Placebos Work -- Even Without Deception

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."

Not necessarily without deception.

[Thornae]

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”

Re:Homeopathic Medicine

[Sonny Yatsen]

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.

Nothing new here - and they don't 'work'

[geekoid]

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.

Re:I await ...

[geekoid]

You do realize they almost all of the 'natural' remedies are made by big pharma, right? As is most vitamins.

Which kind of removes the 'Big Pharma' argument.

Re:Homeopathic Medicine

[macurmudgeon]

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

[geekoid]

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, they 'feel' better but when actually tested they don't actually perform better.

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?

Re:Nope

[Anonymous Coward]

In many studies the placebo effect works better than "no treatment". That's why they do tests of many medical treatments with: placebo treatment, no treatment, actual treatment. If it never worked, medical researchers wouldn't have to bother wasting extra resources doing tests against "placebo". And just compare it with "no treatment".

I know this works on me

[hellfire]

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.

Re:Not necessarily without deception.

[Thornae]

Addtional: The researchers themselves note something along the lines of what I'm talking about:

The placebo response in this trial (59% on IBS-AR) was substantially higher than typical reported placebo responses of 30–40% in double-blind IBS pharmaceutical studies. [15] This finding seems counterintuitive. We speculate that it is an indication of the credibility of our open-label rationale. Patients in our study accepted that they were receiving an active treatment, albeit not a pharmacological one, whereas patients in double-blind trials understand that they have only a 50% chance of receiving active treatment. It may be that one hundred percent certainty that one is receiving the “treatment of interest” (in this case open-label placebo) is more placebogenic than a fifty percent probability of receiving an inactive control.

Re:Homeopathic Medicine

[EllisDees]

From the New England Journal of Medicine: [nejm.org]

"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive."

Real Journal Articles Work -- Even Without Summary

[damn_registrars]

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.

Re:Nothing new here - and they don't 'work'

[Rich0]

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).

Re:Homeopathic Medicine

[Abcd1234]

Bullshit [snopes.com].