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"Even when the clinical evidence isn’t there"

Discussion in 'Other Health News and Research' started by Sean, Feb 18, 2013.

  1. Sean

    Sean Senior Member

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    http://harvardmagazine.com/2013/03/a-cardiac-conundrum
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  2. PhoenixDown

    PhoenixDown Senior Member

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    Thanks for the link.
    Funny how you can get away with mentioning those things in the context of heart disease, but if you mention them in the context of CFS, ME, or Fibromyalgia then you're a "conspiracy theorist". Interesting double standard,
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  3. golden

    golden Senior Member

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    I was shocked to read somewhere that 85% of allopathic meficine has no scientific evidence base whatso ever!

    I had to pause and reflect upon that for considerable time.

    That means only around 15% is scientific (in the way the common person would expect the word scientific to mean)

    Also 60% or more of allopathic drugs are only working at a placebo level.

    It really is peculiar.
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  4. Sean

    Sean Senior Member

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    Just to make life interesting, we can't even assume that the placebo effect has much significance on real world outcomes.

    http://www.ncbi.nlm.nih.gov/pubmed/20091554

    In other words, the majority of allopathic drugs don't work in any way at all, not even as placebo effect modulator.

    Completely useless all round.

    Now, if the placebo effect in the real world is insignificant, then the significance of the flip side of that putative psychogenic process – the nocebo effect, which is theorised by psychogenists to be the primary driver of CFS – is in serious doubt too.

    I think that is the politest way I can say it.
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  5. golden

    golden Senior Member

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    http://www.whale.to/a/evidence_based.html

    I was just looking at this link.

    I do think placebo and nacebo exist though.

    personally, i would be overjoyed if i activated my placebo - people have done this with cancer etc i have read.



    equally when people are given a negative diagnoses from the white coats in the sky - there is substantial evidence that they die on que - even when they discovered they made an error in diagnoses and it was only just a minor ailment!
  6. golden

    golden Senior Member

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    I have just realised there are different types of 'placebo' and 'nacebo'

    The head of glaxo smith kline acknowledged most drugs do not work a few years ago. But its worse than that because they are a toxic substance and have side effects.

    It really does get complicated. hmmmmmm
  7. peggy-sue

    peggy-sue

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    The placebo/nocebo effect does exist.
    The only difference between them is one outcome is beneficial, while the other isn't. The principle is exactly the same.
  8. Sean

    Sean Senior Member

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    Even if the effect exists, there is no good evidence it makes any difference to clinical outcomes.

    The placebo/nocebo effect is vastly over rated.
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  9. peggy-sue

    peggy-sue

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    But it still has to be accounted for in experimental controls.

    Homeopathy depends entirely on the placebo effect - as does acupuncture.
    But I reckon homeopathy and acupuncture are vastly over-rated. :p
  10. golden

    golden Senior Member

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  11. golden

    golden Senior Member

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    I am certain i am missing your main point Sean. I feel hazy on the subject.

    different types of placebo....

    1) the 'sugar pill' - no active ingredients in
    2) The colourful bitter pill provided by a Doctor - no active ingredients in
    3) A tablet with active ingredients in - but which only works at best at placebo levels

    why is this? is it because the side effects cause it to perform worse than a placebo eg: headache tablets cause headaches and anti-depressants can cause depression....

    Then there is Homeopathic Medicine which can be liquid but to add to confusions is actuall also administered in sugar pillules...

    some people believe these are placebo and others say they have been trialled against a placebo and can out perform a placebo.

    4) then there are surgical placebos. eg. terminal cancer has been operated on in surgery and because the patient was told all cancer had gone - then they were cured.

    5) then there is self induced placebo - this must surely be activating the bodies own powers to heal itself.

    6) there is also hypnotic placebo - activated purely by the power the doctor has over you - either positive or negative.

    i think some types of placebo are overated - but the mystery of other types of placebo are massively underated....

    eg: the person just cured themself of heart failure - oh thats kust placebo.

    i find myself asking after all that - what is placebo? :)
  12. MishMash

    MishMash *****

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    Placebo and the over-reliance on mice models. Two major reasons why medical findings turn out to be bogus. Mice are mice. Much more often than not their systems react extremely different than humans'. MS has been cured numerous times in genetically engineered mice. All "cures" have failed miserably when applied to people.

    Mice Fall Short as Test Subjects for Humans’ Deadly Ills: NY Times

  13. Esther12

    Esther12 Senior Member

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    Ta Fire.

    People love stories. Curses.
  14. Esther12

    Esther12 Senior Member

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    Sorry if this is a bit OT, but it seemed a bit relevent, so I thought I'd add it to the thread:p

    http://news.yahoo.com/psychologists-confront-rash-invalid-studies-152250031.html
    Psychologists Confront Rash of Invalid Studies

    By Tia Ghose, LiveScience Staff Writer | LiveScience.com – 11 hrs ago

    In the wake of several scandals in psychology research, scientists are asking themselves just how much of their research is valid.
    In the past 10 years, dozens of studies in the psychology field have been retracted, and several high-profile studies have not stood up to scrutiny when outside researchers tried to replicate the research.
    By selectively excluding study subjects or amending the experimental procedure after designing the study, researchers in the field may be subtly biasing studies to get more positive findings. And once research results are published, journals have little incentive to publish replication studies, which try to check the results.
    That means the psychology literature may be littered with effects, or conclusions, that aren't real. [Oops! 5 Retracted Science Studies]
    The problem isn't unique to psychology, but the field is going through some soul-searching right now. Researchers are creating new initiatives to encourage replication studies, improve research protocols and to make data more transparent.
    "People have started doing replication studies to figure out, 'OK, how solid, really, is the foundation of the edifice that we're building?'" said Rolf Zwaan, a cognitive psychologist at Erasmus University in the Netherlands. "How solid is the research that we're building our research on?"
    Storm brewing
    In a 2010 study in the Journal of Social and Personal Psychology, researchers detailed experiments that they said suggested people could predict the future.
    Other scientists questioned how the study, which used questionable methodology such as changing the procedure partway through the experiment, got published; the journal editors expressed skepticism about the effect, but said the study followed established rules for doing good research.
    That made people wonder, "Maybe there's something wrong with the rules," said University of Virginia psychology professor Brian Nosek.
    But an even bigger scandal was brewing. In late 2011, Diederik Stapel, a psychologist in the Netherlands, was fired from Tilburg University for falsifying or fabricating data in dozens of studies, some of which were published in high-profile journals.
    And in 2012, a study in PLOS ONE failed to replicate a landmark 1996 psychology study that suggested making people think of words associated with the elderly — such as Florida, gray or retirement — made them walk more slowly.
    Motivated reasoning
    The high-profile cases are prompting psychologists to do some soul-searching about the incentive structure in their field.
    The push to publish can lead to several questionable practices.
    Outright fraud is probably rare. But "adventurous research strategies" are probably common, Nosek told LiveScience. [The 10 Most Destructive Human Behaviors]
    Because psychologists are so motivated to get flashy findings published, they can use reasoning that may seem perfectly logical to them and, say, throw out research subjects who don't fit with their findings. But this subtle self-delusion can result in scientists seeing an effect where none exists, Zwaan told LiveScience.
    Another way to skew the results is to change the experimental procedure or research question after the study has already begun. These changes may seem harmless to the researcher, but from a statistical standpoint, they make it much more likely that psychologists see an underlying effect where none exists, Zwaan said.
    For instance, if scientists set up an experiment to find out if stress is linked to risk of cancer, and during the study they notice stressed people seem to get less sleep, they might switch their question to study sleep. The problem is the experiment wasn't set up to account for confounding factors associated with sleep, among other things.
    Fight fire with psychology
    In response, psychologists are trying to flip the incentives by using their knowledge of transparency, accountability and personal gain.
    For instance, right now there's no incentive for researchers to share their data, and a 2006 study found that of 141 researchers who had previously agreed to share their data, only 38 did so when asked.
    But Nosek and his colleagues hope to encourage such sharing by making it standard practice. They are developing a project called the Open Science Framework, and one goal is to encourage researchers to publicly post their data and to have journals require such transparency in their published studies. That should make researchers less likely to tweak their data.
    "We know that behavior changes as a function of accountability, and the best way to increase accountability is to create transparency," Nosek said.
    One journal, Social Psychology, is dangling the lure of guaranteed publication to motivate replication studies. Researchers send proposals for replication studies to the journal, and if they're approved, the authors are guaranteed publication in advance. That would encourage less fiddling with the protocol after the fact.
    And the Laura and John Arnold Foundation now offers grant money specifically for replication studies, Nosek said.
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  15. Sean

    Sean Senior Member

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    The possibility of placebo effect certainly has to be controlled for, no argument there. Placebo arm should be a minimum requirement for all clinical studies, where possible.

    My point is that if a significant generic placebo effect was going to show up in randomised placebo-controlled clinical trials, it should have shown up in that review/meta-analysis I linked to above. But it didn't, and that has serious implications about the significance of placebo/nocebo effect, or lack of it.

    And if there is no significant effect, then I would strongly argue that removes the central theoretical justification for the psychogenic model of CFS.
  16. golden

    golden Senior Member

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    A priori is the first thing to root out.

    For example the assumption that scientifically tested medicine yields better clinical results than other medicines.

    Then I wonder which placebo is being trialled? For example different coloured and sized pills yield differing results. If the pill is bitter it works better than sweet or pleasant. If the pill is administered by a doctor it will work better than a pill administered by a Nurse.

    So we maybe trialling a drug - we may test like for like in the drug and the placebo. A yellow drug and a yellow placebo.

    But what if a purple placebo would do better than the yellow drug? what if a top specialist of which there are only 5 in the world flew in and administered the placebo and yielded better results than the yellow drug?

    The drug companies were fed up with the placebo percentage and so they calculated in the first drug trial all those who were 'susceptible' to the placebo and filtered them out. They did the trial again and profoundly - the same percentage of placebo rate occurred - thats whackey....

    I have not studied what the psychologists say of M.E. and placebo - probably more rubbish :)
  17. golden

    golden Senior Member

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    All Animal Experiments are useless. It is total propaganda.

    Even in 1912 Dr. Wolfgang Bonn wrote in the Medical Journal:

    'The constant spread of the vivisectionist method has achieved but one thing: to increase the scientific torture and murder of human beings. We can expect this increase to continue for it would be the logical consequence of animal vivisection'

    http://www.whale.to/a/ruesch4.html

    So you begin by testing on animals after artificially inducing an illness.

    The results on animals are promising. So the go ahead is given for human trials. The human trials fail - sometimes causing cancer, death or child deformities.

    Scenario 2 - So we test on animals and the results are very bad - cancer, death etc.

    So we go ahead as per scenario 1 and begin the human trials.

    Why? because, the vivisectors argue, animals are not humans and what happens to animals has no relevance to what happens in humans.

    So, whilst anima
    l experiments are a huge money maker - they actually hinder science and medicine.

    Whilst drugs are on the market that cause cancer in animals, there are drugs on the market which have been apprpved as safe in animals and had disastrous effects in humans. This is also why 50-60 plus drugs are removed from the market each year because they are dangerous.

    Dr. Hadwen Trust has some interesting observations on this.

    Over three quarters of animals experimented on have no anaesthetic. And I cant help but wonder of the type of person who can do this and equate it with the fact that human babies were also given no anaesthetic when they qere operated on up until parents found out in 1986. The scientific belief was that babies did not feel pain. They poked them with pins and concluded the cries were random or some other such psychological knowledge.

    Again, anyone who has nursed a baby with teething troubles or colic knows a baby feels pain - and yet doctors insisted on doing open heart surgery on babies with no pain relief.
    It is beyond my comprehension.

    There was a doctor that rushed through some scientific tests to prove that babies did feel pain and so the medical practices changed after 1986.
  18. golden

    golden Senior Member

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    I have been searching for this fascinating story of surgical placebos.

    There was a man called Wright who had cancer and was given water which melted his tumours....

    The stats in these articles rate placebo at 30-40% and upto 90% .

    http://www.wrf.org/alternative-therapies/power-of-mind-placebo.php

    :)

    I also found it interesting that the placebo chemotherapy making 30% of patients loose their hair ...
  19. jimells

    jimells Senior Member

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    There seems to be no end to the cruelty and ignorance of the medical 'profession'. Even though babies are now recognized to feel pain, I have to wonder how many male infants are still subject to genital mutilation without anaesthetic.
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