• Vanda Faria, Joe Kossowsky, Mike P Petkov, Ted J Kaptchuk, Irving Kirsch, Alyssa Lebel, and David Borsook.
• Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Psychology, Uppsala University, Uppsala, Sweden; Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: vanda.rochafaria@childrens.harvard.edu.
• J. Pediatr. 2017 Feb 1; 181: 272-278.e10.

ObjectiveTo assess parental attitudes regarding placebo use in pediatric randomized controlled trials and clinical care.Study DesignParents with children under age 18 years living in the US completed and submitted an online survey between September and November 2014.ResultsAmong all 1300 participants, 1000 (76.9%; 538 mothers and 462 fathers) met the study inclusion criteria. The majority of surveyed parents considered the use of placebos acceptable in some pediatric care situations (86%) and some pediatric trials (91.5%), whereas only 5.7% of parents found the use of placebos in children always unacceptable. The clinical use of placebo was considered acceptable by a majority of parents for only 7 (mostly psychological) of the 17 conditions presented. Respondents' judgment about acceptability was influenced by the doctors' opinions about the therapeutic benefits of placebo treatment, the conditions for pediatric placebo use, transparency, safety, and purity of placebos.ConclusionMost surveyed parents accepted the idea of using placebos in pediatric trials and within the clinic for some conditions without the practice of deception and with the creation of guidelines for ethical and safe use. This study suggests a need to reconsider pediatric trial design and clinical therapy in the light of generally positive parental support of appropriate placebo use.Copyright © 2016 Elsevier Inc. All rights reserved.

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