Placebos work, even when patients are in the know, study finds

[bananas]

http://www.latimes.com/news/science/la-he-placebo-effect-20101223,0,3010085.story

Placebos work, even when patients are in the know, study finds
By Amina Khan, Los Angeles Times
December 22, 2010, 4:12 p.m.

A simple sugar pill may help treat a disease — even if patients know they're getting fake medicine.

The finding, reported online Wednesday in the journal PloS One, may point the way to wider — and more ethical — applications of the well-known "placebo effect."

"The conventional wisdom is you need to make a patient think they're taking a drug; you have to use deception and lies," said lead author Ted Kaptchuk, an associate professor of medicine at Harvard Medical School. And, Kaptchuk added, it seems many doctors do this: In one report, as many as half of rheumatologists and internists surveyed said they had intentionally given patients ineffective medication in the hopes it would have a positive result.

Kaptchuk, however, wondered whether the deception was needed. When he first tried to persuade fellow researchers to explore a sort of "honest" placebo, "they said it was nuts," he said. After all, didn't the whole effect hinge on people believing they were getting real treatment?

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[TwilightGardener]

1. I will believe in the power of placebos when they start using them

to effectively treat kidney stones, heart failure, cancer and burst appendixes in lieu of standard treatments, and people recover and become pain-free. If a sugar pill, or prayer, or relaxation techniques cure you...you weren't really all that sick.

[TheMadMonk]

6. And you would be even more of a dick than homeopaths.

I can tell you from personal experience that a $20 note blu-taced to a ceiling can cure warts. Warts so bad that they were crowding each other and bleeding.

No you're not likely to treat kidney stones, ruptured apendixes with a dose of sugar water.

However, as we are learning, the mind can learn to do some pretty extraordinary tricks when given the right feedback for matters where the body's own systems WILL suffice.

Placebo medicine and homomeopathy both work, they just don't work the way conventional medicine does the job. And they are not the be all and end all that their adherents would have them be.

[varkam]

8. Well...I mean...the placebo effect has been pretty reliably demonstrated....

Not really sure that it's a matter of belief, so much as a matter of data.

[eShirl]

2. a placebo can only "do" what the body already had the ability to do

what I'd like to see is a more reliable way to harness the body's abilities

[markpkessinger]

3. The headline is misleading

The study does not show that "placebos work." It shows that across a group of patients, there will be an observable placebo effect in a certain percentage of them, and that will be true regardless of whether the patients whoa re taking placebos know they are taking them. But since there is no way to predict (at least currently speaking) which patients the effect would occur in, they cannot be said to "work" in the way that a drug whose effectiveness has been tested and borne out by clinical research is said to "work."

The LA Times writers apparently didn't bother to take time to refresh their knowledge of what the placebo effect actually is. It's not complicated, although it is a bit mysterious: in any random sampling of patients, a certain percentage will experience a positive benefit from a placebo. That percentage is measurable when tested against a control group that is given nothing at all (a certain percentage of whom will also improve), but since there is no way to predict exactly who among the placebo takers will experience that benefit, it cannot really be considered a valid medical option. But in order to test an actual drug's effectiveness, researchers must control for that effect; the critical measure of a drug's effectiveness then becomes the measurable difference between the percentage of actual drug takers who improve and the percentage of placebo takers who improve.

Great way to spread massive, unhelpful confusion among the population, LA TIMES!

[laconicsax]

4. Flawed study.

http://www.sciencebasedmedicine.org/?p=9339

In other words, not only did Kaptchuk et al deceive their subjects to trigger placebo effects, whether they realize or will admit that that’s what they did or not, but they might very well have specifically attracted patients more prone to believing in the power of “mind-body” interactions. Yes, patients were informed that they were receiving a placebo, but it must be emphasized again and again that that knowledge was tainted by what the investigators also told them about what the placebo pills could do. After all, investigators told subjects in the placebo group that science says that the placebo pills they would take were capable of activating some sort of woo-ful “mind-body” healing process.

[notesdev]

5. Sounds like people got so used to popping pills that they now associate the pop with the cure

[saras]

7. Not a new, or controversial, finding

It has been well-known that the placebo effect is powerful, and affects many, although obviously not all, conditions.

The hatred and disrespect it gets is, frankly, bizarre.

The last few major metastudies I've read suggest that not only does the placebo effect work, it is getting stronger over the last couple of decades, to the extent where the change is causing concern about the cost-benefit ratio of a number of medicines. We have a lot of 'medicine' that occasionally makes things better, and has well-known harmful side effects that also only happen sometimes. A moderate change in the ratio of these can move a medicine from 'more useful than harmful' to 'more harmful than useful'.

Of course, most of this research does NOT apply to simple medical problems with simple, mechanical solutions - like kidney stones or severed limbs - which only excludes a small minority of issues.