The Placebo Phenomenon
harvardmagazine.com
The Placebo Phenomenon
1–10 of 42 posts
Re: The Placebo Phenomenon
#2From the article: "Kaptchuk . . . doesn’t argue that you can simply 'think yourself better.' 'Sham treatment won’t shrink tumors or cure viruses,' he says."
That's an honest statement and an important point, because many publications with Kaptchuk's name on them are overinterpreted to reach the conclusion that there is a "real" placebo effect that can actually cure disease. In fact, there is no strong evidence of that at all.
This issue has come up often enough on Hacker News that I have gathered some links that are helpful for understanding what placebo effects are all about. Some of these online links cite quite a few useful scholarly publications.
http://www.sciencebasedmedicine.org/index.php/michael-specte...
"In other words, the best research we have strongly suggests that placebo effects are illusions, not real physiological effects. The possible exception to this are the subjective symptoms of pain and nausea, where the placebo effects are highly variable and may be due to subjective reporting."
Numerous press releases on the Web point to publications co-authored by Ted Kaptchuk, the main person profiled in the article kindly submitted here. Although Kaptchuk has the academic title of an associate professor of medicine, he has no medical training or credentials or clinical experience in independently verified patient care.
http://www.sciencebasedmedicine.org/index.php/dummy-medicine...
http://www.sciencebasedmedicine.org/index.php/dummy-medicine...
The article submitted here today, as befits an article from Harvard Magazine, is pretty good about giving the point of view of researchers who disagree with Kaptchuk, and is good about giving his updated opinion on issues he has changed his mind about. The statements found in some earlier articles posted to Hacker News, such as "Recent research demonstrates that placebo effects are genuine psychobiological phenomenon [sic] attributable to the overall therapeutic context, and that placebo effects can be robust in both laboratory and clinical settings" are untrue.
http://theness.com/neurologicablog/index.php/the-rise-and-fa...
"Despite the spin of the authors – these results put placebo medicine into crystal clear perspective, and I think they are generalizable and consistent with other placebo studies. For objective physiological outcomes, there is no significant placebo effect. Placebos are no better than no treatment at all."
http://www.ncbi.nlm.nih.gov/pubmed/20091554
"We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed."
Fabrizio Benedetti, a co-author of one of the most cited papers who is also a medical doctor, sums up his view this way: "I am a doctor, it is true, but I am mainly a neurophysiologist, so I use the placebo response as a model to understand how our brain works. I am not sure that in the future it will have a clinical application."
http://www.brainsciencepodcast.com/storage/transcripts/year-...
To sum up, despite claims to the contrary that are often covered by the lay press, the best-considered view among medical practitioners with clinical experience is that the placebo response has no ethical clinical application.
See also:
http://www.sciencebasedmedicine.org/index.php/does-thinking-...
http://www.skepdic.com/placebo.html
http://www.sciencebasedmedicine.org/index.php/revisiting-dan...
And of course see LISP hacker and Google director of research Peter Norvig's article "Warning Signs in Experimental Design and Interpretation" on how to interpret scientific research.
Re: The Placebo Phenomenon
#3I get very uneasy reading articles that start to pitch "value of caring" and someone who "didn't doubt the value of acupuncture" against "western medicine" and "western doctors" who are portrayed as stubborn and close-minded.
Re: The Placebo Phenomenon
#4From the article: "Kaptchuk . . . doesn’t argue that you can simply 'think yourself better.' 'Sham treatment won’t shrink tumors or cure viruses,' he says." That's an honest statement and an important point, because many publications with Kaptchuk's name on them are overinterpreted to reach the conclusion that there is a "real" placebo effect that can actually cure disease. In fact, there is no strong evidence of tha…
Isn't focusing on the placebo effect ignoring the broader and more important question of the impact of state of mind on the body's ability to fight disease and heal itself? Once that question is well understood I imagine the understanding of notions like the placebo effect will simply fall out.
Re: The Placebo Phenomenon
#5I get very uneasy reading articles that start to pitch "value of caring" and someone who "didn't doubt the value of acupuncture" against "western medicine" and "western doctors" who are portrayed as stubborn and close-minded.
Agreed. "Western medicine" only exists as half of a false dichotomy.
If the doctors so labeled really were stubborn and close-minded, then we would still perform blood-lettings and chew tree mark (instead of just the active ingredient). Instead, these doctors are more open to new information; they're just willing to also incorporate the evidence against efficacy so often ignored by "alternative medicine" practitioners.
Re: The Placebo Phenomenon
#6From the article: "Kaptchuk . . . doesn’t argue that you can simply 'think yourself better.' 'Sham treatment won’t shrink tumors or cure viruses,' he says." That's an honest statement and an important point, because many publications with Kaptchuk's name on them are overinterpreted to reach the conclusion that there is a "real" placebo effect that can actually cure disease. In fact, there is no strong evidence of tha…
Isn't focusing on the placebo effect ignoring the broader and more important question of the impact of state of mind on the body's ability to fight disease and heal itself? Once that question is well understood I imagine the understanding of notions like the placebo effect will simply fall out.
A rather deep research and clinical practice on working with the mind to cure the body has been conducted by John E Sarno.
The Mindbody Prescription [1] and The Divided Mind [2] are two of his books.
My interest in this started with the motivation to get some relief for the RSI-like symptoms and it's been part of my recovery for a few weeks together with the improved ergonomics.
[1] http://www.amazon.com/The-Mindbody-Prescription-Healing-Body...
[2] http://www.amazon.com/The-Divided-Mind-Epidemic-Disorders/dp...
Re: The Placebo Phenomenon
#7On a tangent, I think some of these massive open online courses going around nowadays might act as a form of what Rory Sutherland terms "placebo education". Education where you don't necessarily learn things but that gives you the impression that you did, resulting in extra confidence leading to extra success later on ;-)
Re: The Placebo Phenomenon
#8On a tangent, I think some of these massive open online courses going around nowadays might act as a form of what Rory Sutherland terms "placebo education". Education where you don't necessarily learn things but that gives you the impression that you did, resulting in extra confidence leading to extra success later on ;-)
If you continue this line of thinking, putting items on todo lists and checking them off is a "placebo completion". Getting a fancy title instead of a promotion or raise is a "placebo advancement".
Re: The Placebo Phenomenon
#9From the article: "Kaptchuk . . . doesn’t argue that you can simply 'think yourself better.' 'Sham treatment won’t shrink tumors or cure viruses,' he says." That's an honest statement and an important point, because many publications with Kaptchuk's name on them are overinterpreted to reach the conclusion that there is a "real" placebo effect that can actually cure disease. In fact, there is no strong evidence of tha…
Isn't focusing on the placebo effect ignoring the broader and more important question of the impact of state of mind on the body's ability to fight disease and heal itself? Once that question is well understood I imagine the understanding of notions like the placebo effect will simply fall out.
[deleted]
Re: The Placebo Phenomenon
#10On a tangent, I think some of these massive open online courses going around nowadays might act as a form of what Rory Sutherland terms "placebo education". Education where you don't necessarily learn things but that gives you the impression that you did, resulting in extra confidence leading to extra success later on ;-)
If you continue this line of thinking, putting items on todo lists and checking them off is a "placebo completion". Getting a fancy title instead of a promotion or raise is a "placebo advancement".
A placebromotion, if you will.