The Placebo Effect should be taught in grade school. We shouldn't have to wait until college to realize just how
many products, drugs, professions, etc. are an absolute
sham.
The Placebo Effect Doesn’t Apply Just to Pills
61–70 of 90 posts
Re: The Placebo Effect Doesn’t Apply Just to Pills
#62Earlier quoted context omitted.
> Or is there a case where one could "pass" this test, but still "lose" against a placebo? The main issue is that a lot of the existing drugs aren't better than placebos: - Some were never required to be tested for efficacy by the FDA before approval. - Some were tested for whatever reason., but the methodology used by testing was flawed for whatever reason. - In many the data was blatantly faked or manipulated by th…
Worse yet, I recall a study that found placebos are actually getting better over time. As in: drugs that have been tested successfully before fail in new tests because the placebos perform better than before. I'm not entirely sure what the plausible explanation for that one would be. Other than that the testing methods have changed to create a bias in favour of the placebos being successful.
> Worse yet, I recall a study that found placebos are actually getting better over time.
I think that was just a Jonah Lehrer thing. (I.e. his article The Truth Wears Off in The New Yorker.) What's actually happening is more likely that if a new class of drugs makes it onto the market and becomes popular enough, then it eventually gets studied by people who don't have an economic incentive in 'proving' that the drug is actually effective.
Once you stop cherry picking the subjects of the trials, covering up bad data, and using dubious statistical methods, the drugs start looking much less effective than they did originally.
Re: The Placebo Effect Doesn’t Apply Just to Pills
#63Perhaps we could create a placebo bureaucracy, say an FDA like agency which just approved anything that came through it. And then we could compare the end results of that agency with the FDA to see which one approved the most 'actually useful' medicines and the one which had the most 'later found to be harmful' medicines.
Re: The Placebo Effect Doesn’t Apply Just to Pills
#64It strikes me that for something like knee surgery, at least, the recovery routine might be what provides the benefit. What if you took a group and did not pretend to give them surgery but made them rest and go through physical therapy as if you had?
"Less than a year ago, many were shocked when arthroscopic surgery for meniscal tears performed no better than sham surgery. This procedure was the most common orthopedic procedure performed in the United States."
Earlier this year I re-injured the meniscus in my knee and was about to undergo surgery when a radiologist in the family mentioned this study. I cancelled the surgery and followed the alternative recovery method of ice, ibuprofen and rest. It took a long three weeks for me knee to feel normal again, but it would've been much longer had I undergone the surgery.
Re: The Placebo Effect Doesn’t Apply Just to Pills
#65Earlier quoted context omitted.
Rather than linking to a book on Amazon, could you link to some peer-reviewed journal articles?
http://alphachoices.com/repository/assets/pdf/EmperorsNewDru... http://www.plosmedicine.org/article/info:doi/10.1371/journal...
The PLOS article isn't really news. It's been known for a long time that measuring the efficacy of drugs for CNS diseases is ridiculously hard.
Re: The Placebo Effect Doesn’t Apply Just to Pills
#66Earlier quoted context omitted.
Some were never required to be tested for efficacy by the FDA before approval Yes they were used before the FDA had a formal approval process, but your comments doesn't make sense. If the current standard of care is a drug and you test against it, aren't you showing it's more effective?
> If the current standard of care is a drug and you test against it, aren't you showing it's more effective? The main issue is that a drug can be more effective than an older drug but still be less effective than taking no drug at all. But given all the problems, both theoretical and practical, with current drug trials, there is pretty much no guarantee of anything. Just because something makes sense on paper doesn't…
The Truth About Drug Companies by Marcia Angell
No offense, but Marcia Angell has a tenuous grasp in terms of knowledge of the pharmaceutical industry. I would take her opinions with a grain of salt.[1]
[1]http://www.forbes.com/sites/johnlamattina/2012/12/14/marcia-...
Re: The Placebo Effect Doesn’t Apply Just to Pills
#67Any idea how placebos work so well, what they are, and if we're doing anything to take advantage of the effect?
Right now they don't have a clue. In my world, the effect
is the only existence of God--until proven differently. So
believing strongly in something isn't as foolish as some
"Intellectuals" would berate?
Re: The Placebo Effect Doesn’t Apply Just to Pills
#68Earlier quoted context omitted.
While there is a good amount of controversy around the efficacy of antidepressants, first-line ADHD medications (the stimulants) work in roughly 70% of cases, which is much superior to placebo. For those with ADHD, treatment can make a large quality of life improvement. Source - memory from having written a book on adult ADHD
> first-line ADHD medications (the stimulants) work in roughly 70% of cases What do you mean by 'work'? The research cited by Anatomy of an Epidemic shows that there is no affect on grades or other academic outcomes. And that while concentration itself improves somewhat in the short term, after 2+ years it is worse than if the person were never given the drugs to begin with. See also: http://online.wsj.com/news/artic…
The history behind ADD medications (http://en.wikipedia.org/wiki/Obetrol) is also troubling. This is a drug designed to induce weight loss in adults and today it's widely given to children and even toddlers (http://www.today.com/health/thats-nuts-10-000-toddlers-get-d...).
Re: The Placebo Effect Doesn’t Apply Just to Pills
#69Earlier quoted context omitted.
> If the current standard of care is a drug and you test against it, aren't you showing it's more effective? The main issue is that a drug can be more effective than an older drug but still be less effective than taking no drug at all. But given all the problems, both theoretical and practical, with current drug trials, there is pretty much no guarantee of anything. Just because something makes sense on paper doesn't…
The Truth About Drug Companies by Marcia Angell No offense, but Marcia Angell has a tenuous grasp in terms of knowledge of the pharmaceutical industry. I would take her opinions with a grain of salt.[1] [1] http://www.forbes.com/sites/johnlamattina/2012/12/14/marcia-...
If you had read the actual book, you'd know that this article is completely mischaracterizing her arguments. From the article:
> Angell’s attack came at the same time that the FDA was reporting that much like 2011, 2012 has proven to a great year for patients with the approval of 35 innovative drugs.
Here is the actual argument from the book:
"In the five years from 1998 through 2002 [...] 415 new drugs were approved -- an average of 83 per year. Of those, 133 (32 percent) were new molecular entities. The others were variations of old drugs. And of those 133, only 58 were priority review drugs. That averages out to no more than 12 innovative drugs per year, or 14 percent of the total."
"Over the four years beginning in 2000, there were just 32 innovative drugs out of a total of 314 approved drugs. Even in this small collection, only seven came from the top ten U.S. drug companies."
The book was published ten years ago, but if you look at the most recent data from the FDA then it's similar:
In the five years between 2007 and 2011, a total of 119 New Molecular Entities were approved by the FDA. Of these, only 50 were granted priority review, meaning they were classified by the FDA as having the potential to provide a therapy where none exists or providing a therapy which may be potentially superior to existing therapy. Of these 50 priority NMEs, 30 were orphan drugs, meaning they were approved for diseases that affect 200,000 or fewer Americans. Of these, it's not clear how many (if any) were created by large American pharma companies. [1]
http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugs...
Re: The Placebo Effect Doesn’t Apply Just to Pills
#70> They had an incision, and a procedure was faked so that they didn’t know that they actually had nothing done.
Is it just me, or does this seem ethically dubious? A sugar pill placebo does no harm, but when you are cutting people open to "fake" surgery...just doesn't sit right.