31–40 of 42 posts
The placebo/nocebo effect appears to be simply an example of the confirmation bias, a couple of other psychological biases and various other known statistical effects. > False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variab…
> Companies spend millions of dollars and often decades testing drugs; every drug must outperform placebos if it is to be marketed. “If we can identify people who have a low predisposition for placebo response, drug companies can preselect for them,” says Winkler. “This could seriously reduce the size, cost, and duration of clinical trials…bringing cheaper drugs to the market years earlier than before.” Wat? Is that…
I think what he means to convey there is that a person with a low predisposition would be affected by the actual content in the drug than just taking any pill. Including predisposition to placebo as a variable would just increase the number of experiments needed. Instead, if you could eliminate a variable from the system by preselecting for people for whom the variable doesn't apply, it would reduce the time to exper…
... if the goal is to reduce the time to prove that your drugs work. That goal is different from making drugs that work.
For an analogy - in order to prove that I'm smart, I must compete with those others who're known to be smart, not with those who've (by some agreed on measure) demonstrated a lack of the required aptitude.
Even this article keeps emphasizing throughout that Kaptchuk is at Harvard, he got praise from scholars, etc.
So the real proof of a drug's worthiness ought probably to be that it works over and above the placebo effect shown for those who respond very well to placebos. That would provide more data to help evaluate the risk of a drug to a patient, given placebo predisposition can indeed be measured. That would be important particularly if the drug has significant unwanted side effects.
edit: And fwiw, preselecting for those who would respond well to placebos would also reduce the time to experiment .. but, I think, it would do so in the right way.
http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo...
Going deeper: we human animals have limited physiological resources. Are they channelled into healing or surviving? If you are in a dangerous environment, then it's survival first, healing second. Therefore, a sense of safety will promote healing.
A placebo provides just that.
The placebo/nocebo effect appears to be simply an example of the confirmation bias, a couple of other psychological biases and various other known statistical effects. > False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variab…
But doesn't this matter?
As it says in the article of course, feeling better when you're not actually better can be dangerous for potentially lethal ailments; but in diseases that don't kill you, feeling better means a lot.
From 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…
Huh, your extensive research doesn't square with much of what I learned as a neuroscience undergrad. We read a few papers that demonstrated non-trivial physiological responses due to 'sham' treatments. In particular, placebo treatments have a well established impact on pain by causing release of endogenous opioids (see http://webusers.astro.umn.edu/~larry/CLASS/NOTHING/READINGS/... and http://pharmacology.ucsd.edu/gr…
For practical application there are other OTC substances you can take (such as adaptogens/anxiolytics - e.g. Ashwaganda & l-theanine) which will have a placebo effect (obviously differing on method of deliver (white coat vs. self, injection vs. pill) and additional effects.
Earlier quoted context omitted.
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" practitioner…
That's not 100% true. It's only really the case in patent protected medicines. New drugs undergo testing, to get FDA approval. New surgical treatments don't. New (and old) surgical treatments and old drugs aren't lucrative enough to warrant real testing. Surgeons will claim it's for ethical reasons, or because they just know better, or that they are artists who can't be constrained by the laws of statistics, but it's…
Correct. That's why I expressed it as a relative position instead of making any such absolute claims.
Earlier quoted context omitted.
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.
If the placebo effect is superstition, as most comments in this thread seem to imply, how come pharmaceutical companies are finding it increasingly hard to beat? http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo...
As we address more and more of the "big" pharmaceutical effects, that only leaves the very minor ones or big ones that only apply to increasingly thinner edge cases.
If the human body was software, one might say that the pharmaceutical companies have debugged it to the point that they have little left to find other than kilobyte-sized memory leaks. Beyond that, the vast majority of the blue-screening issues remain PEBKAC errors.
From 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…
http://www.ncbi.nlm.nih.gov/pubmed/22287549
> process by which stress may potentiate carcinogenesis and how reducing body stress may prevent cancer growth and progression. The opioid peptide β-endorphin plays a critical role in bringing the stress axis to a state of homeostasis
http://www.scienceagogo.com/news/20050725232410data_trunc_sy...
> A study from the University of Michigan (U-M) has provided the first direct evidence that endorphins - the brain's own pain-fighting chemicals - do play a role in the phenomenon known as the placebo effect
Sure throws a spanner in the works.