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Placebo Effects in Medicine

Discussion in 'Other Health News and Research' started by MeSci, Jul 20, 2015.

  1. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Interesting NEJM article.

    Full article here

    There's also a Comments section
     
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  2. A.B.

    A.B. Senior Member

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    Worth noting that Kaptchuk has built a career on the supposed benefits of placebos. If placebos can only affect subjective symptoms that are "measured" by questionnaires, then one should reasonably consider the possibility that placebo effects are nothing but an artefact of imperfect methods, and the neurotransmitter responses nothing more than the normal reaction to positive events. What any of this has to do with curing disease I don't know.
     
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  3. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Well, at least he says that placebos can't do that. Not really sure how his approach might affect us, esp. re CBT/GET/PACE and the like. Encourage their use because they can supposedly improve symptoms? Or discourage them because they can't treat the underlying illness...unless it is a psychosomatic one...
     
  4. jimells

    jimells Senior Member

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    I never knew that rituals, symbols, and interactions can cure disease. Sounds like Mind Magic to me.

    Why can't they just admit that "placebo effect" means "we don't know what caused the improvement"? Do doctors go through some kind of indoctrination that causes them to choke on the words "we don't know"?


    So when I showed up at the urgent clinic, barely able to stand, I didn't need albuterol from the respiratory therapist, just a sugar pill? I guess I should've believed the intake nurse who tried to tell me I was only hyperventilating, in spite of rather scary numbers on the pulse oximeter.

    It's good to see that one doctor understands that correlation does not equal causation.


    Silly me. All this time I've been thinking it was effective treatments that makes medicine a healing profession instead of a religion.
     
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  5. Woolie

    Woolie Gone now, come see me in my new home at S4ME.info

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    This guy (Kaptchuk) is interesting, because he has historically taken a view that placebos have "real" effects that should be acknowledged and exploited by medicine. This contrasts with the view of a lot of other researchers, who argue that a big chunk of the placebo effect is an artefact (for example, people who think they've had a treatment are more likely to recall instances recently when they felt good vs. those when they felt bad, leading to an overall rating of better health despite no real improvement).

    What's interesting is that in this study he gets together with one of his opponents and together they talk about problems and issues in measuring the placebo effect. This hardly ever happens in science!

    The conclusion is pretty much that when you control for all the biases, etc, the only place you see any convincing evidence that placebos can actually work is in pain management.

    So no, I say don't encourage the use of placebos in MECFS.
     
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  6. Snow Leopard

    Snow Leopard Hibernating

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    It is funny how as soon as the "placebo effect" is mentioned, otherwise rational doctors suddenly become quacks in believing all sorts of myths about it.
     
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  7. A.B.

    A.B. Senior Member

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    According to Wessely, placebos are one of the most effective treatments in psychiatry. Which suggests that most treatments don't work at all or are harmful.
     
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  8. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    https://www.painscience.com/articles/placebo-power-hype.php#open-label

     
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  9. Woolie

    Woolie Gone now, come see me in my new home at S4ME.info

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    @Kyla, I always enjoy your posts, and this one was especially interesting!

    Do you know of any other articles that discuss these issues - specifically some of the lesser-known components of the placebo effect? I'd like to learn more.
     
  10. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Thanks Woolie :)

    Not sure I have exactly what you are looking for.

    This researcher is trying to debunk the entire idea of placebo (and seems to be doing a pretty good job of it):
    http://www.project-syndicate.org/commentary/the-placebo-myth
    He has a number of meta-analyses and studies on placebo, they might be behind a paywall though.
     
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