Placebo responses are really weird; there's an article here (http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all) discussing how placebos seem to be becoming more powerful over time.
All they've shown is that reverse psychology (you're taken into a medical environment and given something as part of a clinical trial that you've signed up for and you're told that it "Isn't a drug, it's just a placebo", even go to the extreme length of putting the word "PLACEBO" on the side of the pill bottle, and you expect people to believe them that it's a placebo? The entire job of a medical research scientist is to lie to everyone including yourself* on a daily basis – If, after the first week, your clothes don't start to smell of lies and deceit you're doing something wrong) can also produce a placebo effect in a clinical trial.
I hope the paper they eventually submit has "Proving a negative is hard, like, really really hard, like, SERIOUSLY HARD you guys!!eleventy!!!" as the entirety of their conclusion.
* and don't get me started on how this study wasn't even double blind! ffs.
Though if you really did want to do this study properly, what you'd do is set up one group of patients as getting a placebo, but who are not informed that they are getting a placebo, and the second group who is informed that they are receiving a placebo from the get go and given the bottles with the pills that say "PLACEBO" on them – that way you can test the effects of a regular "hidden" placebo treatment versus an "informed" placebo treatment, and are able to actually produce a result that allows you to compare the two types of treatment to find out if placebo treatments require the "hidden" element to produce an effect, rather than compare a placebo effect against no treatment at all (the latter of which may introduce variables that are not only unexaminable in the context of the study but also go unexamined – which is quite frankly pants methodology at its very pantsiest).
The real neat thing to do for this sort of study would involve 4 groups of researchers. You take the first two groups, tell them you're doing a study on the effect that having researchers know that they're administering placebos has on researchers, as a justification for taking these two researcher groups and having them examined and tested by the other two groups, both of whom slip a placebo to the first two groups of researchers – however, one group of subject/researchers is told the real purpose of the overall study and that what is being given to them is a placebo before it's administered, but the other group is told that it's a new tracer substance used to measure something in their renal system. This way you can examine the effect of "informed" placebos versus the effect that slipping a placebo has to people who have no idea at all that they're being administered with any kind of placebo at all (and thereby providing a group that should not produce ANY placebo effect at all), thus achieving the actual aims of the study because even the effect of of being examined and administered with a drug is controlled for, plus you can add in a double blind element by not telling the researchers administering the "real" placebos which is a placebo and which isn't – have the researchers overseeing both experiments be the ones to inform the experimental subject group of researchers that they're being administered with a placebo before the first examination.
The way they've done this though is bad research and the researchers should feel bad for doing it that way. v. sloppy. I'll probably track down who these clowns are and send them an email over the holidays.
might it not also have made sense to have a group/set of gorups that thinks they're giving a placebo, but are in fact administering a 'known' 'effective' treatment?
delusions are powerful: you really ought to try them all before you decide which is better ... >.<
Maybe it's just people using mindfulness/attention to see if this substance makes them feel better during tests, and *the act of observing as opposed to building up drama about their situation* probably helps trremendously--
1. No blinding. 2. Poorly matched groups. 3. They were TOLD they would receive "either placebo (inert) pills, which were like sugar pills which had been shown to have self-healing properties", which is not exactly a placebo, especially given the lack of blinding and that placebo effects increase with expectation. 4. All the outcome measures were highly subjective, which renders placebo effect more 'powerful'. 5. The illness itself is prone to waxing and waning, rendering any positive change more likely to be ascribed to the placebo.
Furthermore, I want to point out yet again that placebo effects do NOT refer to mind-over-matter self healing effects.
Placebo effects are non-specific effects of treatment. This often includes subjective feelings of improvement, especially when reporting outcomes; spontaneous improvement during the study; wanting to please investigators; regression to the mean; and other such artefacts of seeking treatment or enlisting in a study.
(I'd also point out that the authors are NCCAM people and their interpretation of their results should be viewed in that light)
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(no subject)
Date: 2010-12-23 09:44 pm (UTC)(no subject)
Date: 2010-12-23 09:49 pm (UTC)(no subject)
Date: 2010-12-23 10:23 pm (UTC)I hope the paper they eventually submit has "Proving a negative is hard, like, really really hard, like, SERIOUSLY HARD you guys!!eleventy!!!" as the entirety of their conclusion.
* and don't get me started on how this study wasn't even double blind! ffs.
(no subject)
Date: 2010-12-23 11:35 pm (UTC)The real neat thing to do for this sort of study would involve 4 groups of researchers. You take the first two groups, tell them you're doing a study on the effect that having researchers know that they're administering placebos has on researchers, as a justification for taking these two researcher groups and having them examined and tested by the other two groups, both of whom slip a placebo to the first two groups of researchers – however, one group of subject/researchers is told the real purpose of the overall study and that what is being given to them is a placebo before it's administered, but the other group is told that it's a new tracer substance used to measure something in their renal system. This way you can examine the effect of "informed" placebos versus the effect that slipping a placebo has to people who have no idea at all that they're being administered with any kind of placebo at all (and thereby providing a group that should not produce ANY placebo effect at all), thus achieving the actual aims of the study because even the effect of of being examined and administered with a drug is controlled for, plus you can add in a double blind element by not telling the researchers administering the "real" placebos which is a placebo and which isn't – have the researchers overseeing both experiments be the ones to inform the experimental subject group of researchers that they're being administered with a placebo before the first examination.
The way they've done this though is bad research and the researchers should feel bad for doing it that way. v. sloppy. I'll probably track down who these clowns are and send them an email over the holidays.
(no subject)
Date: 2010-12-24 02:57 am (UTC)delusions are powerful: you really ought to try them all before you decide which is better ... >.<
(no subject)
Date: 2010-12-24 01:55 am (UTC)(no subject)
Date: 2010-12-24 09:11 pm (UTC)(no subject)
Date: 2010-12-24 09:22 pm (UTC)(no subject)
Date: 2010-12-26 01:50 pm (UTC)Er, not really.
1. No blinding.
2. Poorly matched groups.
3. They were TOLD they would receive "either placebo (inert) pills, which were like sugar pills which had been shown to have self-healing properties", which is not exactly a placebo, especially given the lack of blinding and that placebo effects increase with expectation.
4. All the outcome measures were highly subjective, which renders placebo effect more 'powerful'.
5. The illness itself is prone to waxing and waning, rendering any positive change more likely to be ascribed to the placebo.
Furthermore, I want to point out yet again that placebo effects do NOT refer to mind-over-matter self healing effects.
Placebo effects are non-specific effects of treatment. This often includes subjective feelings of improvement, especially when reporting outcomes; spontaneous improvement during the study; wanting to please investigators; regression to the mean; and other such artefacts of seeking treatment or enlisting in a study.
(I'd also point out that the authors are NCCAM people and their interpretation of their results should be viewed in that light)