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Home > Archive > Psoriasis support > February 2006 > Placebo effect
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| Fizziwig2 2006-02-25, 8:14 pm |
| I saw an interesting programe on BBC2 on Tuesday "Alternative medicine: the
evidence" which seemed to prove beyond doubt that placebos work. Looking at
spiritual healers and doctors work and experiments in the field.
The scientist Professor Kathy Sykes from Bristol university the presenter,
examined amongst others their effects on Parkinson's disease and even a
surgical experiment when only half the people with osteoarthritis had the
operation and all of them improved.
If it comes your way see it.
It appears to me though, that all the arguments people on this newsgroup put
forward for their own successes are true in their own case - as they
"believe" in them. ie: the placebo effect. Having their treatment damned by
others on the group therefore does them no good.
(In Alternative Medicine: The Evidence, Professor Kathy Sykes examines three
forms of alternative medicine - acupuncture, healing and herbalism - to see
if there is any scientific evidence for their effectiveness).
Acupuncture got a good result too for the relief of pain.
http://www.bbc.co.uk/pressoffice/pr.../medicine.shtml
Skeats
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| JXStern 2006-02-25, 8:14 pm |
| On Thu, 02 Feb 2006 13:55:45 GMT, "Fizziwig2"
<atthebackofthenorthwind@kingdomcom.co.uk> wrote:
>I saw an interesting programe on BBC2 on Tuesday "Alternative medicine: the
>evidence" which seemed to prove beyond doubt that placebos work. Looking at
>spiritual healers and doctors work and experiments in the field.
I'm really sour about "plabebo effect". I think it's mostly bad
statistics, bad observation, and 19th century medicine still being
taught to modern-day med students.
Yes, some people can be made to report modest improvements, if asked
every day by a cute nurse who really wants to record good news. But
that's like the "Hawthorne Effect" in industrial engineering, where
they painted the walls a nice color to see what effect it had, and
productivity improved, and then they changed the color back again, and
productivity ... improved again! In that field, that's now considered
just bad experimental design. News hasn't quite made it over to the
medical field yet, it's only been about 80 years!
A lot of complaints to doctors are just passing pains, or
psychological in nature - bored people who decide to have some minor
pain looked at, that busy people would simply ignore.
And, before antibiotics, way before molecular biology, your average
physician had really nothing to offer but a smile, or an earnest
instruction to get better, and useless potions to base the
recommendations on. Was not all that long ago. AFAIK doctors are
still taught about the importance of a positive mental attitude and so
freely lie to patients about their conditions and outlooks. Then they
put the leeches on you and start dancing and hollering and ...
J.
| |
| Fizziwig2 2006-02-25, 8:14 pm |
|
"JXStern" <JXSternChangeX2R@gte.net> wrote in message
news:k3c4u1592b1g8o0n8t1m0mo1dm90f2okb6@4ax.com...
> On Thu, 02 Feb 2006 13:55:45 GMT, "Fizziwig2"
> <atthebackofthenorthwind@kingdomcom.co.uk> wrote:
>
> I'm really sour about "plabebo effect". I think it's mostly bad
> statistics, bad observation, and 19th century medicine still being
> taught to modern-day med students.
>
> Yes, some people can be made to report modest improvements, if asked
> every day by a cute nurse who really wants to record good news. But
> that's like the "Hawthorne Effect" in industrial engineering, where
> they painted the walls a nice color to see what effect it had, and
> productivity improved, and then they changed the color back again, and
> productivity ... improved again! In that field, that's now considered
> just bad experimental design. News hasn't quite made it over to the
> medical field yet, it's only been about 80 years!
>
> A lot of complaints to doctors are just passing pains, or
> psychological in nature - bored people who decide to have some minor
> pain looked at, that busy people would simply ignore.
>
> And, before antibiotics, way before molecular biology, your average
> physician had really nothing to offer but a smile, or an earnest
> instruction to get better, and useless potions to base the
> recommendations on. Was not all that long ago. AFAIK doctors are
> still taught about the importance of a positive mental attitude and so
> freely lie to patients about their conditions and outlooks. Then they
> put the leeches on you and start dancing and hollering and ...
>
> J.
>
You are right to be suspicious but the programme was very persuasive.
They use leeches in hospitals these days as they have been proved to work.
They also use sterilised maggots to clean and sterilise ulcers and wounds.
Old treatments that have been proved beyond doubt to work.
I wonder how many of us psoriatics are of the "doubting Thomas" kind and
thus impervious to placebo effects?
The arthritis placebo experiment on the programme was particularly
interesting to me though - suffering (slightly) from it myself.
Skeats
| |
| randall 2006-02-25, 8:14 pm |
|
Fizziwig2 wrote:
> "JXStern" <JXSternChangeX2R@gte.net> wrote in message
> news:k3c4u1592b1g8o0n8t1m0mo1dm90f2okb6@4ax.com...
>
> You are right to be suspicious but the programme was very persuasive.
>
> They use leeches in hospitals these days as they have been proved to work.
> They also use sterilised maggots to clean and sterilise ulcers and wounds.
> Old treatments that have been proved beyond doubt to work.
>
> I wonder how many of us psoriatics are of the "doubting Thomas" kind and
> thus impervious to placebo effects?
I prayed for any placebo effects for ever and then doubted they would
ever make much of a difference. Then daveW called me on the carpet for
it as they are significant in the testing process.
So i went did a double blind study. To this day i'm still a little
ambivalent as
to the fact that i didn't get the placebo.
So that set me straight.
And looking back in hind sight I could see I may have been scammed
by my own belief system.
Looking at that now. I 'd have to say the mind doesn't (in my case)
trick the
P genes to produce any more then a few % change.
And with the good gut flora diet and low fats and taking the right
supplements I can
produce a high % clearance naturally.
But who wants to live on a spartan diet 24/7?
I need to hypnotize me in to being happy with the really really simple
life?
randall.. randumb thoughts on P and the weather! or ?
>
> The arthritis placebo experiment on the programme was particularly
> interesting to me though - suffering (slightly) from it myself.
>
> Skeats
Thanks skeats. I will look forward to seeing it. I'll google bbc2 for
it.
| |
| JXStern 2006-02-25, 8:14 pm |
| On Thu, 02 Feb 2006 18:41:29 GMT, "Fizziwig2"
<atthebackofthenorthwind@kingdomcom.co.uk> wrote:
>You are right to be suspicious but the programme was very persuasive.
Persuasive, and wrong.
>They use leeches in hospitals these days as they have been proved to work.
>They also use sterilised maggots to clean and sterilise ulcers and wounds.
>Old treatments that have been proved beyond doubt to work.
I meant no disrespect to leeches or maggots!
But if they work, it's not because of the patient's mental attitude.
>I wonder how many of us psoriatics are of the "doubting Thomas" kind and
>thus impervious to placebo effects?
Not me. I believed it all, the first six or seven times.
Yes, yes, I know that attitude produces or suppresses endorphins and
immune responses and stuff, I'm all for encouraging a positive
outlook, but snake oil is snake oil no matter how much you wish, and
all the sucker really gets out of it is a lighter wallet.
>The arthritis placebo experiment on the programme was particularly
>interesting to me though - suffering (slightly) from it myself.
I should probably shut up. A lot of people will confuse two things, a
positive mental attitude about treatment X, and the ability to hope
for good results. On the second, I completely endorse it. I just
don't like quacks hanging around and blaming the illness on the
patient, and I also don't like prominent doctors who can't read their
own patient notes and then blow up at the patient for not getting
better (based on a true story ...). Bottom line - hope is good, fraud
is bad, and placebo is just bad science at best, fraud at least as
often.
J.
| |
|
| On Thu, 02 Feb 2006 16:24:57 GMT, JXStern <JXSternChangeX2R@gte.net>
wrote:
>On Thu, 02 Feb 2006 13:55:45 GMT, "Fizziwig2"
><atthebackofthenorthwind@kingdomcom.co.uk> wrote:
>
>I'm really sour about "plabebo effect". I think it's mostly bad
>statistics, bad observation, and 19th century medicine still being
>taught to modern-day med students.
I believe in the Placebo effect. Not only with sugar pills, but any
body reaction to events with "expected results." Probably "fire
walkers" believe in the trance state enough that their bodies resist
burning.
I find your reference to the "Hawthorne Effect" interesting. I had
never thought of it as related to Placebos. The employees'
expectations for the changes may have been "improved performance".
The mind certainly is a powerful tool. Mind over body is a pretty
well established concept.
Why are you "sour" over this concept?
dick
>
>Yes, some people can be made to report modest improvements, if asked
>every day by a cute nurse who really wants to record good news. But
>that's like the "Hawthorne Effect" in industrial engineering, where
>they painted the walls a nice color to see what effect it had, and
>productivity improved, and then they changed the color back again, and
>productivity ... improved again! In that field, that's now considered
>just bad experimental design. News hasn't quite made it over to the
>medical field yet, it's only been about 80 years!
>
>A lot of complaints to doctors are just passing pains, or
>psychological in nature - bored people who decide to have some minor
>pain looked at, that busy people would simply ignore.
>
>And, before antibiotics, way before molecular biology, your average
>physician had really nothing to offer but a smile, or an earnest
>instruction to get better, and useless potions to base the
>recommendations on. Was not all that long ago. AFAIK doctors are
>still taught about the importance of a positive mental attitude and so
>freely lie to patients about their conditions and outlooks. Then they
>put the leeches on you and start dancing and hollering and ...
>
>J.
>
| |
|
| x-no-archive: yes
JXStern wrote:
> I'm really sour about "plabebo effect". I think it's mostly bad
> statistics, bad observation, and 19th century medicine still being
> taught to modern-day med students.
Yup.
Is the placebo powerless? An analysis of clinical trials comparing
placebo with no treatment.
Hrobjartsson A, Gotzsche PC.
Department of Medical Philosophy and Clinical Theory, university of
Copenhagen, Panum Institute, and the Nordic Cochrane Centre,
Rigshospitalet, Denmark. a.hrobjartsson@cochrane.dk
BACKGROUND: Placebo treatments have been reported to help patients with
many diseases, but the quality of the evidence supporting this finding
has not been rigorously evaluated. METHODS: We conducted a systematic
review of clinical trials in which patients were randomly assigned to
either placebo or no treatment. A placebo could be pharmacologic (e.g.,
a tablet), physical (e.g., a manipulation), or psychological (e.g., a
conversation). RESULTS: We identified 130 trials that met our inclusion
criteria. After the exclusion of 16 trials without relevant data on
outcomes, there were 32 with binary outcomes (involving 3795 patients,
with a median of 51 patients per trial) and 82 with continuous outcomes
(involving 4730 patients, with a median of 27 patients per trial). As
compared with no treatment, placebo had no significant effect on binary
outcomes (pooled relative risk of an unwanted outcome with placebo,
0.95; 95 percent confidence interval, 0.88 to 1.02), regardless of
whether these outcomes were subjective or objective. For the trials with
continuous outcomes, placebo had a beneficial effect (pooled
standardized mean difference in the value for an unwanted outcome
between the placebo and untreated groups, -0.28; 95 percent confidence
interval, -0.38 to -0.19), but the effect decreased with increasing
sample size, indicating a possible bias related to the effects of small
trials. The pooled standardized mean difference was significant for the
trials with subjective outcomes (-0.36; 95 percent confidence interval,
-0.47 to -0.25) but not for those with objective outcomes. In 27 trials
involving the treatment of pain, placebo had a beneficial effect (-0.27;
95 percent confidence interval, -0.40 to -0.15). This corresponded to a
reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue
scale. CONCLUSIONS: We found little evidence in general that placebos
had powerful clinical effects. Although placebos had no significant
effects on objective or binary outcomes, they had possible small
benefits in studies with continuous subjective outcomes and for the
treatment of pain. Outside the setting of clinical trials, there is no
justification for the use of placebos.
Publication Types:
Review
Review, Academic
PMID: 11372012 [PubMed - indexed for MEDLINE]
Susan
| |
| JXStern 2006-02-25, 8:15 pm |
| On Fri, 03 Feb 2006 05:47:38 -0600, Dick <remdickhm@sbcglobal.net>
wrote:
>Why are you "sour" over this concept?
For the reasons I just gave?
J.
| |
|
| On Fri, 03 Feb 2006 09:44:43 -0500, Susan <nevermind@nomail.com>
wrote:
>x-no-archive: yes
>
>JXStern wrote:
>
>
>
>Yup.
>
>Is the placebo powerless? An analysis of clinical trials comparing
>placebo with no treatment.
>
>Hrobjartsson A, Gotzsche PC.
>
>Department of Medical Philosophy and Clinical Theory, university of
>Copenhagen, Panum Institute, and the Nordic Cochrane Centre,
>Rigshospitalet, Denmark. a.hrobjartsson@cochrane.dk
>
>BACKGROUND: Placebo treatments have been reported to help patients with
>many diseases, but the quality of the evidence supporting this finding
>has not been rigorously evaluated. METHODS: We conducted a systematic
>review of clinical trials in which patients were randomly assigned to
>either placebo or no treatment. A placebo could be pharmacologic (e.g.,
>a tablet), physical (e.g., a manipulation), or psychological (e.g., a
>conversation). RESULTS: We identified 130 trials that met our inclusion
>criteria. After the exclusion of 16 trials without relevant data on
>outcomes, there were 32 with binary outcomes (involving 3795 patients,
>with a median of 51 patients per trial) and 82 with continuous outcomes
>(involving 4730 patients, with a median of 27 patients per trial). As
>compared with no treatment, placebo had no significant effect on binary
>outcomes (pooled relative risk of an unwanted outcome with placebo,
>0.95; 95 percent confidence interval, 0.88 to 1.02), regardless of
>whether these outcomes were subjective or objective. For the trials with
>continuous outcomes, placebo had a beneficial effect (pooled
>standardized mean difference in the value for an unwanted outcome
>between the placebo and untreated groups, -0.28; 95 percent confidence
>interval, -0.38 to -0.19), but the effect decreased with increasing
>sample size, indicating a possible bias related to the effects of small
>trials. The pooled standardized mean difference was significant for the
>trials with subjective outcomes (-0.36; 95 percent confidence interval,
>-0.47 to -0.25) but not for those with objective outcomes. In 27 trials
>involving the treatment of pain, placebo had a beneficial effect (-0.27;
>95 percent confidence interval, -0.40 to -0.15). This corresponded to a
>reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue
>scale. CONCLUSIONS: We found little evidence in general that placebos
>had powerful clinical effects. Although placebos had no significant
>effects on objective or binary outcomes, they had possible small
>benefits in studies with continuous subjective outcomes and for the
>treatment of pain. Outside the setting of clinical trials, there is no
>justification for the use of placebos.
>
I don't see how giving a placebo is in conflict with "do no harm."
I think of hypochondriacs being given real medication as harmful.
Not everyone is going to respond to therapy to solve their delusions.
If they are satisfied with a placebo, where is the harm? I presume a
true medical condition does not exist and the patient is having a
positive reaction to the placebo.
>Publication Types:
>Review
>Review, Academic
>
>PMID: 11372012 [PubMed - indexed for MEDLINE]
>
>
>Susan
| |
|
| x-no-archive: yes
Dick wrote:
> I don't see how giving a placebo is in conflict with "do no harm."
> I think of hypochondriacs being given real medication as harmful.
> Not everyone is going to respond to therapy to solve their delusions.
> If they are satisfied with a placebo, where is the harm? I presume a
> true medical condition does not exist and the patient is having a
> positive reaction to the placebo.
I always hear other folks talk about hypochondriacs, but I've never met
one, even after decades of working in mental health.
I suspect that more often than not, it's a term used by others to
dismiss the difficult to diagnose or discern illnesses of others out of
hand.
The deception involved in treatment with a placebo undermines good
medical practice, it's experimentation without informed consent.
The article shows that the placebo does not work, BTW, except for small
effects on subjective symptoms, even when those are real, so to use it
would be unethical since it's got no track record of benefits.
Susan
| |
| JXStern 2006-02-25, 8:15 pm |
| On Sat, 04 Feb 2006 05:03:27 -0600, Dick <remdickhm@sbcglobal.net>
wrote:
>I don't see how giving a placebo is in conflict with "do no harm."
>I think of hypochondriacs being given real medication as harmful.
Reminds me of a cliche from the old Soviet Union.
"We pretend to work,
and they pretend to pay us."
J.
| |
| Fizziwig2 2006-02-25, 8:15 pm |
|
"Susan" <nevermind@nomail.com> wrote in message
news:44kb7dF2j4nmU3@individual.net...
> x-no-archive: yes
>
> Dick wrote:
>
>
> I always hear other folks talk about hypochondriacs, but I've never met
> one, even after decades of working in mental health.
>
> I suspect that more often than not, it's a term used by others to dismiss
> the difficult to diagnose or discern illnesses of others out of hand.
>
> The deception involved in treatment with a placebo undermines good medical
> practice, it's experimentation without informed consent.
>
> The article shows that the placebo does not work, BTW, except for small
> effects on subjective symptoms, even when those are real, so to use it
> would be unethical since it's got no track record of benefits.
>
>
> Susan
Thanks for that Susan.
My aches and pains, fibrositis, back, stomach aches etc., (called
hypochondria by doctors who couldn't find anything wrong), were caused by
depression and they disappeared after being diagnosed and treated properly a
long time after.
Child depressives don't know what "normal" is and battle on until probably
breaking down later in life as I did.
Treating for depression didn't do my psoriasis any good though but diet did.
(also getting early retirement, a good pension and time to do the
treatments)!
Much more cheerful nowadays.
Skeats
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