The claim was recently made that Placebos are getting more effective. That would be like water getting less wet. It makes no sense. White Coat Underground dismantled that claim (see that post for the original claim) but I mention it here because Slashdot has now picked up the story. So lookout. Oh, Slashdot, it was dumb to pick up this story.
Slashdot’s summary, wirtten by Scuttle Monkey:
Wired is reporting that the well-known “placebo effect” seems to be increasing as time goes on. Fewer and fewer medications are actually making it past drug trials since they are unable to show benefits above and beyond a placebo.
What I find astonishing is that Slashdot readers are normally people who think a bit more before they write.
Have you read the breakthrough novel of the year? When you are done with that, try:
In Search of Sungudogo by Greg Laden, now in Kindle
or Paperback
*Please note:
Links to books and other items on this page and elsewhere on Greg Ladens' blog may send you to Amazon, where I am a registered affiliate. As an Amazon Associate I earn from qualifying purchases, which helps to fund this site.
or Paperback
*Please note:
Links to books and other items on this page and elsewhere on Greg Ladens' blog may send you to Amazon, where I am a registered affiliate. As an Amazon Associate I earn from qualifying purchases, which helps to fund this site.
Maybe we should read the story as “people becoming more gullible.”
The Placebo piece at White Coat Underground is getting more interesting. The author of the piece that PalMD wrote about had jumped into the thread and there is a respectful, civil, productive conversation going on.
Yup. you should definitely read the comments on the White Coat Underground article. I was pleased to scroll down and see things had kicked off because, having read the orginial article when it first came out, I really didn’t feel WCU’s piece deserved the credit of “dismantling” the original. Far from it. The original was an excellently written and researched article on an exceptionally interesting topic and all WCU seems to have done is whine about semantics and accuse people like me of being stupid for falling for the woo. I was really pleased to see Steve defending his article so well, he is clearly a very knowledgeable man and his report fully deserves the attention it has received.
Just for the sake of argument lets assume that for some odd reason people become more gullible and susceptible to suggestion. That no matter what you do the majority of people feel better. That the normal percentage who feel better with a placebo suddenly jumps up to 60%.
What if pretty much 100% of people receiving the placebo feel better and some lesser percentage receiving the test drug, because active ingredients have side effects, feel better.
Given these results; how would you characterize them?
The poor drug companies can’t find anything more effective than placebos.
Paying off doctors to do bogus research isn’t working as well as it use to, either.
What does it mean that ‘placebos are becoming more powerful’?
I’m still unclear on what that could possibly mean. The difference between the placebo controlled group and the test group is called “placebo effect”. If this gap is smaller in a greater number of studies, why should we conclude that the inert medication is stronger rather than something is happening to the test drugs or to the procedures?
oops..mistyped…the gap between placebo and no-placebo control is “placebo effect”
I can think of two things that might cause someone to say this. I strated to write it in a comment. Then it became a post .Now it is an epic post. I’m still working on it.
I’ll let you know when I’m done with it. I realized that this is all about variation, and I’m kind of into the study of variation in various system. So this is fun. But hard.
One way that readers can find out what my article could “possibly mean” is to read it:
http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect
I’m grateful to Peter and his well-informed readers at White Coat Underground for such a productive discussion. We all learned a lot and were able to explore the complexity of this issue in ways that are not possible in a mass-market magazine.
Greg, I’m a regular reader of this blog. Keep up the great work.
Steve: That’s what I”m actually doing!!!!!
Greg, I look forward to reading your epic post.
Note that my article — which, hopefully, you will read in its entirety? — goes into some depth (at least for a pop culture magazine!) about the various elements that may be contributing to this problem for Big Pharma. As I pointed out in the White Coat Underground thread, Peter’s initial impression that I was declaring that sugar pills are somehow mysteriously getting stronger was off the mark. There are a LOT of factors in play here, some of which I talk about in the article, and many of which I couldn’t get into in a limited space for a general readership.
I look forward to your thoughts!
One thing that often isn’t noted is that there is a difference between a subjective placebo and an objective placebo. Let me explain.
Many studies try to answer a question like: do you feel less pain? The answer to that is pretty subjective, and can really vary depending upon one’s expectations. I could see how a measured placebo effect might thereby change over time. A more stoic society might report less pain (even though the actual nerve stimulation or reaction remained the same).
However, there are a lot of other studies that are objective. Does Chondroitin actually promote joint healing? In this case, it either does or it doesn’t, and a proper double-blind experiment ought not see a change in the effect of the placebo. There is no subjectivity involved.
I seem to remember that placebos do vary in effectiveness. For example little red pills are more effective than large white ones. Sticking needles in (anywhere) seems more effective than taking a pill and so on. However, how the patient feels is very subjective. I suspect you could get a big improvement in this category by administering morphine for almost anything. What is more interesting is objective measures of the patients problem. As mentioned by Ahcuah above.
Even in the Chondroitin study, you’re likely to see differences that are purely behavioral. Don’t ever underestimate the power of a test subject’s desire to please. “Oh, they’re testing this pill. I’d best not screw anything up in their results. I guess I’ll take it easy instead of taking that mountain hike.” That behavioral change is not going to be there except under study conditions.
I will explain this all in a very few minutes.
Well, not all. But I’ll do it in such a way that your stress levels go way down and you feel better.
I see in my using Chondroitin I was not careful in what I meant by objective. I did not mean to imply that how the patient felt would be a good result, but actual examination (via MRI or whatever) of the joint.
And of course that would have to be double-blind so that the examiner’s (unconscious) expectations played no role, either.
Actually, what I meant was that knowing that one is in a study and wanting that study to turn out well can change how well people take care of themselves otherwise. The examination in the case I gave above would reflect a real difference, but that difference would have nothing to do with the treatment being studied, only with the fact that the subject was being helpfully careful.
My more extensive take on the placebo effect is here.
I’m going to reply to Stephanie’s comment over there.
The drugs they’re testing are probably close to worthless. If they don’t work much better than placebo, they generally don’t work.