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Medicine

Placebos Work -- Even Without Deception 430

Posted by CmdrTaco
from the smoke-and-mirrors dept.
An anonymous reader writes "For most of us, the 'placebo effect' is synonymous with the power of positive thinking; it works because you believe you're taking a real drug. But a new study rattles this assumption. Researchers at Harvard Medical School's Osher Research Center and Beth Israel Deaconess Medical Center have found that placebos work even when administered without the seemingly requisite deception. The study was published on December 22 in PLoS ONE."
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Placebos Work -- Even Without Deception

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  • by Sonny Yatsen (603655) * on Thursday December 23, 2010 @11:36AM (#34651798) Journal

    If deception isn't necessary for placebos to work, does this mean the homeopathic medicine advocates can admit it's bullshit now?

    • by happylight (600739) on Thursday December 23, 2010 @11:42AM (#34651856)
      If it works, how can it be bullshit?
      • by Sonny Yatsen (603655) * on Thursday December 23, 2010 @11:45AM (#34651890) Journal

        The theory is bullshit. They dilute a compound until they're essentially giving somebody water and claiming that the water will have some memory of some compound being dissolved in it and that will cure people of their illnesses. Placebos might work, but the theory is pure bunkum.

        • by MoonBuggy (611105)

          "They dilute a compound until they're actually giving somebody water..."

          A minor distinction, perhaps, but one worth making. The majority of homoeopathic 'medicines' contain literally zero active ingredient.

          • by Jay L (74152) * <jay+slash@nOSpam.jay.fm> on Thursday December 23, 2010 @12:44PM (#34652528) Homepage

            the guy who died from homeopathic medicine?

            Yeah, he forgot to take it and overdosed!

            Butseriouslyfolks... I'd like to see someone argue that homeopathy DOES work if you do a placebo-controlled trial. A homeopathic placebo-controlled trial, which means the placebo is actually undiluted. Hey, 100% of the patients given placebo arsenic died, and only 50% of the patients who took the diluted version! Whaddayaknow: a diluted dose of arsenic cures arsenic poisoning.

            • by Chris Burke (6130) on Thursday December 23, 2010 @01:35PM (#34653062) Homepage

              Yeah. The only positive thing homeopathy did for the world was prevent people from dying from their "medicine" in a time when things like significant dosages of mercury were considered "medicine". It turns out not dosing people with mercury is better than doing so. Medical fact.

              Too bad it wasn't a "let's not give people poisons" movement and instead was a "hey since giving people less mercury is better for them than giving them lots of mercury, maybe that means the more dilute any solution is, the better for you it will be!"

        • by ColoradoAuthor (682295) on Thursday December 23, 2010 @12:27PM (#34652326) Homepage

          I like to think of homeopathy as optimized placebo effect.

          I still haven't figured out why homeopathic pills have been so very effective in pets (mine, and those of friends), however. Does my dog sense my confidence? How does that affect measures such as thyroid levels, joint inflammation, or ability to climb stairs? As with many alternative therapies, the commonly-spouted theory makes no sense, but nevertheless there's something going on which deserves investigation.

          • Re: (Score:3, Interesting)

            by trum4n (982031)
            Drink 8 cups of water a day. You'll be shocked how good you feel. 90% of humans are technically dehydrated.
            • by Abcd1234 (188840) on Thursday December 23, 2010 @01:27PM (#34652996) Homepage

              Bullshit [snopes.com].

              • by tbannist (230135)

                He's wrong on the amount, but I did hear a nutrition researches say on the radio earlier this year that people tend be about 10% dehydrated (ie, 90% of optimal water level) before they feel thirsty, but performance impacts tend to appear at around 5% dehydrated. So drinking a little more water for most people might be a good idea, and an increase in water levels could explain much of the perceived improvement in condition. Somebody should probably study that.

              • Re: (Score:3, Interesting)

                by losfromla (1294594)

                I call bullshit on your bullshit. I also call bullshit on snopes.com

                I read the books, he based his findings on research (not reading as snopes.com claims). Clinical research on people who got better following his regiment.
                I myself have been diagnosed at various times with asthma, post-nasal drip (cough) which would require surgery to fix...
                After finding out about "The Water Cure" and drinking the requisite 8+ glasses of (purified/filtered) water per day, the cough (which was the primary manifestation of m

          • by Jay L (74152) *

            Keep in mind: Of the three things you mention - thyroid levels, joint inflammation, and ability to climb stairs - only the first is even theoretically measurable. And unless you're switching the homeopathic remedy in and out, and confirming the change each time, and changing nothing else, you don't know that it's truly the medicine that's affecting it. Normal, cyclical events can appear to be cause-and-effect, and that's why people swear homeopathy works.

            As for joint inflammation - you're taking a subject

          • by Chris Burke (6130) on Thursday December 23, 2010 @01:45PM (#34653144) Homepage

            I like to think of homeopathy as optimized placebo effect.

            Yeah, optimized for the profits of those selling these pills with nothing in them.

            Does my dog sense my confidence?

            Yes, of course dogs can sense the attitudes of their owners, and owners will subconsciously give their dogs extra encouragement when they expect them to get better (which is why real medical studies are double-blind wherever possible).

            That plus coincidence and confirmation bias explain the anecdotal evidence.

            but nevertheless there's something going on which deserves investigation.

            There is nothing going on. No scientific study has demonstrated homeopathic preparations to have an effect greater than a placebo. Because they are placebos. So there's nothing which deserves investigation, except the placebo effect itself, which can easily be studied while completely ignoring the particular kind of placebo called homeopathy.

          • I still haven't figured out why homeopathic pills have been so very effective in pets (mine, and those of friends), however. Does my dog sense my confidence? How does that affect measures such as thyroid levels, joint inflammation, or ability to climb stairs? As with many alternative therapies, the commonly-spouted theory makes no sense, but nevertheless there's something going on which deserves investigation.

            There's a reason why people do double-blind studies, where the experimenter also doesn't know which is the control group. If you're the one measuring these things you may be inadvertently inserting bias. "Hey, look...I think he climbed the stairs a little bit better this time." Especially since the things you mention may naturally vary from day to day, and even different times of the same day.

            A proper double-blind study with a control group and probably a larger sample size than the number of pets you've

      • by geekoid (135745)

        Because it doesn't work.

        What they are referring to when they say 'work' is that people believe they feel better, not that they are actually better. Or in the posters case, effective.

        It's bullshit as any non-subjective treatment.

        • Re: (Score:2, Informative)

          by macurmudgeon (900466)

          No, homeopathy may be bogus, but the placebo effect is not just bullshit. Actually with the placebo effect people don't just feel better but get the same results they would have had they had the real medicine. It goes even further than that. There are well documented instances of cancer remission with placebo pills and relief from angina with sham operations.

          • Nope (Score:3, Informative)

            by geekoid (135745)

            No, you clearly don't understand the placebo effect.

            Caner remission can happen with no pills medication at all. It's rare, but it happens. So Yes we would expect to see some remission from taking a non active ingredient pill, but in no case is it about the rates expected for 'spontaneous' remission.

            EVERY test I have read about(100s) regard placebo effects show no real effect. Whether that placebo was administered by pill, fake surgery, acupuncturist, chiropractor, or prayer.

            People believe they are better, t

            • Re: (Score:3, Insightful)

              by icebraining (1313345)

              Look. I can read through a phone book, claim my magic powers heal people, and someone in the phone book will have gotten better. Does that mean I have magic powers, or their body was just able to heal itself?

              The placebos work by improving the body's ability to heal itself, by changing some process in the brain. Just like vaccines work by strengthening the immune system without actually fighting any diseases.

              • by gblackwo (1087063)
                Vaccines do not work in any manner comparable to the placebo effect. You are spreading ignorance.
                • I'm not saying placebos act the same way as vaccines. I'm saying placebos, or better yet, the act of taking them, helps the body heal itself.

                  I'm NOT saying the sugar in the pill actually interacts with the brain.

              • by radtea (464814)

                The placebos work by improving the body's ability to heal itself, by changing some process in the brain

                How do you know?

                Have you tested this idea with published controlled experiments and systematic observations?

                In the scientific literature--the public record of ideas tested by controlled experiment and systematic observations--there is still an open question regarding how and why placebos work. On what basis do you make this claim that you know how they do it?

                Are you just engaging in pre-scientific speculation of the same useless and frequently counter-productive kind that dominated human thought for all th

              • You are either making a very bad and potentially misleading analogy or you have no idea how vaccines work. If the latter, please hand in your posting card on the way out. If the former, welcome fellow /.er!

            • Re:Nope (Score:5, Interesting)

              by radtea (464814) on Thursday December 23, 2010 @02:50PM (#34653692)

              EVERY test I have read about(100s) regard placebo effects show no real effect. Whether that placebo was administered by pill, fake surgery, acupuncturist, chiropractor, or prayer

              You've missed some really important and classic placebo studies then. Google "placebo opiate production" and see what you'll find. There is ample evidence that placebos are capable of increasing endogenous endorophin production, which is why they are particularly effective against pain and inflamation.

              This effect of placebos has been known for decades, so it kind of harms your credibility that you aren't aware of it.

            • FYI: Prayer actually lowers the odds of getting better.

              Acupuncture works, BTW - obviously not for every claim made just as many "proven" drugs don't meet all their marketing claims (hence the small print as required by law-- although, not necessarily still correct since in the USA a lot of things get a pass until some class action lawsuits.)

              This study is another re-affirming obvious study except that many people probably don't have the background to have already seen it. The subconscious is more powerful th

          • by nospam007 (722110) * on Thursday December 23, 2010 @12:30PM (#34652356)

            "Actually with the placebo effect people don't just feel better but get the same results they would have had they had the real medicine."

            Actually no. 'Real' medicine is considered real only if it works _considerably_ better than the placebo sugar pill the other half in the double blind tests are getting.

            • by drinkypoo (153816)

              Actually no. 'Real' medicine is considered real only if it works _considerably_ better than the placebo sugar pill the other half in the double blind tests are getting.

              Patent law and the FDA have redefined "real" medicine, at least in the USA. You do not have to prove that a derivative of an existing drug is more effective than its predecessor, as effective as its predecessor, or indeed effective at all, all you have to do is show that it does not kill substantially more people than the placebo, and the FDA permits you to market it as if it were its predecessor. The new drug is marketed and some of the less damning condemnations of the former drug are permitted to leak ou

      • Re: (Score:3, Insightful)

        by xystren (522982)

        Because the uninformed equate that placebo effect = not effective... where they should be thinking, placebo effect = effective without an identified factor/cause.

        Honestly, if I have the choice between a placebo effect or some medication that has major side-effects (ie: damage to the liver/kidney), I will take the placebo. If one can elicit a placebo effect without the dangers of medication side-effects, why is that a bad thing?

        For example, morphine does exactly zero for me with regards to pain management. W

    • by gstoddart (321705)

      If deception isn't necessary for placebos to work, does this mean the homeopathic medicine advocates can admit it's bullshit now?

      Arguably, if it works as well as what modern medicine is doing, is it any more bullshit than that is?

      I'm not advocating for homeopathy, but from what I understand ... in some cases modern medicine would consider itself doing well if they could reach the levels of relief they get with placebos using actual medicine.

      And, as someone I used to know in sales used to say ... it's not a

      • I'm not advocating for homeopathy, but from what I understand ... in some cases modern medicine would consider itself doing well if they could reach the levels of relief they get with placebos using actual medicine.

        A drug cannot get approval from the FDA if it is no better than a placebo. In many cases it must demonstrate in clinical trials that it has superior results to not only a placebo, but, also, to any existing drug which is used to treat the problem.

      • by monoqlith (610041)

        Arguably, if it works as well as what modern medicine is doing, is it any more bullshit than that is?

        Yes. While I agree that modern medicine is by no means the end of the discussion (it fails a lot, after all) I still believe that the scientific method it at least purports to follow is instrumental for discovering new medicines and applying them safely and effectively.

        it's not a lie if you believe it.

        I respectfully disagree. The power of positive thinking isn't going to heal a tumor, a scorching case of c

      • by Chris Burke (6130)

        Arguably, if it works as well as what modern medicine is doing, is it any more bullshit than that is?

        They don't work as well. Not working better than the placebo is the definition of an ineffective medicine (aka "not medicine") and won't be approved.

        To the extent that some medicines were erroneously thought to be better than placebo, but then proved not to be, we move towards rejecting those medicines, not accepting every type of placebo on earth as a legitimate treatment.

        I'm not advocating for homeopathy,

    • I think you misunderstand the homeopathic point of view to believe that this weakens the legitimacy of their approach at all.

      I'm not an expert in the field, but my understanding is that Homeopathy is based on the idea that there is a fundamental vital force that is responsible for overall well-being, which can be strengthened by taking particular concoctions that resonate with this force in the person. Maybe these placebos inadvertently had a homeopathic quality that was helpful for IBS sufferers.
    • by mcgrew (92797) * on Thursday December 23, 2010 @11:57AM (#34652014) Homepage Journal

      TFA: data on placebos is so compelling that many American physicians (one study estimates 50 percent) secretly give placebos to unsuspecting patients.

      This isn't "ethically questionable" as TFA posits, it's a GOOD thing, especially with viral diseases like colds and flu. People insist on antibiotics, but antibiotics are no better than placebos on viral infections, and placebos don't cause antibiotic-resistant strains of bacteria to evolve.

      • by MartinSchou (1360093) on Thursday December 23, 2010 @12:57PM (#34652688)

        People insist on antibiotics, but antibiotics are no better than placebos on viral infections, and placebos don't cause antibiotic-resistant strains of bacteria to evolve.

        Well, sure, you say that now, but just you wait until we get placebo-resistant strains of bacteria! What'll you do then?!? ;)

        • by sorak (246725) on Thursday December 23, 2010 @04:13PM (#34654394)

          People insist on antibiotics, but antibiotics are no better than placebos on viral infections, and placebos don't cause antibiotic-resistant strains of bacteria to evolve.

          Well, sure, you say that now, but just you wait until we get placebo-resistant strains of bacteria! What'll you do then?!? ;)

          I'm waiting for placebo-based biological weapons. Some guy blows up a box full of flour on a bus and fifty people die of Anthrax. How would the court case play out on that?

    • If deception isn't necessary for placebos to work, does this mean the homeopathic medicine advocates can admit it's bullshit now?

      Wait!? Doesn't that mean that homeopathic bullshit works?

    • by locofungus (179280) on Thursday December 23, 2010 @12:56PM (#34652676)

      Don't understand your comment.

      I have to say I wasn't aware that "placebos work even without deception" was new but perhaps this is the first rigorously controlled trial.

      I've seen stuff before like "What should you tell your patient?" with suggestions like:

      "Nobody understands why it works but in one in three cases, just taking one of these sugar pills three times a day can help with the symptoms."

      For that matter, "Nobody understands why it works but in one in three cases, taking homeopathic remedies helps with the symptoms" ought to be equally valid, especially for things like chronic pain where conventional medicine doesn't really have an answer and is just used to mask the symptoms. If homeopathy works for someone then it's almost certainly a better option than morphine.

      The main objection to homeopathy is that some people recommend it over conventional therapy that is known to be both required and effective in treating the particular problem.

      Article on BBC today: http://www.bbc.co.uk/news/health-12060507 [bbc.co.uk]

      Alternative remedies 'dangerous' for kids says report

      "In 30 cases, the issues were "probably or definitely" related to complementary medicine, and in 17 the patient was regarded as being harmed by a failure to use conventional medicine.

      "The report says that all four deaths resulted from a failure to use conventional medicine."

      Tim.

  • Same Deception (Score:5, Interesting)

    by Anonymous Coward on Thursday December 23, 2010 @11:37AM (#34651814)

    The lack of misinformation doesn't negate the plethora of ignorance - their probably thinking "they're just saying this is a placebo to test if it's really working".

    • Re:Same Deception (Score:5, Insightful)

      by Monkeedude1212 (1560403) on Thursday December 23, 2010 @11:48AM (#34651918) Journal

      Moreover, I'm confused how on Earth they would manage to test something like this.

      If you tell them it's a placebo, doesn't that, in a way, make it no longer a placebo? How can you observe a positive effect from placebos if they aren't even placebos anymore?

      There's any number of things that could cause the "Positive thinking". They might be glad their Doctor is honest with them. They might like the sugar they put in them. They might be lessed stress knowing its not 100% necessary to get up at 6 in the morning to make sure you pop your placebo in time.

      I'll read the full Article after this cup of coffee. I Can never seem to keep focused before having a cup of Decaf.

  • Study proves sugar pills alleviate IBS in 60% of patients!
  • ... big pharma going to market with the 'New, extra strength placebo'.
  • False deception (Score:5, Insightful)

    by Thanshin (1188877) on Thursday December 23, 2010 @11:41AM (#34651844)

    A guy dressed in a white lab coat, doing an experiment, gives you some medicine and tells you: "This is a placebo. Trust me, there is no active component of any kind.". Then, as soon as you swallow the medicine he, and three other lab coated investigators watch you attentively for an hour, asking if you feel strange in any way.

    What would be the chances of you believing them and having no doubts about the placebo nature of what you had taken?

    • by MoonBuggy (611105)

      The same theory could actually work for a marketed product. Adverts (truthfully) saying that "In a study, 78% of participants felt better after taking our product" or some such, combined with the general population's underlying trust in the fact that "they wouldn't sell it if it didn't do something" could well be enough. As others mentioned, it seems to work for homoeopathy!

    • What would be the chances of you believing them and having no doubts about the placebo nature of what you had taken?

      I dunno. In this strictly hypothetical situation, do I have a coin or a die in my possession?

    • Absolutely, this was not a well conducted trial. The labeling on the bottle and the structure of the experiment both remove the blind portion. The placebo wasn't so much the pill as the structure of the study. Somebody had too narrow a definition of placebo.

  • by Lilith's Heart-shape (1224784) on Thursday December 23, 2010 @11:41AM (#34651854) Homepage
    The article suggests at the end that patients who responded to the placebos despite knowing that they were taking placebos might be benefiting from a "medical ritual", but I suspect it simpler than that. I suspect that the patients were just receiving some sort of psychosomatic benefit from having an actual human being pay attention to them for a little while. I can't prove it, but I suspect that a lot of modern chronic illnesses are psychosomatic and are a consequence of loneliness.
    • by Scubaraf (1146565) on Thursday December 23, 2010 @11:54AM (#34651982)
      Bingo!

      But that's a huge point to prove. As obvious as it may sound, it's evidence that validating patients and their concerns may be among the best things we can do as physicians. It's absolutely not billable, so many docs don't do it - instead focusing on seeing the next person quickly or doing another billable procedure.

      Maybe with more studies aimed at understanding the effect of doctor-patient interactions, we'll start reimbursing MD's for what works and patients find valuable.
      • by hellfire (86129) <deviladv@gmCOFFEEail.com minus caffeine> on Thursday December 23, 2010 @12:45PM (#34652548) Homepage

        I've been to the doctor several times for things I know he won't prescribe for me for anything, but I go there just in case. Until I make the appointment, I feel crappy for an extended period of time, but the moment I do, I start to feel better. As a skeptical person, I know there's know magic to it, no strange force, no "God is looking after me," or whatever. But I do know my emotions and my mental attitude have a direct effect on my physical well being. I know is just all in my head, and my doctor is very helpful, sometimes not charging me and never prescribing me something I do not need (he's definitely old school!)

        It's the emotions of dealing with the issue. I when I have any problem in front of me, it always feels best for me to deal with it, or put a plan into motion to deal with it. Putting off a fix or plan makes me feel crappy and annoyed.

    • by geekoid (135745)

      It has been shown over and over again that the ritual has a stronger placebo effect.

      This also happens with acupuncture. If you take sham acupuncture by someone who is not attentive, and 'cold' to the patient you have less of a placebo effect then someone who gets sham acupuncture where the person performing the ritual is 'warm' to the patient.

      Of course, no actual benefits happens.

    • by gstoddart (321705)

      I can't prove it, but I suspect that a lot of modern chronic illnesses are psychosomatic and are a consequence of loneliness.

      I can't speak to all chronic illness ... but I've know at least two people with IBS. Trust me, loneliness wasn't the cause of it in either case. Milk, however, in one case had observable and, er, 'dramatic' results in a very short time.

      It's easy to dismiss this stuff as purely psychosomatic, I'm just not sure that is always (or even mostly) the case. In its early stages, Multiple S

      • The fact that the symptoms are real doesn’t rule out the possibility that their cause is completely mental. And that applies even if the symptoms are clearly exacerbated by real physical stimuli (such as milk).

  • This seems hardly worth mentioning. It was one small study done for amusement. No earth has been shattered here.
    • by Delusion_ (56114)

      There have been other studies that have shown that the placebo effect works better when people are aware of the placebo effect, and others which have demonstrated that it works better not only when people are aware of it, but when they're aware of the placebo effect and know they're taking one. So, effectively, the same sort of study as this.

      Just because it's a new idea to you doesn't mean it's new, trivial, or hardly worth mentioning.

  • by Thornae (53316) on Thursday December 23, 2010 @11:44AM (#34651876)

    From the actual study [plosone.org], the wording used to present the placebos to the patients seems to have been very carefully chosen to be utterly truthful, yet implicitly deceptive:

    ...open-label placebo pills presented as “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes”

    • by ceoyoyo (59147)

      It sounds like they showed a meta-placebo effect. If your patients believe in the placebo effect (they even gave them some mind-body catch phrases to latch onto) then they'll believe a "placebo treatment" will make them better. From there you're back to classic placebo effect.

      It would be interesting to replicate the study but tell patients flat out - "this is a sugar pill and doesn't have any chance whatsoever of making you better."

    • by Abcd1234 (188840)

      I thought the same way when I read the study, and you know what? It's a damned clever way of both a) informing the patient, b) dealing with the ethical issues associated with informed consent, and yet c) still managing to trigger the placebo effect by *telling people about the placebo effect*.

      The sad thing is it took a damned BS alt-med institution to fund a truly interesting study like this.

  • I can relate... (Score:5, Interesting)

    by dejanc (1528235) on Thursday December 23, 2010 @11:45AM (#34651892)

    I have allergies each spring. After I tried several different medications, I finally found one which advertises as "non-drowsy" - essentially a low dose of loratadine. I started taking it and yeah, it both worked and didn't make me feel sleepy all day long.

    A couple of months later, I talked to a friend who is a doctor, and he told me (not knowing that I take that medication) that clinical studies for the medication showed that it worked for about 50% of people who took the drug, as well as for around 50% of people who were on placebo (I can't remember if it was 50, but the percentage was about the same). I read some more upon it, and the conclusion most knowledgeable people made was that the dosage of loratadine in the drug is too low, and that it works only as a placebo.

    Knowing what I know, I still take that medication and it still helps me. Perhaps the low dosage really works for me, but more likely, I keep being fooled by a placebo I know about...

  • This is fascinating to me.It proves how much we don't know about how people work.

    As a physician I have on several occasions wanted to prescribe a placebo, knowing that time would be the best remedy and that simply feeling like the patient is doing something might improve their outlook immediately. Of course, I consider that misleading and unethical. To know that it might work even if you are up front about it is amazing. I'm not sure that it would work outside of a clinical trial though. I'd love to kno
    • by gstoddart (321705)

      I also don't know how they got the study past the scientific review board, which I thought, would laugh them out of the room.

      Well, it's not like he endangered the placebo group any more than the control group.

      I should think it would be an interesting conversation ... "I'm going to do nothing with one group, and tell the other group I'm giving them a placebo and then I'm gonna see what happens".

      Fun job though, medical studies without medicine. :-P

  • by boristdog (133725) on Thursday December 23, 2010 @11:48AM (#34651926)

    I'm cured by just reading about these amazing placebos!

  • by geekoid (135745) <dadinportland.yahoo@com> on Thursday December 23, 2010 @11:49AM (#34651934) Homepage Journal

    This is known information, and I don't understand why the Dr. was surprised by the result.

    A placebo effect* doesn't fix anything,ever. It makes people feel better subjectively. When you couple that with things that getting better in a few days on their own. people start thinking they 'cured' them, when in fact it was just the bodies normal process.

    *there are different types. Depending on the invasiveness of the fake treatment.

    • It makes people feel better subjectively.

      Is there an objective measurement of a persons feeling of wellness?

      And if there is, does it matter? No-one else can feel the patient's discomfort.

    • by Rich0 (548339) on Thursday December 23, 2010 @01:18PM (#34652896) Homepage

      I'd need to see a cite for your claim.

      Just look up the results for any drug clinical trial, and you'll see objective clinical results in the placebo arm of the trial. Give somebody a statin and it will lower their LDL by 30%, but give them a placebo and it will probably drop it around 5-10%. No need to ask the patient how they're feeling, just take a blood sample and send it to a lab, all in a blinded trial where nobody doing the testing knows how it will turn out.

      Placebos achieve all kinds of documented clinical outcomes. You could probably improve the lives of poor people tremendously while not raising healthcare costs a dime if we just gave them all placebos for their ails. The question is which is more unethical - letting poor people die because we're unwilling to spend money on their care, or letting fewer poor people die by lying about the fact that we're unwilling to spend money on their care... If you look at it objectively, that's a pretty potent question. Of course, people will point to the third option - simply spending more money on their care, but if we were willing to do that we wouldn't be talking about the topic in the first place, and there will always be a limit beyond which we could still gain marginal improvements by using placebos (give somebody a statin, and a "Super Statin" placebo).

  • Doing something makes people feel better... even when what they’re doing is completely useless... and even when they know it.

    And when it’s something that even the laziest person can do (popping a pill), it’s an all-around win.

  • by DarkOx (621550) on Thursday December 23, 2010 @11:53AM (#34651974) Journal

    What about the possibility, I know it sounds crazy, but what if sugar pill is actually an effective treatment for IBS. Seems like they need to use the same placebo on test groups with other conditions to eliminate that possibility.

  • by JSBiff (87824) on Thursday December 23, 2010 @11:57AM (#34652010) Journal

    After reading the slashdot summary, I got to wondering - do Placebos actually "work" or is it simply that the patients would get better all by themselves (immune system and other self-healing mechanisms in the body)? So, I did a few seconds of googling "placebo vs no treatment", and came upon a paper online at the NIH website:

    http://www.ncbi.nlm.nih.gov/pubmed/12535498 [nih.gov]

    The author of that paper concludes, "There was no evidence that placebo interventions in general have clinically important effects."

    If the healing happens a certain percentage of the time regardless of whether treatment is even administred, then it makes perfect sense that placebo would work that same percentage of the time, even if people didn't believe they were being treated - e.g. "belief" has nothing to do with recovery - that is, it's very possible, and that NIH paper appears to confirm the hypothesis, that with "placebo effect", the conscious mind plays no role in the improvements witnessed.

  • doesn't mean they don't suspect it might be real and they were lied to.
  • The placebo effect isn't based on the belief that it's medicine, it's based on the belief that it will work. The patient takes the pills because even though they're just sugar pills, their doctor says they will help anyway. A trained medical person believes they will get better taking them. So they believe it too. So they get better.

    The doctor could probably save the patient a few calories and some trouble if they just lightly hit the patient on the forehead with the heel of their hand yelling "By the power

  • The article doesn't say exactly what the summary says. This is a clear case of Science news cycle [phdcomics.com].
  • People generally don't drink enough clear, fresh water. Often, when they're taking a pill it's the only circumstance they're doing so. Perhaps that's the reason why even placebos work.
  • I'll believe it works without the deception if it works with people taking them by finding the pills in the street.

    When a doctor hands you a pill, you ASSUME he is doing it for a reason and to help you. Thus the deception is still there.

    That said, I wish it was easier to get sugarpills I'd love to screw with friends with bottles of "actual prescription" penis enlargement pills.. NO really dude, they work!

  • Um.... (Score:2, Interesting)

    by ilsaloving (1534307)

    If the placebo works, doesn't that mean it's not a placebo?

  • I won't lie and suggest there's any kind of supporting evidence for that statement. I am merely stating it in a confident and authoritative manner as a service to beer lovers everywhere.

    Drink up, and think about what I have told you.

    I won't insult your intelligence by asking you to to believe that drinking beer is slimming, I simply ask you to keep the notion in mind whenever you have a drink. It is the mere presence of this idea in your mind as you drink that does you good, not your belief nor any propert

  • by decipher_saint (72686) on Thursday December 23, 2010 @12:21PM (#34652258) Homepage

    I'm addicted to placebos!

  • Not so fast (Score:5, Insightful)

    by Suddenly_Dead (656421) on Thursday December 23, 2010 @12:23PM (#34652288)

    As pointed out by Orac [scienceblogs.com], things are nowhere as simple here as they've been presented. There was still an establishment of expectation of the treatment working, which is exactly one would expect would elicit the placebo effect.

    ...the investigators deceived their subjects to induce placebo effects. Here's how they describe what they told their patients:

    Patients who gave informed consent and fulfilled the inclusion and exclusion criteria were randomized into two groups: 1) placebo pill twice daily or 2) no-treatment. Before randomization and during the screening, the placebo pills were truthfully described as inert or inactive pills, like sugar pills, without any medication in it. Additionally, patients were told that "placebo pills, something like sugar pills, have been shown in rigorous clinical testing to produce significant mind-body self-healing processes." The patient-provider relationship and contact time was similar in both groups. Study visits occurred at baseline (Day 1), midpoint (Day 11) and completion (Day 21). Assessment questionnaires were completed by patients with the assistance of a blinded assessor at study visits.

    Moreover, the investigators recruited subjects thusly:

    Participants were recruited from advertisements for "a novel mind-body management study of IBS" in newspapers and fliers and from referrals from healthcare professionals. During the telephone screening, potential enrollees were told that participants would receive "either placebo (inert) pills, which were like sugar pills which had been shown to have self-healing properties" or no-treatment.

    Even the authors had to acknowledge that this was a problem:

    A further possible limitation is that our results are not generalizable because our trial may have selectively attracted IBS patients who were attracted by an advertisement for "a novel mind-body" intervention. Obviously, we cannot rule out this possibility. However, selective attraction to the advertised treatment is a possibility in virtually all clinical trials.

    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 that the power of "mind-body" interactions. Yes, patients were informed that they were receiving a placebo, but that knowledge was tainted by what the investigators told them about what the placebo pills could do.

  • You don't have to take the word of the magazine as to what is in the article - you can read it for yourself [plosone.org]

    Conveniently enough the P in PLoS stands for Public - as in you can download the articles from anywhere without paying for a subscription.
  • by sarkeizen (106737) on Thursday December 23, 2010 @01:20PM (#34652928) Journal
    "work" is ambiguous and slightly deceptive. What we should say is there is a "reported effect". That is different (from my perspective) as having a clinical effect.

    Hróbjartsson & Gøtzsche did an interesting meta-analysis [nih.gov] of studies with both a placebo and no-treatment arm. For binary outcomes (except pain) there was no significant difference and for continuous outcomes and binary pain outcomes there was a difference but it increased inversely with sample size. They postulate that what people call the "placebo effect" is really just a form of reporting bias. People have been "treated" or have gone though the motions of treatment and as a result they change their expectations.

    I mean, what is more likely some mysterious force which crosses every clinical boundary...or that people are (unintentionally) fudging things a bit.
  • by shish (588640) on Thursday December 23, 2010 @02:16PM (#34653418) Homepage

    The general public were starting to learn what placebos are, and not believing in them any more, and the effect stopped; now that there is "proof" that they work, the skeptics can believe again, so the effect returns.

    News in 10 years: "Placebos still work even when you learn that the 'placebos still work without deception' story was fake"

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