8 ms·

Here is a simple rule. Any condition that can be improved with a placebo, has a possible psychological component that can either be a cause or a contributing f

by btilly 8y ago

Here is a simple rule. Any condition that can be improved with a placebo, has a possible psychological component that can either be a cause or a contributing factor. This is not to say that it is all in your head, or that all people with it have it due to psychological reasons. But some of the people have at least some of their symptoms worsened by psychological factors. Anyone who finds this controversial has psychological issues with reality. And this is true whether your condition is CFS or high blood pressure+heart disease. Now people don't want to believe that acupuncture is a placebo, but there is ample evidence that it is. Therefore this applies to every condition that people find that acupuncture can help for. And that is a lot.

SubiculumCode 8y ago
Curious, if put in practice, what is the reference group for the placebo group?
- ativzzz 8y ago
  I don't think it exists outside of scientific trials. I can't imagine getting a prescription from your doctor only to find out it was a sugar pill to be accepted by society in any way.
  - mar77i 8y ago
    Two words. Essential oils.
  - superhuzza 8y ago
    Definitely happens: https://www.cbc.ca/news/health/placebos-widely-prescribed-by-doctors-1.1410636 https://www.cbc.ca/news/health/placebos-widely-prescribed-by...
- pard68 8y ago
  Not parent, but don't we buy into our own placebos all the time? I was told I had RSI. I got a trackball and a ergodox. I don't have any issue when I use these two devices. When I use my planck my hand is a giant cramp within five minutes. Sure, I think that the ergodox' layout helps and the trackball sure feels better. But based on the level of difference these two things have made and so quickly, I can't help but believe this is just a placebo. Before the ergodox I used a planck and a vortex vibe and had zero problems with them. I initially purchased these two devices to combat my RSI and they too worked. Then I was recommended the ergodox and after using it the other keyboards are no longer effective. Swapped one placebo for another.
magduf 8y ago
>Anyone who finds this controversial has psychological issues with reality. Isn't that something you can say about much of the population though? It seems to me that humans, in general, have psychological issues with reality.
- joejerryronnie 8y ago
  But who’s to say which group’s reality is real and which group’s reality is false? In the end it boils down to politics and public perception - or in today’s world, whichever group is more effective in leveraging the large online platforms to their advantage.
  - btilly 8y ago
    Whatever side is more populated with people who think that is an important question, is likely to be the side that I'm against. Reality is. I am willing to accept that the best well-conducted research available is a better guide to that than my own knowledge unless it is in one of the very limited areas where I have personal expertise. And those are very, very limited areas indeed.
    - joejerryronnie 8y ago
      I agree with you personally, but the cynic in me believes the vast majority of people fall under the category of my original post.
doctorpangloss 8y ago
It’s way more complicated than that. The diagnostic criteria changes over time, for many diseases with psychological components, in ways that make formerly pathological behaviors now healthy and vice versa. Placebo doesn’t actually help you, obviously, despite what the outcome you’re measuring suggests. It represents a slack (something not quite an error, but not quite a useful measurement) in the outcomes based measurement regime. It’s a “cosmological constant” as a side effect of the limitations of enumerating causal and contributing factors. People believe acupuncture is a placebo, and in an evidence based medicine regime it seems reasonable to prescribe it. But it depends what you’re calling pathological. Today, a population of video game players versus a control will score better on many psych outcomes. Tomorrow, they’ll change the tests, subtly, to account for “factors” better, and the results will reverse. The USMLE study book in 2018 pathologizes “video game fixation” (they can’t call it an addiction) before such a test change has occurred. The simple rule is that whatever society determines to be pathological will trickle down to the field of medicine, and placebo effects are the loudest signal of the limitations of an otherwise most superior way to administer therapies.
- logifail 8y ago
  > Placebo doesn’t actually help you What? The first definition of the placebo effect I found was this: "a beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment" My highlight.
  - UnFleshedOne 8y ago
    He means that most of the placebo is covered by a statistical effect, regression to the mean, etc. https://sciencebasedmedicine.org/the-placebo-myth/ https://sciencebasedmedicine.org/the-placebo-myth/
    - btilly 8y ago
      That may be most of the effect on the group taking the placebo. But it is not the placebo effect. Were there no placebo effect, then we could test the effectiveness of drugs by simply observing one group and giving the other our proposed treatment.
new12345 8y ago
I agree with possible psychological components is several health conditions. But saying that all acupuncture treatments are placebo is contradicting your first point, besides there are scientific studies that explains mechanisms behind acupunture.
- btilly 8y ago
  What scientific studies would those be? And by what standards are they scientific? Until a randomized controlled study can demonstrate real differences between acupuncture conducted with real needles and sham needles, I will happily call it a placebo. Ditto for acupuncture conducted per the way that acupuncturists think it should be conducted and acupuncture conducted per the way that they think it should not. Those studies have, in fact, been conducted. Acupuncture did not, in fact, do anything detectable. I am therefore on the side of calling it a placebo. See http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatrical-placebo-the-end-of-a-myth/ http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatri... for more.
internet_user 8y ago
you know whats funny? CFS has one of the lowest placebo response rates. Mandatory reference for those unable to google: https://www.ncbi.nlm.nih.gov/pubmed/15784798 https://www.ncbi.nlm.nih.gov/pubmed/15784798

by btilly 8y ago

SubiculumCode 8y ago

Curious, if put in practice, what is the reference group for the placebo group?

ativzzz 8y ago
I don't think it exists outside of scientific trials. I can't imagine getting a prescription from your doctor only to find out it was a sugar pill to be accepted by society in any way.
- mar77i 8y ago
  Two words. Essential oils.
- superhuzza 8y ago
  Definitely happens: https://www.cbc.ca/news/health/placebos-widely-prescribed-by-doctors-1.1410636 https://www.cbc.ca/news/health/placebos-widely-prescribed-by...
pard68 8y ago
Not parent, but don't we buy into our own placebos all the time? I was told I had RSI. I got a trackball and a ergodox. I don't have any issue when I use these two devices. When I use my planck my hand is a giant cramp within five minutes. Sure, I think that the ergodox' layout helps and the trackball sure feels better. But based on the level of difference these two things have made and so quickly, I can't help but believe this is just a placebo. Before the ergodox I used a planck and a vortex vibe and had zero problems with them. I initially purchased these two devices to combat my RSI and they too worked. Then I was recommended the ergodox and after using it the other keyboards are no longer effective. Swapped one placebo for another.

magduf 8y ago

>Anyone who finds this controversial has psychological issues with reality. Isn't that something you can say about much of the population though? It seems to me that humans, in general, have psychological issues with reality.

joejerryronnie 8y ago
But who’s to say which group’s reality is real and which group’s reality is false? In the end it boils down to politics and public perception - or in today’s world, whichever group is more effective in leveraging the large online platforms to their advantage.
- btilly 8y ago
  Whatever side is more populated with people who think that is an important question, is likely to be the side that I'm against. Reality is. I am willing to accept that the best well-conducted research available is a better guide to that than my own knowledge unless it is in one of the very limited areas where I have personal expertise. And those are very, very limited areas indeed.
  - joejerryronnie 8y ago
    I agree with you personally, but the cynic in me believes the vast majority of people fall under the category of my original post.

doctorpangloss 8y ago

It’s way more complicated than that. The diagnostic criteria changes over time, for many diseases with psychological components, in ways that make formerly pathological behaviors now healthy and vice versa. Placebo doesn’t actually help you, obviously, despite what the outcome you’re measuring suggests. It represents a slack (something not quite an error, but not quite a useful measurement) in the outcomes based measurement regime. It’s a “cosmological constant” as a side effect of the limitations of enumerating causal and contributing factors. People believe acupuncture is a placebo, and in an evidence based medicine regime it seems reasonable to prescribe it. But it depends what you’re calling pathological. Today, a population of video game players versus a control will score better on many psych outcomes. Tomorrow, they’ll change the tests, subtly, to account for “factors” better, and the results will reverse. The USMLE study book in 2018 pathologizes “video game fixation” (they can’t call it an addiction) before such a test change has occurred. The simple rule is that whatever society determines to be pathological will trickle down to the field of medicine, and placebo effects are the loudest signal of the limitations of an otherwise most superior way to administer therapies.

logifail 8y ago
> Placebo doesn’t actually help you What? The first definition of the placebo effect I found was this: "a beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment" My highlight.
- UnFleshedOne 8y ago
  He means that most of the placebo is covered by a statistical effect, regression to the mean, etc. https://sciencebasedmedicine.org/the-placebo-myth/ https://sciencebasedmedicine.org/the-placebo-myth/
  - btilly 8y ago
    That may be most of the effect on the group taking the placebo. But it is not the placebo effect. Were there no placebo effect, then we could test the effectiveness of drugs by simply observing one group and giving the other our proposed treatment.

new12345 8y ago

I agree with possible psychological components is several health conditions. But saying that all acupuncture treatments are placebo is contradicting your first point, besides there are scientific studies that explains mechanisms behind acupunture.

btilly 8y ago
What scientific studies would those be? And by what standards are they scientific? Until a randomized controlled study can demonstrate real differences between acupuncture conducted with real needles and sham needles, I will happily call it a placebo. Ditto for acupuncture conducted per the way that acupuncturists think it should be conducted and acupuncture conducted per the way that they think it should not. Those studies have, in fact, been conducted. Acupuncture did not, in fact, do anything detectable. I am therefore on the side of calling it a placebo. See http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatrical-placebo-the-end-of-a-myth/ http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatri... for more.

internet_user 8y ago

you know whats funny? CFS has one of the lowest placebo response rates. Mandatory reference for those unable to google: https://www.ncbi.nlm.nih.gov/pubmed/15784798 https://www.ncbi.nlm.nih.gov/pubmed/15784798