6 ms·

Here's a randomized trial with placebos that did work. I wasn't able to find one where it didn't work. http://annals.org/aim/article-abstract/2545886/effect-fe

Here's a randomized trial with placebos that did work. I wasn't able to find one where it didn't work. http://annals.org/aim/article-abstract/2545886/effect-fecal-microbiota-transplantation-recurrence-multiply-recurrent-clostridium-difficile-infection http://annals.org/aim/article-abstract/2545886/effect-fecal-...

cpncrunch 9y ago
I submitted on a while back. Will check later if people reverse the downvotes and assume good faith.
- AndrewDucker 9y ago
  You'll provide evidence for your claims if people down downvote you for making claims without evidence? I'm not terribly impressed by that approach.
  - cpncrunch 9y ago
    In my world people ask politely for refs or search for it themselves, rather than downvoting first (which is saying "your comment isn't worth reading"). I got up out of bed, posted a comment and was going to look for the link later if people asked. (I did a quick search and didn't find it). However, from the comments here, it's pretty clear people aren't interested in the science. Carry on...
- icebraining 9y ago
  Is this the post you're referring to? "There have been a total of 2 placebo-controlled trials into fecal transplants for C.Diff AFAIK. One showed some benefit over placebo, and the other showed no difference." https://news.ycombinator.com/item?id=10679823#10680173 https://news.ycombinator.com/item?id=10679823#10680173
  - epmaybe 9y ago
    In case people can't read the article as it's behind a paywall, it's not the primary source. However, to summarize the differences, this one study should not be representative of fact, as it very well could be that in the trial that did not show any benefit, patients could have had very aggressive treatment prior to beginning the study, and thus may have already been clinically cured prior to the study actually beginning. I would definitely trust the OPs meta analysis and systematic review of multiple different trials before believing this placebo controlled trial, for a number of reasons: 1. What I already mentioned above regarding the conflicting results of these two placebo controlled trials 2. The studies used in the nhs article are all done for patients that we're currently undergoing treatment for c diff, not after a long treatment time. 3. Meta analyses and systematic reviews are always going to be higher powered statistically speaking. As long as the papers looked at don't stink of publication bias it's a very valid way of looking at all the research done on fecal transplants for c diff.
    - cpncrunch 9y ago
      The primary source is the one posted above by elsherbini. I would definitely trust a small negative placebo controlled trial over a large meta-analysis that didn't include any placebo controlled trials, especially for a treatment that has a 90% placebo responder rate (as the trial posted by elsherbini shows).
      - meowface 9y ago
        Why not publish your own meta-analysis, then? Or if not publish, at least write an amateur meta-analysis?
        cpncrunch 9y ago
        Because I'm not a scientist. And anyway, the reason they didn't include this is because back in July 2016 when this review was written, there were no published placebo controlled trials. The Kelly trial was only published in Nov 2016. Presumably newer meta analyses will take this into account.
cpncrunch 9y ago
That's the study I was referring to. You'll see that there was no difference between donor and placebo in the NY group.
- morsch 9y ago
  But there was a difference in the other group, right? Isn't that still relevant? The study's authors certainly seem to think so. I've only read the abstract.
  - cpncrunch 9y ago
    Yes, that group had a 40% placebo rate vs the 90% placebo response of the NY group. However it is a very small group, and only marginally significant. It needs a larger, better designed study (preferably one which objectively measures c.diff infection status before and after), but if one study fails to show a response that's a pretty good indication that the treatment is suspect.

cpncrunch 9y ago

I submitted on a while back. Will check later if people reverse the downvotes and assume good faith.

AndrewDucker 9y ago
You'll provide evidence for your claims if people down downvote you for making claims without evidence? I'm not terribly impressed by that approach.
- cpncrunch 9y ago
  In my world people ask politely for refs or search for it themselves, rather than downvoting first (which is saying "your comment isn't worth reading"). I got up out of bed, posted a comment and was going to look for the link later if people asked. (I did a quick search and didn't find it). However, from the comments here, it's pretty clear people aren't interested in the science. Carry on...
icebraining 9y ago
Is this the post you're referring to? "There have been a total of 2 placebo-controlled trials into fecal transplants for C.Diff AFAIK. One showed some benefit over placebo, and the other showed no difference." https://news.ycombinator.com/item?id=10679823#10680173 https://news.ycombinator.com/item?id=10679823#10680173
- epmaybe 9y ago
  In case people can't read the article as it's behind a paywall, it's not the primary source. However, to summarize the differences, this one study should not be representative of fact, as it very well could be that in the trial that did not show any benefit, patients could have had very aggressive treatment prior to beginning the study, and thus may have already been clinically cured prior to the study actually beginning. I would definitely trust the OPs meta analysis and systematic review of multiple different trials before believing this placebo controlled trial, for a number of reasons: 1. What I already mentioned above regarding the conflicting results of these two placebo controlled trials 2. The studies used in the nhs article are all done for patients that we're currently undergoing treatment for c diff, not after a long treatment time. 3. Meta analyses and systematic reviews are always going to be higher powered statistically speaking. As long as the papers looked at don't stink of publication bias it's a very valid way of looking at all the research done on fecal transplants for c diff.
  - cpncrunch 9y ago
    The primary source is the one posted above by elsherbini. I would definitely trust a small negative placebo controlled trial over a large meta-analysis that didn't include any placebo controlled trials, especially for a treatment that has a 90% placebo responder rate (as the trial posted by elsherbini shows).
    - meowface 9y ago
      Why not publish your own meta-analysis, then? Or if not publish, at least write an amateur meta-analysis?
      - cpncrunch 9y ago
        Because I'm not a scientist. And anyway, the reason they didn't include this is because back in July 2016 when this review was written, there were no published placebo controlled trials. The Kelly trial was only published in Nov 2016. Presumably newer meta analyses will take this into account.

cpncrunch 9y ago

That's the study I was referring to. You'll see that there was no difference between donor and placebo in the NY group.

morsch 9y ago
But there was a difference in the other group, right? Isn't that still relevant? The study's authors certainly seem to think so. I've only read the abstract.
- cpncrunch 9y ago
  Yes, that group had a 40% placebo rate vs the 90% placebo response of the NY group. However it is a very small group, and only marginally significant. It needs a larger, better designed study (preferably one which objectively measures c.diff infection status before and after), but if one study fails to show a response that's a pretty good indication that the treatment is suspect.