Placebos work even when you know they don't contain medicine


#1

Originally published at: http://boingboing.net/2017/05/29/placebos-work-even-when-you-kn.html


#2

I’m going to put my altoids in a fancy bottle with an even fancier label


#3

Shouldn’t the control group have gotten openly-declared “placebos” with actual medicine?


#4

Your breath smells fresher already!


#5

:joy::joy::joy: not only that, once I’m finished with this label, my humble altoids will treat insomnia, heart burn, allergies, fatigue, ennui, ear aches, … the list goes on until the I run out of room on the label


#6

Or maybe the “you get nothing!” group actually did worse than the baseline.


#7

Ugh… no, this study isn’t saying that placebos work– it is just demonstrating how systematic biases can alter outcomes in a study.

If you are told that you’re getting a placebo, you might be motivated to report that you’re feeling better, or if the researcher isn’t blinded, they might subtly influence the reporting as well… For an IBS study there’s no objective test to know if the patient is actually better, it’s just how the patient reports they feel. People have been primed to believe in placebo magic, so if they feel just about the same as they did before, they might mistakenly report feeling better. It can often be hard to remember past pain compared to current pain.

Add to that the natural course of the disease (some patients will feel better anyway, same as you’d get in the no-treatment arm), and you could easily and erroneously conclude that the placebo arm fares better than no treatment. I think it’s sad to see effort wasted on treatments that have no plausibility– literally giving people nothing. People suffering from non-specific symptoms and chronic pain deserve better.


#8

Eureka!

I’ll take a placebo and dilute it a quadrillion times! It’s safer than Western medicine!


#9

well after being told for years and years that placebos work of course they’re going to work.


#10

I thought this was already a well known part of the Placebo Effect.

You’re right that some people might give objectively biased reporting, but I think others may actually receive some actual effects of the Placebo. That is, even though there is not chemical reason they feel better, they feel better. The mind is pretty mysterious still on how we perceive pain some times or how or why we feel how we feel. Even knowing something shouldn’t work might still make a real difference because our mind decided it should. I honestly think that is how it helps half the people who try crap like holistic medicine. “This shouldn’t work, but I will give it a shot.” And then it does even though it shouldn’t.

Also, this might account for some off label use of prescription medicine.

I don’t think anyone is suggesting we treat things with placebos. But yes, it’s a bitch and we wish we had things that worked better.


#11

It may be well-known, but not in the public understanding… It could be that the placebo is 100% the result of chance combined with flawed study design– that’s not how it is ever discussed in popular literature. The popular narrative is that our minds are healing our bodies, when the reality might just be subjective reporting, flawed studies, and statistical noise.

I appreciate what you mean, I disagree about what we should take-away from this mystery… I don’t think there is enough evidence to suggest that our minds are ‘making us feel better’ in the sense that we are actually better: we are pretty good at tricking ourselves and pain is subjective. We have no reason to assume that anything beyond bias is at work– it is impossible to disentangle from actual improvement and until we have better evidence, should remain skeptical. I also find it instructive that ‘the placebo’ works best (perhaps only) for subjective symptoms.

Think again… The guy who ran the study literally does.

Here’s a good take on the guy:
https://sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again/


#12

Lol. Yeah. The control group in trials is often an established treatment. It is usually unethical to give patients an actual placebo when there is a treatment that works. Also, it doesn’t really matter that much if a treatment works better than nothing as much as it matters that it works better than the current treatment (all other things being equal, which they aren’t).

Edit: But this study isn’t a normal RTC about a treatment.


#13

#14

For people suffering from these illnesses, I think it probably feels better just to be taken seriously.


#15

If only we could use animated gifs instead of studies!


#16

There are some indicators that placebos are as effective as penicillin or cipro for treating MRSA.


#17

#18

I don’t know what study you’re talking about, but my guess is that if that’s what it showed, penicillin and cipro are ineffective for treating MRSA. The placebo is the control arm of a study. If treatment is no better than the control, it shows that the treatment doesn’t work, not that the control works.


#19

My office has two “medicine cabinets.” White enameled boxes stocked with first aid supplies and OTC remedies.

The stock is replenished and rotated by a specialized supply company.

Whenever I see one of the staff inventorying a cabinet, I say something along the lines of “Oh, good. We’re outside of placebo.”

Well more than half of them get the joke.


#20

This guy gets it!