Placebo control subjects receive a similarly
looking treatment which does not contain the study agent, where no-treatment
control subjects receive literally no (i.e. absence of) treatment. The major
difference between the two designs is that placebo-controlled trials are almost
always double-blind, but blinding of the subjects and investigators are
impossible in no treatment-controlled.

The purpose of a control group is to serve as a
reference and to differentiate outcomes due to the study intervention form
those due to other factors.

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“Best available” refers to the evidence produced by
a study that has the strongest and most precise methodology on the hierarchy of
evidence.

“Gold standard” describes the currently best obtainable
method or procedure that is supported by sound evidence and
broad consensus; it serves as a guideline which clinician and researchers
should follow. 

Best available therapy control is currently
advocated in the declaration of Heslinki.  Use of placebo or no-treatment control group are justifiable when there
is no available proven treatment, when they are supported by valid
methodological consideration, and when they pose no extra risk of harm to the
participant.

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