3 ms·

I didn't say I understood how the placebo effect works (although perhaps I have a better idea than many people, as I've written a book about it). What I meant

I didn't say I understood how the placebo effect works (although perhaps I have a better idea than many people, as I've written a book about it). What I meant is that - as I pointed out above - this study will have a siginificant placebo effect, and the results should therefore be treated with extreme caution. We still have no idea whether this treatment actually works, and I'm constantly surprised that studies like this continually make the first page of HN. I think the problem is that most people don't know that the placebo effect actually exists (or at least, they forget about it when they read a study like this, or downplay its significance). Even many researchers underestimate the placebo effect, and then we end up spending billions of dollars a year on a useless treatment until someone actually proves that it is no better than placebo. http://www.nytimes.com/2014/10/07/upshot/the-placebo-effect-doesnt-apply-just-to-pills.html?_r=0&abt=0002&abg=0 http://www.nytimes.com/2014/10/07/upshot/the-placebo-effect-...

ZenoArrow 12y ago
"this study will have a siginificant placebo effect, and the results should therefore be treated with extreme caution" You have no way of proving this. Let's face it, we do not have a good grasp on the factors involved in the placebo effect, for example we don't know whether someone needs to be susceptible to it for it to work, we don't know how to reliably trigger it, we don't know whether there are limits on its effects in the body. As you're an author of a book on the subject, you already know all this. Regarding people's hope, there's no guarantee that people will read more into the study than they should, but we should give people the benefit of the doubt. It's fairly common to read about promising scientific studies that take a long time to develop into something more tangible, if at all (for example, here's a whole website full of such stories... http://phys.org/ http://phys.org/). Anyone with an interest in science is going to be used to these stories by now, but it doesn't mean there isn't something promising that can come of single research studies, once the data can be verified.
- cpncrunch 12y ago
  The study just looked at number of bowel movements and self-rated health, both of which have been shown to have a significant placebo effect. See for example: http://www.webmd.com/ibs/news/20101221/secrecy-may-be-unnecessary-for-placebo-effect http://www.webmd.com/ibs/news/20101221/secrecy-may-be-unnece... A Nature review looking at fecal transplants for C difficile cautions that a strong placebo effect is common with invasive procedures. (This particular study isn't invasive, but it is highly novel, and that has also been shown to correlate with a large placebo effect). http://tcminfection.com/pdf/5%20(119).pdf http://tcminfection.com/pdf/5%20(119).pdf
  - refurb 12y ago
    From your second link: "FMT holds considerable promise as a therapy for recurrent CDI but well-designed, RCTs and long-term follow-up registries are still required. These are needed to identify the right patient, efficacy and safety profi le of FMT before this approach can be widely advocated." I don't disagree with this conclusion at all. The existing data is very encouraging, but more studies are needed before it can be considered for widespread use.

ZenoArrow 12y ago

"this study will have a siginificant placebo effect, and the results should therefore be treated with extreme caution" You have no way of proving this. Let's face it, we do not have a good grasp on the factors involved in the placebo effect, for example we don't know whether someone needs to be susceptible to it for it to work, we don't know how to reliably trigger it, we don't know whether there are limits on its effects in the body. As you're an author of a book on the subject, you already know all this. Regarding people's hope, there's no guarantee that people will read more into the study than they should, but we should give people the benefit of the doubt. It's fairly common to read about promising scientific studies that take a long time to develop into something more tangible, if at all (for example, here's a whole website full of such stories... http://phys.org/ http://phys.org/). Anyone with an interest in science is going to be used to these stories by now, but it doesn't mean there isn't something promising that can come of single research studies, once the data can be verified.

cpncrunch 12y ago
The study just looked at number of bowel movements and self-rated health, both of which have been shown to have a significant placebo effect. See for example: http://www.webmd.com/ibs/news/20101221/secrecy-may-be-unnecessary-for-placebo-effect http://www.webmd.com/ibs/news/20101221/secrecy-may-be-unnece... A Nature review looking at fecal transplants for C difficile cautions that a strong placebo effect is common with invasive procedures. (This particular study isn't invasive, but it is highly novel, and that has also been shown to correlate with a large placebo effect). http://tcminfection.com/pdf/5%20(119).pdf http://tcminfection.com/pdf/5%20(119).pdf
- refurb 12y ago
  From your second link: "FMT holds considerable promise as a therapy for recurrent CDI but well-designed, RCTs and long-term follow-up registries are still required. These are needed to identify the right patient, efficacy and safety profi le of FMT before this approach can be widely advocated." I don't disagree with this conclusion at all. The existing data is very encouraging, but more studies are needed before it can be considered for widespread use.