placebo

Blogging is a funny thing. Sometimes the coincidence involved is epic. For instance, as I do on many Mondays, yesterday I crossposted a modified and updated version of a post from a week ago from my not-so-super-secret other blog. This time around, it just so happened to be a post about what I like to refer to as the placebo narrative. As is my wont, I described in the usual ridiculous level of detail why that narrative is so popular among promoters of pseudoscientific medical treatments and, more importantly, why that narrative is approaches black hole density bullshit. It’s something that…
I write quite a bit about placebo effects. Of course, part of the reason is that placebo effects are just plain interesting from a scientific perspective. After all, if one can relieve symptoms with inert sugar pills or other ineffective interventions because of the power of expectation, that’s something we should want to understand. Also, given the mission of this blog, another major reason is that placebo effects are inextricably bound to the question of whether the alternative medicine modalities that are being “integrated” into medicine through the brand of integrative medicine actually…
Back when advocates of “alternative” medicine were busily trying to legitimize their quackery by first renaming it “complementary and alternative medicine” (CAM), long before CAM “evolved” into “integrative medicine,” they really believed that if their favorite woo were to be studied scientifically it would be shown to be efficacious. Thus was born the Office of Alternative Medicine in the NIH, which later became the National Center for Complementary and Alternative Medicine (NCCAM), which more recently became the National Center for Complementary and Integrative Health (NCCIH), thus utterly…
It's an understatement to say that I'm not exactly a fan of the National Center for Complementary and Integrative Health (NCCIH), the institute formerly known as the National Center for Complementary and Alternative Medicine (NCCAM) and, even a year after its name change, probably still better known by its old moniker. Just type "NCCAM" or "NCCIH" into the search box of this blog if you don't believe me. Basically, it's an institution forced upon the National Institutes of Health in the 1990s by Senator Tom Harkin (D-IA), a woo-friendly senator who believed that bee pollen cured his allergies…
It's always disappointing to see a good journal fall for bad medicine, particularly when it's in your field. For example, the Journal of Clinical Oncology (affectionately referred to by its abbreviation JCO) is the official journal of the American Society of Clinical Oncology (ASCO) and probably the most read clinical journal by those involved in the clinical care of cancer patients. Just as most oncologists, surgeons, and radiation oncologists who specialize in the care of cancer patients belong to ASCO, most of them also at least peruse JCO on a regular basis because major results of large…
If there's one thing that's become clear to me over the years about acupuncture, it's that it's nothing more than a theatrical placebo. Many are the times that I've asked: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Most recently, I asked this question in 2012. What science-based medicine answers is yes. However, there's a large contingent of physicians under the sway of practitioners of traditional Chinese medicine (TCM) who have fallen under the spell of that theatrical placebo, leading to a whole subdiscipline of quackademic medicine in which tooth…
Ever since moving back to the Detroit area nearly seven years ago, one thing I've noticed is a propensity for our local news outlets to go full pseudoscience from time to time. I'm not sure why, other than perhaps that it attracts eyeballs to the screen, but, in reality, most of these plunges into pseudoscience and quackery are so poorly done that I find it hard to believe that even believers find them interesting. For example, back in 2008, I discussed a particularly dumb story aired by our local NBC affiliate WDIV entitled Orbs: Myth or Real?, which, not having started my new job yet, I…
One of the biggest medical conspiracy theories for a long time has been that there exist out there all sorts of fantastic cures for cancer and other deadly diseases but you can’t have them because (1) “they” don’t want you to know about them (as I like to call it, the Kevin Trudeau approach) and/or (2) the evil jackbooted thugs of the FDA are so close-minded and blinded by science that they crush any attempt to market such drugs and, under the most charitable assessment under this myth, dramatically slow down the approval of such cures. The first version usually involves “natural” cures or…
Although I'm a translational researcher, I'm also a surgeon. That was my first and primary training and only later did I decide to get my PhD during my residency, when the opportunity to do so with a decent stipend presented itself. From my perspective, clinical research in surgery is difficult, arguably more difficult than it is for other medical modalities, at least in some ways. For instance, in surgery, it usually very difficult to do a double-blind placebo-controlled trial. For one thing, doing "sham" surgery on patients in the placebo arm is ethically dicey, and it's very hard to…
Here we go again. In the wake of study after study that fails to find activity of various "complementary and alternative medicine" (CAM) beyond that of placebo, the campaign to a "rebrand" CAM as "working" through the "power of placebo" continues apace, in the wake of the successful campaign to "rebrand" various needle-based medical modalities as "acupuncture." Personally, I've argued that in reality this new focus on placebo effects as the "mechanism" through which CAM "works" is in reality more a manifestation of the common fantasy that wishing makes it so. Meanwhile I've argued that this…
Heidi Stevenson amuses me. The reasons are legion. Be it the time when Heidi lectured scientists on anecdotal evidence (which she values far more highly than scientists, of course, declaring it the "basis of all knowledge"); launched a vile and nonsensical attack on Stephen Barrett; argued against prior plausibility with using a straw man argument so massive that if it were set on fire (which she did) it could be seen from space; or made an even more idiotic argument to try to "prove" that wi-fi signals and EMF cause autism, Heidi never fails to deliver the stupid in mass quantities of black…
Now that Trine Tsouderos no longer works for the Chicago Tribune, there aren't that many reliable generalist medical/science reporters around any more. For example, here in the U.S. there's Marilyn Marchionne at the AP, Gina Kolata of the New York Times, and then there's Sharon Begley, who used to be at Newsweek but is now at Reuters I'm having trouble thinking of others with national prominence, other than Nancy Snyderman, who has recently profoundly disappointed me with a fawning report on "complementary and alternative medicine" (CAM) that made it seem to be the greatest thing since sliced…
If there's one thing that goes back to the very beginning of this blog (or at least it started in the first year), it's having a bit of fun with Deepak Chopra. I realize that to some it might seem like shooting the proverbial fish in a barrel. With a rocket launcher. On the other hand, I like to look at it this way. Deepak Chopra has a multimillion dollar alternative medicine and "quantum consciousness" empire milking the credulous to buy attend his lectures, buy his DVDs and books, and even to buy his video games. He's on television all the time, including appearances on Dr. Oz's show and on…
I'm not even going to mention why it took fifteen hours to get from DC to Boston. By plane. Except that US Airways sucks. Anyway, you might have heard about the placebo-effect article recently published in PLoS One. I was going to blog about this yesterday, but events overtook my schedule (by twelve fucking hours). Anyway, when I was visiting relatives, I decided to actually read the article, and I had some serious doubts about the conclusions. Fortunately, I don't have to discuss them, since I found two good posts dealing with this article. PalMD makes the good point that paying…
The placebo effect - the phenomenon where fake medicines sometimes work if a patient believes that they should - is a boon to quacks the world over. Why it happens is still a medical mystery but thanks to a new study, we have confirmation that the spine is involved. Frank Eippert from the University Medical Center Hamburg-Eppendorf used a technique caled functional magnetic resonance imaging (fMRI) to scan the backbones of volunteers as they experienced the placebo effect. Eippert heated the recruits' forearms to the point of pain and he gave them cream to soothe the sting. The creams were…
I'm an anthropologist and a biologist, so really, I have no problem with the idea of a "placebo effect" in which people become convinced that they are being given an effective treatment and thus, because of that thought in their mind, improve. Editorial Note: I'm classifying this post as a "falsehood" because it does fit nicely with that series, though this was not on the original list of falsehoods. Also note, this is a hastily dashed off first draft, so please be ruthless in your comments so I may move ever towards the unattainable perfection. I doubt very much that this works for many…
Philip Dawdy takes a interesting look at a new study of the safety of placebo arms in clinical trials of antidepressants in teens. My own quick scan of the study [which Dawdy makes available as pdf download] suggests it's full of great nuggets. Its take-home: Placebo treatments produced remission rates of 48%, while the rate for active treatment was 59%. And, quite interestingly, the study concludes: Patients who responded to placebo generally retained their response. Those who did not respond to placebo subsequently responded to active treatment at the same rates as those initiallyl…
With so much written here lately about placebos and drug effectiveness, I would not want to leave out this remarkable study: Placebo effect is stronger, apparently, if you pay more for the placebo. This is a fascinating study described in a letter to the Journal of the American Medical Association. A crudely shortened version: Some researchers at MIT (none of them Bill Murray, as far as I can tell) gave light shocks to volunteers, then gave them some placebos that were costly and some that were cheap. The costly ones worked better. It sounds like a bit of a stunt, but as Respectful…