

Placebos work, even when patients are in the know, study finds - Alex3917
http://articles.latimes.com/print/2010/dec/22/health/la-he-placebo-effect-20101223

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m104
I just spent an hour yesterday explaining to a coworker that correlation !=
causation, data and statistics can easily deceive, and that most published
study findings are likely incorrect. It was a little soul-crushing, therefore,
to run across this headline and simultaneously hear an uncritical summary of
this study on NPR this morning...

Said coworker told me, after seeing that correlation != causation, that she
was never taught that in school. I replied that likely she _had_ but that the
concept is easy to forget and almost never reinforced in daily life. Thinking
about it today, it seems like nearly all marketing efforts try to convince the
intended audience that correlation == causation.

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Luc
We're used to scientific studies being misrepresented, but additionally the
study itself seems to have some problems:

[http://scienceblogs.com/insolence/2010/12/more_dubious_state...](http://scienceblogs.com/insolence/2010/12/more_dubious_statements_about_placebo_ef.php)

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Alex3917
The author of that blog post is a moron. He couldn't find a single flaw in the
methodology that the researchers don't bring up themselves. All he's doing he
cut and pasting directly from the journal article and pretending to be
intelligent, when in fact he's adding absolutely nothing to the conversation.

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extension
I would like to see this repeated with a medical condition that can be
diagnosed without blindly trusting the word of the patient.

It should also be verified that the patient fully understands the meaning of
"placebo".

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mansr
This is perfectly logical, assuming the patients were aware of the placebo
effect. I wonder what the results would be if some patients were given real
medication while being told it was placebo.

~~~
hugh3
No, it's surprising. I was under the impression that a placebo worked only if
you didn't know it was a placebo. If you feed me a placebo while telling me
it's a placebo then I would be under the impression that it would be non-
effective, thus we wouldn't expect to get any placebo effect since I wasn't
expecting it to work.

Having read this headline, though, I now have the opposite expectation: that
placebos work even when you know they're placebos. This, for me, is
_excellent_ news, since I can now start taking placebos every time I feel sick
and thus get better due to the placebo effect due to the fact that I now
expect placebos to work and hence will now get a significant placebo effect
from placebos!

The best part is that this works even if this study _is_ bullshit.

~~~
andylei
Maybe not. From the article:

>> "My personal hypothesis is this would not happen without a positive doctor-
patient relationship," Kaptchuk said.

>> Others agreed.

>> "What seems to be the active ingredient is the warm, personal
relationship," said Dr. Howard Brody of the University of Texas Medical Branch
in Galveston.

~~~
gwern
Those quotes excellently work with the theory of health care & placebos in
<http://hanson.gmu.edu/showcare.pdf>

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A1kmm
Firstly, placebo studies don't require deception - patients are generally told
that they might be getting the placebo, or they might be getting the real
thing; they don't know which one, but uncertainty is different to deception.
In a double blind study) the people interacting with the patient don't know
who gets which either - so they aren't deceiving the patient, they genuinely
don't know.

Secondly, in this case, what if the placebo is not genuinely inert? The
'placebo' was cellulose (dietary fibre) in a gelatine capsule, and apparently
fibre is the standard treatment for irritable bowel syndrome.

Thirdly, showing that open label placebos might be better than controls is not
enough to justify using an open label placebo in a clinical; instead, they
would need to have compared an open to a closed label placebo. If a closed
label placebo works better than an open label one, then a drug which is not
efficacious could be accepted by a clinical trial because it was an
unintentional closed label placebo and did better than the intentional open
label placebo. In addition, closed label placebos are not just for the patient
- they also play a role in double blind clinical trials of keeping the doctors
dealing with the patient / assessing results from knowing.

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rflrob
There's also the possibility that the placebo effect in this case was due to
some attempt to reduce cognitive dissonance: "why would they have me take this
pill if it's actually useless?"

I suspect the Hawthorne Effect is the most likely explanation, though.

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js2
And here's the study:
[http://www.plosone.org/article/info:doi/10.1371/journal.pone...](http://www.plosone.org/article/info:doi/10.1371/journal.pone.0015591)

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JulianMorrison
This post is a placebo. You are now cured.

