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BBC trust me I’m a doctor tests a placebo for back pain and sees significant results

Discussion in 'Other health news and research' started by Cinders66, Oct 4, 2018.

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  1. Barry

    Barry Senior Member (Voting Rights)

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    Whatever it is that is going on, I strongly suspect it is something different (as yet unknown) to the conclusions these people are jumping to. There must be other confounding factors, which any further research would hopefully uncover.
     
  2. Wonko

    Wonko Senior Member (Voting Rights)

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    Some of the time doing something, anything, is better than doing nothing. Of course this doesn't work long term, or even mid term, that's probably why 2 of more dozing sessions a day.

    It may simply be distraction, it takes a while for the body to figure out nothing has changed, especially when constant internal monitoring alters perception, and by the time that approaches, time for more placebo capsules.

    Of more interest, to me anyway, is why people on stronger pain relief noticed the placebos didn't do squat, and then a few days later, fully armed with this knowledge, some reported they started working.
     
  3. wdb

    wdb Senior Member (Voting Rights)

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    This is a good analysis of placebo effect:

    Is the Placebo Powerless? — An Analysis of Clinical Trials Comparing Placebo with No Treatment

    RESULTS
    ...As compared with no treatment, placebo had no significant effect on binary outcomes, regardless of whether these outcomes were subjective or objective. For the trials with continuous outcomes, placebo had a beneficial effect, but the effect decreased with increasing sample size, indicating a possible bias related to the effects of small trials. The pooled standardized mean difference was significant for the trials with subjective outcomes but not for those with objective outcomes. In 27 trials involving the treatment of pain, placebo had a beneficial effect, as indicated by a reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue scale.

    CONCLUSIONS
    We found little evidence in general that placebos had powerful clinical effects. Although placebos had no significant effects on objective or binary outcomes, they had possible small benefits in studies with continuous subjective outcomes and for the treatment of pain. Outside the setting of clinical trials, there is no justification for the use of placebos.
     
  4. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The ethics of these things very much involves what the purpose of the exercise is. If it was to make a TV programme showing that you can fool people that is unethical.

    I do not have the energy (even me) to look at this carefully but my impression increasingly is that it is now ethical open season and anything goes because everyone supposed to be policing things has lost the plot.

    Everyone has lost the plot.

    Everything is lost...

    Oh bother ...

    Except that at S4ME sanity still reigns.
     
    andypants, Judee, MEMarge and 11 others like this.
  5. large donner

    large donner Guest

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    That should be an alarm bell in itself.

    I think the conclusion of this study should be that Michael Mosely is Jesus.
     
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  6. Esther12

    Esther12 Senior Member (Voting Rights)

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    To me, that study had aspects that looked likely to risk problems with response bias, eg:

    I don't think it really shows us much.
     
    andypants, MEMarge, Trish and 4 others like this.
  7. inox

    inox Senior Member (Voting Rights)

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    Perhaps, you guys are probably right, did notice it was a smallish study as well.

    I'd still argue though, that if anyone haven't checked to see if placebo needs to be blinded to have an (placebo)effect - then it's an assumption. But my google-fu went away with my mudlded brain :p
     
    Last edited: Oct 6, 2018
    andypants, Trish and Esther12 like this.
  8. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

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    Last edited by a moderator: Oct 10, 2018
    Skycloud, andypants, Hoopoe and 3 others like this.
  9. Esther12

    Esther12 Senior Member (Voting Rights)

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    Welcome to the forum! You have been promptly moved to our pre-prepared discussion on this.
     
  10. Hoopoe

    Hoopoe Senior Member (Voting Rights)

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    It's a cognitive bias. Placebos seem to only work for things we can't measure objectively.
     
  11. obeat

    obeat Senior Member (Voting Rights)

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    Harvard university are carrying out open label placebo studies where the patient knows they are receiving a placebo. ( Inside Health BBC radio 4 09/10/2018)
     
    MEMarge, ScottTriGuy and andypants like this.
  12. TiredSam

    TiredSam Committee Member

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    How the NHS can save even more money - give the patients nothing. All you have to do beforehand is convince them that nothing is better than something. So butter them up with a few well-placed TV progs, and make them feel all clever when they walk into their GP's saying "I insist on one of those placebos, I've heard they work". HA!! The saps will probably even be willing to pay for it.

    We will then have the MUS brigade and the Placebo brigade fighting to convince the NHS who can save them the most money.
     
  13. JemPD

    JemPD Senior Member (Voting Rights)

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    Indeed. I think the placebo brigade are just a section of the MUS brigade really though. Placebo is just a large part of MUS theory in reverse after all - a glorified nocebo effect if you will.

    Interesting that the wiki nocebo page https://en.wikipedia.org/wiki/Nocebo says "placebo & nocebo can produce measurable changes in the body". (My bolding)
    Reaaaalllly? Measurable effects? - 'measurable' to me means objectively measurable not subjective assessments of experience.
    I've no strength to check their citations but I'd be interested to see placebo or nocebo research showing objectively measurable effects.

    But it comes back round to part of the reason i think the BPSers are so happy to have only subjective outcome measures, since they believe all our symptoms to be a merely experiential phenomena, so if you can make people think they're better then that really is a cure because they only think they're ill.
     
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  14. wdb

    wdb Senior Member (Voting Rights)

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    I suspect these measurable effects are knock on effects from placebo/nocebo induced emotional changes such as changes in adrenaline, blood pressure or perspiration. I'm pretty sure placebo penicillin wouldn't clean up a case of meningitis.
     
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