Tag: placebo effect
Placebo Myths Debunked
Placebo treatments are often sold as magical mind-over-matter healing effects, but they are mostly just illusions and non-specific effects.
ORBITA: Another clinical trial demonstrating the need for sham controls in surgical trials
Last week, the results of ORBITA were published. This clinical trial tested coronary angioplasty and stenting versus optimal medical management in patients with single-vessel coronary artery disease. It was a resoundingly negative trial, meaning that adding stenting to drug management didn't result in detectable clinical improvement. What was distinctive about this trial is that it used a sham procedure (i.e., placebo) control,...
An Industry of Worthless Acupuncture Studies
Even more interesting to me than the question of whether or not acupuncture is effective for any particular symptom is the meta-question of how acupuncture proponents have managed to promote a treatment with systematically terrible scientific data. A new study provides a fresh example of this, which I will discuss below. I think the behavior of acupuncturists reflects the fact that there...
Placebo by Conditioning
Truly understanding placebo effects (note the plural) is critical to science-based medicine. Misconceptions about placebo effects are perhaps the common problem I encounter among otherwise-scientific professionals and science communicators. The persistence of these misconceptions is due partly to the fact that false beliefs about placebos, namely that “the” placebo effect is mainly an expectation mind-over-matter effect, is deeply embedded in the culture....
Placebo, Are You There?
By Jean Brissonnet, translation by Harriet Hall Note: This was originally published as “Placebo, es-tu là?” in Science et pseudo-sciences 294, p. 38-48. January 2011. It came to my attention in the course of an e-mail correspondence with the editors of that magazine, where one of my own articles was published in French translation in January 2015. I thought this was the...
Acupuncture Odds and Ends
I’m cheating. No, I’m recycling. ‘Tis the season to have to no time to get anything done. Since I know none of you pay attention to the blog of at the Society for Science-Based Medicine and I have no time with work and the holidays to come up with new material, I am going to collect and expand on the entries on...
Michael Specter on the Placebo Effect
Michael Specter is a good science journalist. I particularly enjoyed his book, Denialism. In a recent New Yorker article he tackles the difficult question of the placebo effect in modern medicine. While he does a fair job of hitting upon the key points of this question, I think he missed some important aspects of this question and allowed the views of Ted...
Placebos as Medicine: The Ethics of Homeopathy
Is it ever ethical to provide a placebo treatment? What about when that placebo is homeopathy? Last month I blogged about the frequency of placebo prescribing by physicians. I admitted my personal discomfort, stating I’d refuse to dispense any prescription that would require me to deceive the patient. The discussion continued in the comments, where opinions seemed to range from (I’m paraphrasing) ...
Pragmatic Studies and Cinderella Medicine
Explanatory studies are done under controlled conditions to determine whether a treatment has any efficacy compared to a placebo. Pragmatic studies are designed to assess how the intervention performs in everyday real world practice. Pragmatic studies measure practical success but don’t determine actual efficacy: that requires a proper randomized controlled trial (RCT) with an appropriate control. Pragmatic studies have their place, but...
Placebo Prescriptions
Whether it’s acupuncture, homeopathy or the latest supplement, placebo effects can be difficult to distinguish from real effects. Today’s post sets aside the challenge of identifying placebo effects and look at how placebos are used in routine medical practice. I’ve been a pharmacist for almost 20 years, and have never seen a placebo in practice, where the patient was actively deceived by...