Poll Concerning the Placebo Effect

[Celebration]

Assume the following facts about your disease, known as condition C .

Large scintific studies have been conducted on Condition C. Treatment A and Treatment B are the only two treatments. Neither have any known or demonstrable side effects. Both have the same cost and time involved.

Treatment A has been shown to be effective 35% of the time. The placebo for treatment A is effective 20% of the time. There is a statistically significant difference in the two.

Treatment B has been shown to be effective 70% of the time. The placebo for treatment B has shown to be effective 70% of the time. There is no statistial difference between the two, obviously.

The placebos are different because treatment A is a pill and treatment B involves a more active treatment involving the patient.

What treatment do you choose first?

[godai]

1. Treatment B has not been shown to be effective.

What you present is an example of cross-study comparisons. Clinical trial results vary a lot and the high placebo effect with treatment B shows that the 'more active treatment' is no different than placebo.

Treatment B is not more effective than treatment A. In fact, it's no more effective than placebo.

[bananas]

2. Placebo B

Even though they don't know about any side effects yet for Treatment B, they might find some in the future. Therefore, Placebo B is the safest and most effective treatment.
It's probably cheaper, too.

[Celebration]

3. I thought about that

It would be fine with me, but is it possible to give yourself a placebo? Don't you have to believe that you are getting the real thing?

[godai]

4. Depends what you're treating.

If it is something like headache, there would have to be a placebo administered (pill with no drug) to get a placebo effect and, perhaps, headache relief. If you're treating something like cholesterol levels, a placebo pill would have no effect on cholesterol levels. A placebo pill might be used for various conditions effecting mood, pain, things like that.

[Celebration]

5. well, treatment B was assumed not to be a pill but had a more active component

That's why the placebo for A and B had to be different.

Even if the placebo was a pill, taking a placebo pill might not have much of an effect if you KNEW it was a placebo.

In the studies you think there is a chance that you are getting the active one.

But I am all for studies on placebo pills. I actually used some cell salts once as a sort of active placebo. I never thought they would work, they didn't make sense. It just gave me something to do if I felt overwhelmed or something. Oh, reach for the cell salts. They seemed to work okay, but I haven't felt compelled to write a post about the experience. They were cheap.

Hmm-- I might go out and get some more cell salts.

[godai]

6. But it was no more effective than placebo.

Without being more specific (disease being treated etc), it's hard to discuss this further.

[Celebration]

7. if these were the only studies

And they were large, than it would seem that Placebo used for B is more effective than the placebo used for A.

How could that be?

Remember the study on arthroscopic knee surgery being no more effective than a placebo? The placebo WAS ALSO AN OPERATION. They put the people under, and just made a little cut in the knee, and did none of the other stuff. This was just as effective as the surgery.

Both were better than a pill, or doing nothing.

[muriel_volestrangler]

12. Seems the right answer, to me

It has to be cheaper than treatment B, because some step has been missed out - preparing something, diluting something, training in a (non-effective) practice ...

But, no option for that in the poll. :shrug:

[Cleita]

8. I'm becoming very cynical about pills that are only so, so effective,

especially since they have become so expensive. I think their only purpose is to make the manufacturer rich.

[TZ]

21. Have you ever actually looked at clinical data?

Nothing is on the market that doesn't have a measurable effect..and NOT a placebo effect. Just becuase you don't BELIEVE something works doesn't invalidate it. Why don't you wake up tomorrow and say "I don't believe in gravity!" and see how far that gets you.
FYI, I work in support of clinical trials quantifying the amount of experimental drug and the patients response to it.
Just cause something doesn't work for you or only so-so doesn't mean its not effective. and there is tons of data that shows this. But since you probably wouldn't understand it, it can't be true right?
God damn I'm tired of people who think just because they lack personal understanding of something that makes it untrue.

[cosmik debris]

9. More Bullshit!

You say: "The placebo for treatment A is effective 20% of the time."

WRONG!

Placebos are not effective. Placebos have absolutely no value in curing disease.

The placebo effect is an illusion. It is a mirage. It is a measure of how often a symptom will subside without treatment--because placebos ARE NOT TREATMENT!

Your presentation of placebo data is a red herring.

Your poll is meaningless.

[Celebration]

13. LOL

Placebos do work. If they didn't, then there would be no need to do studies comparing something to its placebo treatment. You could just use people that get no treatment.

Why do Drug A vs. Placebo for Drug A

instead of

Drug A vs. doing nothing.

That's because there is an effect of the placebo.

[cosmik debris]

14. You're joking right?

Nobody could really be that stupid could they?

A placebo is a substance or procedure a patient accepts as medicine or therapy, but which has no objectively verifiable therapeutic activity. Any therapeutic effect is thought to be based on the power of suggestion.
http://en.wikipedia.org/wiki/Placebo

In other forums I have used one of your previous statements about seeking out placebos as the perfect example of scientific illiteracy. Your lack of understand is absolutely overwhelming, but it is also comical.

A placebo is an inert substance intended to fool you and it sure made a fool out of you!

:rofl:

[Celebration]

15. Answer this

Why do we bother to test against placebos, if they have no effect? It would be a waste of time.

http://www.biomedcentral.com/1471-2288/5/26

We conclude that the placebo response rate in controlled clinical trials is not due to methodological artifacts, to disease history alone or to circumstantial characteristics of studies, but seems to reflect a genuine improvement, unless one invokes publication bias for all negative studies. This improvement accounts for roughly 60% of the variance of all therapeutic gains across trials.

You really do need to keep up with published literature on the subject of placebos.

[cosmik debris]

16. I've already answered that.

"It is a measure of how often a symptom will subside without treatment--because placebos ARE NOT TREATMENT!"

[Celebration]

17. Then just do NO TREATMENT AT ALL--no placebo

Did you even read the published study on placebos?

[cosmik debris]

18. Never mind

I can't believe I would waste my time arguing with a rock.

[Pierre.Suave]

19. I certainly do hope it is just you...

dear god...

:banghead:

[Celebration]

22. Uh, did YOU read the study on placebos?

Placebos have an effect, whether you like it or not. If they had no effect, we wouldn't need to "control" for it. Every drug would test against the "no treatment" group, and save a lot of money in the trials. After all, the no treatment group is a measure of the people who would improve without any treatment.

The placebo group is the group that think they may be getting treatment.

And, different placebos for different treatments have different results, no matter what you think or try to peddle here.

READ THE STUDY!! Here is another

http://arthritis.about.com/od/trials/a/placebo.htm


In the second phase of the study, researchers randomly assigned half of the participants to a sham acupuncture procedure versus real acupuncture for four more weeks. The other half of the participants were randomized to receive either a placebo pill or a real pain pill for six more weeks.
Results From Placebo Study

Results from the second phase revealed that participants receiving sham acupuncture reported more significant decrease in pain and symptoms than the participants who received placebo pills. Researchers concluded that:

# the subjective reports from study participants show that the placebo used impacts placebo effect.
# objective assessments such as grip strength revealed no difference.

In the study, using a medical device seemed to impact the patient response more than merely taking a pill.

[Pierre.Suave]

24. ok, I have had my two cups of coffee for the day now, and...

I still have no idea what your point is...

Do you know why Placebos are used, and how, in studies of treatments and medicines?

[Celebration]

25. the point is

That placebos do have clinical effects. If they had no clinical effect, then the placebo versus no treatment would be the same, and it isn't. If there was no clinical effect from a placebo, then trials controlled for placebo would be unnecessary. All drugs would be tested against "no treatment."

That different placebos have different effects. Look at the studies. A placebo for a pill is often not as strong as other types of placebos. Please at least read this--

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WC1-4KJDWVD-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=e010707c947a9fa7444693d6e5c0c61d

The use of placebo may have accompanied healing and medical practices since their origins (Plato; Charmides, 155–156). Recent experimental data indicate that we would be well advised to further consider placebo effects in future therapeutic strategies, with a better knowledge of their potency, psychological basis and underlying neurobiological mechanisms. Current research in the areas of pain, depression and Parkinson’s disease has uncovered some of the potential neurobiological mechanisms of placebo effects. These data indicate that conscious expectation and unconscious behavioral conditioning processes appear to be the major neurobiological mechanisms capable of releasing endogenous neurotransmitters and/or neurohormones that mimic the expected or conditioned pharmacological effects. To date, research on placebo responses affecting immune-related diseases is scarce, but there are consistent indications that skin and mucosal inflammatory diseases, in particular, are strongly modulated by placebo treatments. However, the brain’s capability to modulate peripheral immune reactivity has been impressively demonstrated by paradigms of behavioral conditioning in animal experiments and human studies. Thus, placebo effects can benefit end organ functioning and the overall health of the individual through positive expectations and behavioral conditioning processes.

[Jim__]

23. It's fascinating that publication bias may explain a large portion of the correlation between ...

... medication response rates and placebo response rates:

Our simulation runs brought one other explanatory option to the fore: publication bias. Under the assumption that only trials are published that prove the significance of the treatment over placebo and the non-significant trials are filed away, simply by this publication bias alone, a correlation can be obtained which is close to the one we observed empirically. Thus it is tempting to assume that the true reason for the high correlation between treatment and placebo improvement rates is, at least partially, publication bias. This points, once more, to the importance of publishing all evidence, not only positive studies. However, bearing in mind that the simulation produced a correlation of r = .63 under the precondition that all non-significant evidence, i.e. 87% of all evidence remained unpublished, publication bias cannot account for the whole correlation, but perhaps for a substantial amount.

Interesting article. Thanks for posting it.

[TZ]

20. Name a disease cured by a placebo

Name a drug thats marketed SPECIFICALLY AS A PLACEBO.
If you've ever seen a clinical trial then you know that the placebo effect is NEVER EVER as effective as the drug on the market.
If the placebo effect is so effective then WHY PRODUCE ANY DRUG?
Good god you are gullible. You are why snake oil merchants still exist.
Placebo effect=twenty first century version of believing that germs are demons.

[Celebration]

26. what a silly argument

By definition, drugs cannot be marketed as a placebo.

The placebo effect is never ever as effective as a drug?

Oh really? What about a drug trial that fails? Are there none of those?

I said a placebo has a real effect. I did not say that they superseded drugs. Why do you try to put words in my mouth, words that I did not say?

[TZ]

10. This is the dumbest thing I've seen in awhile

Just take a sugar pill and be done with it if you don't like things that actually you know..work.
Placebo effect only goes so far. Nobody has ever cured a disease with a placebo.

[cosmik debris]

11. Why ingest the empty calories

Just pretend to take a pill that doesn't work. You'll get exactly the same results.

If you click your heels together and say three times "There is no place like the hospital" I'm sure you'll be there in no time! :)