Small Catch The Practice Effect

As discussed in the Preface, in evaluating treatments for memory loss, a unique factor absolutely mandates a placebo-controlled trial. This is called the practice effect.

When you first try to complete neuropsychological tests, which include the tests of memory described in chapter 1, some parts seem difficult. The next time you do the same tests, you are likely to perform better, even on those tests that seemed hard to do the first time. This is the practice effect, which means that repeated testing results in superior performance because the brain automatically (even without conscious learning) begins to figure out how best to do the test. In people with little to no memory loss, the practice effect can last for many months after only a single testing session. Therefore, if neuropsychological test performance is compared before and after medication (or other) treatment for memory loss, there will often be some improvement due to the practice effect. If, however, active medication is compared to placebo, subtracting the change on placebo from the change on active medication gives us the real medication effect, thus accounting for the practice effect, which is assumed to be equal in people on active medication and people on placebo.

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