A double-blind study uses a format where neither the participants nor the researchers know who receives a specific treatment. This procedure is useful because it prevents bias from forming in the achievable results. It is used most often when there is a direct need to understand the benefits of demand characteristics against the placebo effect.
What is unique about the placebo effect is that a person receives an inert substance that has no medical benefit. Participants believe that it is real medicine because a double-blind study wouldn’t inform anyone who gets the actual drug being studied. Researchers don’t receive that information either.
That means the results between the two groups can get compared to see if the effects of the drug are better than that of the placebo. It can also be a way to check for the development of side effects.
Several double-blind study advantages and disadvantages are worth reviewing when considering this format.
List of the Advantages of a Double-Blind Study
1. Three groups are typically part of a double-blind study.
The typical double-blind study project will involve three groups of participants. You’ll have the treatment group, the placebo, group, and a control group. The first two receive the item in question based on their name, although only the administrator knows for certain who is getting what since researchers are kept in the dark. The control group doesn’t receive anything because it serves as the baseline against which the other two sets of results get compared.
When people in the placebo group improve more than the control group, then it shows a belief that the product works. If the treatment group shows better results than those who receive a placebo, then you know the medication worked.
2. It avoids deception in the research process.
One of the criticized shortcomings of this approach is the fact that no one knows if the items they take or use is real or a placebo. The solution is to create two placebo subgroups where one is told that it is real medicine and the other is told it isn’t, which means researchers would need to deceive one set of participants. That process would violate the principles of informed consent.
The double-blind structure avoids this issue by providing complete information to all participants without letting on who receives the actual product getting studied.
3. It reduces the issue of experimenter bias.
Using double-blind procedures can minimize the potential effects of research bias when collecting data. This issue often occurs when experimenters knowingly or unknowingly influence the results during information gathering or product administration during the project. There can also be subjective feelings that drive specific decisions that would occur if less information was present in the study.
By limiting the potential influences that could impact the collected data, the final results produced by the research or experiment has more validity.
4. The results of a double-blind project can get duplicated.
One of the reasons why a double-blind study is considered a best practice is because the results offer the potential for duplication. Other researchers can follow the same protocols for administering placebos and the item being examined against a control group. If the results are similar, then it adds even more validity to the ability of a product or service to provide benefits. When duplication doesn’t happen, then the information from both studies can get compared to see what may have created a divergence in the data.
5. Double-blind assignment factors are randomized.
No one knows who is going to be part of what group at the beginning of a double-blind study. The only participant group that knows they aren’t part of the placebo or target group are those who provide the control baselines. When looking at an intervention-based process, the fact that random assignment occurs for willing participants works to reduce the influence of confounding variables in the material.
6. High levels of control are part of the research process.
The context of a double-blind research study allows administrators to manipulate variables so that the setting allows for direct observation. Control factors that could influence the environment can get added or removed to assist with the limitation of outside factors that would potentially change the data. This process allows for an accurate analysis of the collected data to ensure the authenticity of the results gets verified.
7. It is a process that’s usable in multiple industries.
The double-blind study might be used primarily by the pharmaceutical industry because it can look directly at the impact of medication, but any field can use the processes to determine the validity of an idea. Agriculture, biology, chemistry, engineering, and social sciences all use these structures as a way to provide validation for a theory or idea.
List of the Disadvantages of a Double-Blind Study
1. It doesn’t reflect real-life circumstances.
When a patient receives a pill after going to the doctor, they are told that the product is actual medicine intended to provide specific results. When participants receive something in a double-blind placebo study, then each person gets told explicitly that the item in question might be real medicine or a placebo. That leads to a different set of expectations that can influence the results of the work in adverse ways.
These artificial environments can cause an over-manipulation of the variables to produce circumstances that fall outside of the study’s parameters. When situations don’t feel realistic to a participant, then the quality of the data decreases exponentially.
2. Active placebos can interfere with the results.
Double-blind studies respond to the objections of researchers unintentionally when communicating information about the results of a pill being authentic or a placebo. Objections to the pill offering this information don’t exist with this structure. Although both items look identical, the real medication provides biological effects. Even if the results aren’t measurable, the individuals can feel the impact of the medicine on their bodies.
This outcome may cause them to conclude that they are in the treatment group. That means some participants have a higher positive expectancy than those who don’t feel those effects. It is a disadvantage that can lead to a misinterpretation of the results being experienced in real-time.
3. It is not always possible to complete a double-blind study.
There are times when a double-blind study is not possible. Any experiments that look at types of psychotherapy don’t benefit as an example because it would be impossible to keep participants in the dark about who receives treatment and who didn’t get the stated therapy. It only works when there is a way to provide two identical processes without clear communication about who receives the authentic item and who receives the placebo.
4. We do not fully understand the strength of the placebo effect.
Research published by Science Translational Medicine in 2014 found that the simple act of taking a pill can establish a placebo effect for people. A migraine was being tested in this study. The control group took nothing, while the placebo group took a medication clearly labeled as “placebo.” Then one group took a migraine drug labeled with its name. Those who took the placebo had results that were 50% effective when reducing pain during a migraine effect.
The placebo effect can stimulate the brain into believing that the body is being healed, creating a natural mechanism that encourages better health. The presence of this effect doesn’t indicate the success or failure of a medication or another process in a double-blind study. It may be an indication that the group receiving the placebo has a powerful internal mechanism that provides self-healing.
5. Some people can have a negative response to a placebo.
There can be times when an individual doesn’t have a response to the placebo at all. When that outcome occurs, then the effects of a process or medication can receive a direct comparison to see if the real product is useful. Some people can have an adverse reaction to the placebo, even producing unwanted side effects as if they were taking a real medication. It all depends on how each person feels.
A study involving people with asthma showed that using a placebo inhaler caused patients to do no better on breathing tests than sitting and doing nothing. When researchers asked how they felt about using the product, they reported that the placebo was just as effective as the regular medicine they used.
6. Randomization must use a structured process to be useful.
The most common example of using randomization when assigning people to a group in a double-blind study is to flip a coin. It is an action that’s random and cannot be predicted, which means it is likely to be a 50/50 scenario over time as it gets tossed frequently. Assigning people who come to a specific location based on a day of the week can influence the results of the study unintentionally because there are other dynamics that control the behavior. That bias would be in the data without anyone recognizing its presence since it was placed there in the initial design.
7. Most double-blind studies are too small to provide a representative sample.
Winchester Hospital, which is a division of Beth Israel Lahey Health in Massachusetts, says that a good double-blind study should enroll at least 100 individuals, “preferably as many as 300.” Effective treatments can prove themselves in small trials, but research requires more people to establish patterns so that results can be verified. Even when you have hundreds, or sometimes thousands, of participants in this work, the results might not extrapolate to the general population.
There were more than 4,100 trials in progress for pain treatments in 2011, but the only new approvals given were for formulations or updated dosages for existing medications. Even when drugs get into the third phase of testing, the product only has a 60% chance to continue moving forward. Divergent results often create failure.
8. It doesn’t work well for functional disorders.
The highest response rates for a placebo occur when researchers are looking into functional disorders like Irritable Bowel Syndrome. It also happens when there are imprecise endpoint measurements, as with Crohn’s disease. People who have other immune-response conditions like rheumatoid arthritis. The FDA even notes that the placebo response is steadily growing in the general population.
This disadvantage creates another limitation where the structure of a double-blind study may not provide useful information.
9. Double-blind studies are an expensive effort to pursue.
A double-blind study takes several months to complete so that researchers can look at each possible variable. It may be necessary to complete several efforts using different groups to collect enough data. When corporations look at the cost of these efforts, it can be an expense that reaches several million dollars before its completion. Government studies can quickly reach $1 billion or more, depending on the extent of the work and the industry or product under consideration.
When the Tufts Center for the Study of Drug Development looked at the cost of creating and bringing a new drug to the market, the expense was pegged at $2.6 billion. That’s why new prescription medicines are so expensive. Even the clinical trials for FDA approval have an average cost of $19 million.
Double-blind placebo studies are often called the gold standard for testing medications. This description is at its most powerful when studying new psychiatric medications since the placebo effect is a psychological benefit. It is a process that improves on the experiments that compare the response of someone taking a pill with those who do not.
Since no one knows who is getting what in a double-blind study, the danger of a researcher accidentally communicating non-verbally about the expectation of an item to work or not gets eliminated.
When reviewing these double-blind study advantages and disadvantages, the benefits that come from this process can only be achieved when structures that counter the potential negatives are in place. It gives us a baseline from which to work, but there are no guarantees that results are achievable.
Blog Post Author Credentials
Louise Gaille is the author of this post. She received her B.A. in Economics from the University of Washington. In addition to being a seasoned writer, Louise has almost a decade of experience in Banking and Finance. If you have any suggestions on how to make this post better, then go here to contact our team.