What happens when a medical procedure is put to the placebo test? Professor Rasha Al-Lamee, Clinical Professor of Cardiology at the National Heart and Lung Institute, explores the surprising results of the first placebo-controlled trial of coronary stenting for angina, the questions it raised about what drives symptom relief, and how a negative clinical trial led to positive changes. Please register to attend in person. A live stream link for online attendance will be available here shortly. We look forward to seeing you on Wednesday 9 December! Imperial Inaugurals are term-time lectures that celebrate our newest Professors, recognising their academic journey and showcasing their research. Abstract We hold drugs to the highest standard. Before a medicine reaches patients, it must outperform placebo in a randomised controlled trial. Medical procedures have largely escaped that same scrutiny. When placebo-controlled trials of medical procedures are performed, the results are often unexpected. Angina is a symptom. It is subjective, variable, and shaped by what a patient expects will happen to them. It is therefore susceptible to the placebo effect when treated by drugs or procedures. Our group ran the first placebo-controlled trial of coronary stenting for angina: ORBITA. The results were surprising and caused shockwaves across the global cardiology community. While the findings were not what many wanted to hear, they led to a much wider discussion about the value of placebo control and the impact that these trials might have on medical practice. From ORBITA came many more questions about angina. Which medications and procedures work best? What drives symptom relief? How large are the placebo and physical components of our treatments? And importantly, who benefits most? Disappointing results and the acknowledgement of the placebo effect are not always a reason to abandon procedures. They lead us to consider placebo a scientific phenomenon and an important part of the d

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