Invasive procedures with questionable indications and possible placebo effects

Abstract

Sergei V. Jargin

This article provides an overview of surgical procedures performed with questionable or excessively radical indications, such as the lung denervation as a treatment of asthma, or the porto-systemic shunting for Type 1 diabetes mellitus. An immediate effect of an invasive procedure including a surgical operation can be influenced by different non-specific factors including a placebo effect. There is an opinion that surgery is associated with a placebo-effect, which can be stronger in case of a more invasive procedure. Reported moderate efficiency of the procedures discussed here could have been caused by placebo effect and/or inexact evaluation. These days, the improvement of Russian economy has enabled the acquisition of modern equipment and supported increasing levels of medical research. Under these circumstances, the purpose of this review is to help to correct the historical problems of surgery in Russia and to remind that, when performing surgical or other invasive procedures, the risk-to-benefit ratio should be minimized.