Out of Control: How to Design Digital Placebos

Abstract

Abstract Purpose Placebo terminology and their applications are well embedded in clinical and research contexts. This review seeks to clarify the principles of good placebo control design and to offer recommendations for improving placebos in digital mental healthcare. Recent Findings Terminological confusions associated with understanding the function of placebos in pharmacology and psychotherapy reveal an underappreciation of the challenges associated with designing adequate placebo controls in clinical trials. It would be surprising if similar challenges did not arise with the testing of digital therapeutics, and emerging evidence shows an attendant lack of placebo literacy in digital health. Summary Despite the burgeoning health app economy with tens of thousands of apps now available to download by consumers, few researchers have interrogated what constitutes a good placebo control in digital healthcare. This review sought to disambiguate placebo concepts and to offer recommendations for improving placebo design to advance and future proof the field digital therapeutics.