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Medical Forum / Diseases and Disorders / Tinnitus / June 2007Is a study involving the use of placebo as precise a science as mathematics?
When asked if something is this or that, or effective or not for this or that illness, the people in the theoretical ivory towers like to support their views with the results of controlled studies in which placebos are used. And they do that as if a placebo study is as precise as the science of mathematics or physics. My own view is that medical science is hardly as precise a science as maths or physics. Thus any controlled study that involves placebos has to be taken with a grand of salt. Views? > When asked if something is this or that, or effective or not for this > or that illness, the people in the theoretical ivory towers like to [quoted text clipped - 4 lines] > Thus any controlled study that involves placebos has to be taken with > a grand of salt. Short answer: No, it's not as precise as mathematics. But a double-blind placebo-controlled study is a heck of a lot better than a study that doesn't use a placebo control, or anecdotal reports, or no study at all. Longer answer: Humans vary in their response to drugs (or any other treatment, for that matter). And humans can show large responses to "treatment" even if that treatment really doesn't do anything - that's the placebo effect. So when you ask the question, "does drug A have an effect?" you need to ascertain whether _any_ "treatment" (placebo) has an effect, and whether the drug then has an effect beyond the placebo effect. Because humans vary in their responses, both to drugs and to placebos, you will not get answers with pin-point precision; you will see variation between one person's response and the next. So medical researchers use statistics to help them decide if the drug effect, on average, is larger than the placebo effect on whatever change it is that they are trying to measure. And because human responses do vary, a drug that works for one person may be ineffective for another, and dangerous for a third. The same can be said for home remedies, herbs, mechanical stimulation, or any other "treatment" you care to mention. Researchers in ivory towers generally understand the above, but they often oversimplify when speaking to the general public, many of whom do not understand research methodologies or statistics. FurPaw  SignatureThe Bush legacy - no child left a dime. To reply, unleash the dog. > Short answer: No, it's not as precise as mathematics. Word to the wise; this nut is a full time troll. Susan > x-no-archive: yes > [quoted text clipped - 3 lines] > > Susan Susan, People can judge from the response of anyone whether or not an element of trolling is present. Thus words of insult to anyone who responds are not warranted. On 6/27/07 5:17 PM, in article r_WdnQOVg_62Yx_bnZ2dnUVZ_sCinZ2d@comcast.com, >> When asked if something is this or that, or effective or not for this >> or that illness, the people in the theoretical ivory towers like to [quoted text clipped - 36 lines] > > FurPaw Placebos have several beneficial effects Patient now takes charge of his treatment - HE takes the pill 4x a day The anxiety reinforcement effect is reduced Since he is getting attention and treatment, he is more relaxed which is therapeutic. Murray Grossan <hydromed@adelphia.net> wrote in part: >Placebos have several beneficial effects >Patient now takes charge of his treatment - HE takes the pill 4x a day >The anxiety reinforcement effect is reduced >Since he is getting attention and treatment, he is more relaxed which is >therapeutic. I think there are better ways to address anxiety and the desire for attention than with a placebo. SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > Murray Grossan <hydromed@adelphia.net> wrote in part: > [quoted text clipped - 6 lines] > I think there are better ways to address anxiety and the desire for > attention than with a placebo. I would agree - but these are some possible explanations for how the placebo effect works. Google on placebo effect frmi and you will turn up a number of studies that have detected brain response changes when a placebo has been administered. Placebos do result in biological changes in the body and brain. If you're assessing the effectiveness of a treatment or a drug, you need to do it against a baseline of the placebo effect; if the results don't differ between the drug and placebo group, you haven't demonstrated that the drug itself is effective. FurPaw SignatureThe Bush legacy - no child left a dime. To reply, unleash the dog. FurPaw <furrealpawdog@gmail.com> wrote in part: >> Murray Grossan <hydromed@adelphia.net> wrote in part: >> [quoted text clipped - 19 lines] > >FurPaw You are preaching to the choir. Much of the work on placebo effect is of poor quality and the actual placebo effect is actually almost never measured... As a statistical means of controlling for all those things that might effect the outcome, it is an effect whose size is not measured, but used to cancel out all effects but those due to the "active" treatment being tested. Unfortunately, the "placebo effect" is widely misunderstood. SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > Google on placebo effect frmi and you will > turn up a number of studies that have detected brain response changes > when a placebo has been administered. Aargh! fumblefingers - that should be placebo effect fmri . SignatureThe Bush legacy - no child left a dime. To reply, unleash the dog. On 6/28/07 6:29 PM, in article p2o8839kged09u7oa9ajio4lg3dk1i0sgg@4ax.com, > Murray Grossan <hydromed@adelphia.net> wrote in part: > [quoted text clipped - 6 lines] > I think there are better ways to address anxiety and the desire for > attention than with a placebo. It is unfortunate, Jim, that you misunderstand what I wrote. What I am saying is that the scientist must be aware of these factors to understand his results. In one study of a new drug, the doctor was so gracious and warm, the patients responded by getting well - with the placebo. Don't forget too, the other side. You can have 37% side effects from the placebo too. snipped... > Researchers in ivory towers generally understand the above, but > they often oversimplify when speaking to the general public, And as a result of this 'oversimplication', unprofessionally albeit unintentionally delivered of course, the general public has been misled in many cases to look up to a placebo study as being absolute in an authoritative sense and sadly make decisions based upon the result of the study presented in an oversimplistic manner. > snipped... >> Researchers in ivory towers generally understand the above, but >> they often oversimplify when speaking to the general public, >> _many of whom do not understand research methodologies or statistics_. >> [added back snipped fragment] > And as a result of this 'oversimplication', unprofessionally albeit > unintentionally delivered of course, the general public has been > misled in many cases to look up to a placebo study as being absolute > in an authoritative sense and sadly make decisions based upon the > result of the study presented in an oversimplistic manner. I don't feel bad for the general public in this regard. The information about the nature of double-blind placebo-controlled trials is hardly a deep dark secret; it's available to anyone who looks for it and it's understandable by anyone who bothered to pay attention during a high school science class and to stay awake during algebra. People who refused to get even a basic education in science and math may be misled by oversimplified explanations, but most of them wouldn't even sit through an explanation of the research targeted at an "educated layperson," much less comprehend it - so whose fault is it that? [Actually, IME, when I read research press releases and articles in science news and medical news periodicals, which ARE targeted at the educated layperson, I don't find much of the gross oversimplification that you refer to. Most of the oversimplification takes place when it passes through the hands of some of the so-called science writers in the general media. So perhaps you're looking at the wrong sources for your information, and blaming the wrong people for oversimplification.] These links provide accessible explanations of double-blind placebo-controlled trials; the second one goes too far in its use of "prove;" it should substitute "provide strong evidence for" when discussing the outcomes of experiments. http://en.wikipedia.org/wiki/Double-blind http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe 33da65dd4&chunkiid=38405 or http://preview.tinyurl.com/2hv2vn FurPaw SignatureThe Bush legacy - no child left a dime. To reply, unleash the dog. > fyfp...@gmail.com wrote: > [quoted text clipped - 28 lines] > So perhaps you're looking at the wrong sources for your > information, and blaming the wrong people for oversimplification.] I have been looking at the style by which the results of controlled studies have been presented in ALT. I did pay attention to my teachers in my high school studies of science and algebra. But I still find the ways by which the results of controlled studies have been presented in ALT to be full of oversimplications and in some ways misleading. But then again, my perception in this regard is a matter of individual reaction which, like the individual reaction to a medicine, differs amongst individuals. > These links provide accessible explanations of double-blind > placebo-controlled trials; the second one goes too far in its use [quoted text clipped - 8 lines] > > To reply, unleash the dog.
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