {"month"=>"3", "year"=>"2018", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"152"}
• {"month"=>"4", "year"=>"2018", "pdf_views"=>"33", "xml_views"=>"0", "html_views"=>"145"}
• {"month"=>"5", "year"=>"2018", "pdf_views"=>"7", "xml_views"=>"1", "html_views"=>"83"}
• {"month"=>"6", "year"=>"2018", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"96"}
• {"month"=>"7", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"3", "html_views"=>"48"}
• {"month"=>"8", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"1", "html_views"=>"52"}
• {"month"=>"9", "year"=>"2018", "pdf_views"=>"22", "xml_views"=>"1", "html_views"=>"79"}
• {"month"=>"10", "year"=>"2018", "pdf_views"=>"11", "xml_views"=>"1", "html_views"=>"75"}
• {"month"=>"11", "year"=>"2018", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"121"}
• {"month"=>"12", "year"=>"2018", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"140"}
• {"month"=>"1", "year"=>"2019", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"124"}
• {"month"=>"2", "year"=>"2019", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"77"}
• {"month"=>"3", "year"=>"2019", "pdf_views"=>"19", "xml_views"=>"2", "html_views"=>"103"}
• {"month"=>"4", "year"=>"2019", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"96"}
• {"month"=>"5", "year"=>"2019", "pdf_views"=>"21", "xml_views"=>"1", "html_views"=>"81"}
• {"month"=>"6", "year"=>"2019", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"53"}
• {"month"=>"7", "year"=>"2019", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"60"}
• {"month"=>"8", "year"=>"2019", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"32"}
• {"month"=>"9", "year"=>"2019", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"20"}
• {"month"=>"10", "year"=>"2019", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"84"}
• {"month"=>"11", "year"=>"2019", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"101"}
• {"month"=>"12", "year"=>"2019", "pdf_views"=>"35", "xml_views"=>"1", "html_views"=>"156"}
• {"month"=>"1", "year"=>"2020", "pdf_views"=>"20", "xml_views"=>"2", "html_views"=>"105"}
• {"month"=>"2", "year"=>"2020", "pdf_views"=>"12", "xml_views"=>"2", "html_views"=>"71"}
• {"month"=>"3", "year"=>"2020", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"65"}
• {"month"=>"4", "year"=>"2020", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"53"}
• {"month"=>"5", "year"=>"2020", "pdf_views"=>"35", "xml_views"=>"1", "html_views"=>"67"}
• {"month"=>"6", "year"=>"2020", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"32"}
• {"month"=>"7", "year"=>"2020", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"32"}
• {"month"=>"8", "year"=>"2020", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"29"}
• {"month"=>"9", "year"=>"2020", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"40"}
• {"month"=>"10", "year"=>"2020", "pdf_views"=>"29", "xml_views"=>"0", "html_views"=>"52"}
• {"month"=>"11", "year"=>"2020", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"86"}
• {"month"=>"12", "year"=>"2020", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"90"}
• {"month"=>"1", "year"=>"2021", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"29"}

Figshare

• {"files"=>["https://ndownloader.figshare.com/files/1012996"], "description"=>"<p>Summary of placebo usage.</p>", "links"=>[], "tags"=>["placebo"], "article_id"=>673403, "categories"=>["Science Policy", "Medicine", "Biotechnology", "Pharmacology"], "users"=>["Jeremy Howick", "Felicity L. Bishop", "Carl Heneghan", "Jane Wolstenholme", "Sarah Stevens", "F. D. Richard Hobbs", "George Lewith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0058247.t001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_placebo_usage_/673403", "title"=>"Summary of placebo usage.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-03-20 00:56:43"}
• {"files"=>["https://ndownloader.figshare.com/files/1013019"], "description"=>"*<p>CBT, ferrous sulphate, gesture and intonation in addition to positive suggestion, medication, physiotherapy, joint injection, reassurance, referral to website, reassurance, ‘tell them my own or my family member with the same problem’, unnecessary referrals.</p>", "links"=>[], "tags"=>["placebo"], "article_id"=>673427, "categories"=>["Science Policy", "Medicine", "Biotechnology", "Pharmacology"], "users"=>["Jeremy Howick", "Felicity L. Bishop", "Carl Heneghan", "Jane Wolstenholme", "Sarah Stevens", "F. D. Richard Hobbs", "George Lewith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0058247.t002", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Frequency_of_placebo_use_by_type_of_placebo_/673427", "title"=>"Frequency of placebo use by type of placebo.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-03-20 00:57:07"}
• {"files"=>["https://ndownloader.figshare.com/files/1013042"], "description"=>"<p>Summary of practitioner beliefs about ethical acceptability of placebo use.</p>", "links"=>[], "tags"=>["beliefs", "acceptability", "placebo"], "article_id"=>673447, "categories"=>["Science Policy", "Medicine", "Biotechnology", "Pharmacology"], "users"=>["Jeremy Howick", "Felicity L. Bishop", "Carl Heneghan", "Jane Wolstenholme", "Sarah Stevens", "F. D. Richard Hobbs", "George Lewith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0058247.t003", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_practitioner_beliefs_about_ethical_acceptability_of_placebo_use_/673447", "title"=>"Summary of practitioner beliefs about ethical acceptability of placebo use.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-03-20 00:57:27"}

PMC Usage Stats | Further Information

• {"unique-ip"=>"7", "full-text"=>"11", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"3"}
• {"unique-ip"=>"52", "full-text"=>"56", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"4"}
• {"unique-ip"=>"17", "full-text"=>"17", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"5"}
• {"unique-ip"=>"7", "full-text"=>"15", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2013", "month"=>"6"}
• {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"7"}
• {"unique-ip"=>"12", "full-text"=>"15", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"8"}
• {"unique-ip"=>"6", "full-text"=>"8", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"9"}
• {"unique-ip"=>"24", "full-text"=>"30", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2013", "month"=>"10"}
• {"unique-ip"=>"35", "full-text"=>"39", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"11"}
• {"unique-ip"=>"11", "full-text"=>"14", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"12"}
• {"unique-ip"=>"14", "full-text"=>"16", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
• {"unique-ip"=>"16", "full-text"=>"15", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"2"}
• {"unique-ip"=>"20", "full-text"=>"20", "pdf"=>"5", "abstract"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"3"}
• {"unique-ip"=>"14", "full-text"=>"30", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"5"}
• {"unique-ip"=>"16", "full-text"=>"17", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"6"}
• {"unique-ip"=>"11", "full-text"=>"16", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"4"}
• {"unique-ip"=>"18", "full-text"=>"22", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
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• {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
• {"unique-ip"=>"13", "full-text"=>"14", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
• {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
• {"unique-ip"=>"15", "full-text"=>"14", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
• {"unique-ip"=>"21", "full-text"=>"24", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
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• {"unique-ip"=>"15", "full-text"=>"15", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
• {"unique-ip"=>"18", "full-text"=>"17", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"2"}
• {"unique-ip"=>"18", "full-text"=>"20", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
• {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
• {"unique-ip"=>"21", "full-text"=>"16", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
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Relative Metric

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F1000Prime