5 ms·

If you were going to RCT, in this instance, why would you not blind? Sham injections - it's a no brainer. Why get the second best level of evidence if you can g

by robbiep 10y ago

If you were going to RCT, in this instance, why would you not blind? Sham injections - it's a no brainer. Why get the second best level of evidence if you can get the best?

Darwin226 10y ago
It's a needle to the spine...
- Noseshine 10y ago
  Hmm... maybe use people who require surgery/anesthesia and just tell them they were injected? I've taken a few courses on clinical trial design just out of curiosity, but now I find I can't really say anything substantial about my own idea. Back to the courses?
  - JshWright 10y ago
    Sham surgery is a thing (there have been some interesting studies looking at the efficacy of knee surgery compared with sham surgery for a variety of common knee issues...) https://www.youtube.com/watch?v=P_pAdg8Y70Y https://www.youtube.com/watch?v=P_pAdg8Y70Y
JshWright 10y ago
People much smarter than me have been wrong about the placebo effect in the past, but I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury... This procedure clearly needs to be tested against "doing nothing" (but it's impossible to blind against that, obviously). You only need to blind a study when you are testing against a placebo.
- lisper 10y ago
  > I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury... You would be amazed. The placebo effect is surprisingly powerful. https://en.wikipedia.org/wiki/Sham_surgery https://en.wikipedia.org/wiki/Sham_surgery
  - JshWright 10y ago
    Yeah, I'm familiar with the effect (I linked to a Healthcare Triage video on that topic in another leaf). I still think the placebo effect is likely to be very small when it comes to the restoration of movement (as opposed to reduction in pain, or other symptoms).
    - lisper 10y ago
      Yes, but the only way to know for sure is to do the experiment. Wouldn't it be cool if you turned out to be wrong?

by robbiep 10y ago

If you were going to RCT, in this instance, why would you not blind? Sham injections - it's a no brainer. Why get the second best level of evidence if you can get the best?

Darwin226 10y ago

It's a needle to the spine...

Noseshine 10y ago
Hmm... maybe use people who require surgery/anesthesia and just tell them they were injected? I've taken a few courses on clinical trial design just out of curiosity, but now I find I can't really say anything substantial about my own idea. Back to the courses?
- JshWright 10y ago
  Sham surgery is a thing (there have been some interesting studies looking at the efficacy of knee surgery compared with sham surgery for a variety of common knee issues...) https://www.youtube.com/watch?v=P_pAdg8Y70Y https://www.youtube.com/watch?v=P_pAdg8Y70Y

JshWright 10y ago

People much smarter than me have been wrong about the placebo effect in the past, but I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury... This procedure clearly needs to be tested against "doing nothing" (but it's impossible to blind against that, obviously). You only need to blind a study when you are testing against a placebo.

lisper 10y ago
> I think it's pretty unlikely that a placebo effect will result in the restoration of function after a traumatic spinal cord injury... You would be amazed. The placebo effect is surprisingly powerful. https://en.wikipedia.org/wiki/Sham_surgery https://en.wikipedia.org/wiki/Sham_surgery
- JshWright 10y ago
  Yeah, I'm familiar with the effect (I linked to a Healthcare Triage video on that topic in another leaf). I still think the placebo effect is likely to be very small when it comes to the restoration of movement (as opposed to reduction in pain, or other symptoms).
  - lisper 10y ago
    Yes, but the only way to know for sure is to do the experiment. Wouldn't it be cool if you turned out to be wrong?