Open Mind said:
At what point does an improvement become ‘insignificant’? For example even if we assume it is only making patients feel less depressed, does that truly make it ‘insignificant’?
When that improvement is considerably less than improvement with conventional medical means, it is an 'insignificant improvement'.
75% of the effectiveness of antidepressants is replicated by a placebo, that still sounds large but is only about 2 points on the HAM-D scale. If these drugs truly have a powerful antidepressant effect, then it is being largely masked by a placebo effect.
I won't disagree on antidepressants, for two main reasons: 1) I personally doubt the effectiveness of the diagnosis and treatment of some patients, considering many don't need the drugs at all and some are actually harmed by the drugs. I've seen that myself. - and 2) I'm not knowledgable on the broad scope of psychological drug therapy, except to notice that some scientists consider many of those drugs nearly as quack-oriented as some of the alt-med treatments.
Yes the drugs consistantly beat the placebo effect, however one study, researchers analyzed 345 antidepressant trials for depression with 36,000 men and women. The goal was to determine if a link existed between the use of SSRIs and suicide attempts. Out of a 140 suicide attempts, the suicide rate was twice as high in patients taking SSRIs, when compared to those taking placebo pills.
See above. I don't doubt that one bit.
So would you recommend people just needing reassurance and reduced depression take an antidepressant instead, with a list of possible side effects never mentioned to those tested in original trials (that might reduce effectiveness in actual prescribed trials?) I supposed you could give them an unethical placebo but if it says placebo on the bottle it is no longer a placebo.
Of course not. See above.
With regard to ‘touch therapy’ how do you know it has no beneficial effect? …..in 1995 rat pups deprived touch were found to have dramatic reduction in growth hormone
http://www.nature.com/npp/journal/v28/n6/full/1300125a.html
Earlier studies on human emotional deprivation suggest similar too (e.g. G.Powell studies in 1967 and 1973) .
Also read the ‘effects of healing with intent on pepsin enzyme activity’ Journal of Scientific Exploration Volume 13, Number 2, 1 July 1999, pp. 139-148(10)
I mispoke. There is a beneficial effect, with regards to growth and development, and emotional well-being; but people are getting 'touch therapy' for ailments that have nothing to do with these areas of medicine. It's fairly well known, I thought, that infant and toddler development is enhanced - even dependent upon - caring physical contact.
Easy to test, give people a placebo but tell them it is a inactive placebo, if the effect is less in comparison to another placebo told to be a wonderfully powerful new drug …. This would suggest my statement in principle is correct.
No, this would be comparing a nocebo to a placebo. The placebo - the pills claimed to be a new wonder drug - would have an improved effect, there can be no doubt. But the effect has nothing to do with the pills, rather than the presentation.
How do you know it never worked at all, perhaps snake oil cannot work because skeptics have told people it cannot work
By 'skeptics' I presume you actually mean 'valid scientific research'?
I should really look into researching whether famous past drugs that got abandoned lost effectiveness over time with doubt or were always rather ineffective.
That would be difficult, since famous past drugs generally had numerous anecdotal reports and very little valid scientific data to read through; in other words, by looking at case studies, these drugs should most often be demonstrably effective, up to the point someone realizes they don't work at all. Bias, and all that, you know.
Have you considered the possibility that the information you are reading on organized skeptic websites is somewhat biased? Being skeptical is fine but that should include being skeptical of organized skepticism!
Since this is the only 'organized skeptic website' I've ever been to, and since I base my information on real science and actual studies, then, no, I don't consider the information here to be an y more biased than on any other public web forum. Skepticism is a technique of basing judgements upon valid evidence; therefore, skeptical claimes are
less biased than other claims.
The skeptic paradigm has moved from ‘doubt’ to a defense of the conventional and predictable science against anything that falls outside the conventional that is hard to predict or understand …
Total strawman - and completely wrong.
And a placebo was conventionally supposed to be completely useless and inactive patient deception, rather than admit a placebo can have a beneficial effect.
Also wrong. Placebos are conventionally supposed to be a psychological means of dealing with patients whose symptoms cannot be treated through available medicine, where those symptoms are not life-threatening or crippling. In science, placebos are conventially a means of removing one more variable - the psychosomatic variable - from drug testing.
It seems skeptics, in a desire to shoot down anything alternative, prefer to dismiss weak effects altogether.
No, skeptics, in a desire to shoot down quackery and fraud, prefer to dismiss lame theories about how some alt-med ]i]might[/i] work in favor of valid scientific research.
Can conventional medicine cure AIDS? Are you claiming belief and emotion has no effect upon AIDS?
Putting more words in my mouth. I never said conventional medicine can cure AIDS - but some alt-med practicioners are claiming they can, wrongly. Conventional medicine isn't claiming a cure, now, is it?
People do occassionally recover from cancer after conventional medicine as said it can do no more, of course a skeptic will offer another (unproven) explanation as to what really occured..... but are you claiming emotion and belief can never have an effect upon cancer?
Did I make that claim? I seem to have missed it. But some alt-meds are claiming total cure of cancer - are you claiming that alt-meds that play on one's emotions and beliefs are valid and consistent cures for cancer?
I’m feeling too lazy too look
But I know there are at least 3 trials showing a possible link between emotions, stress and immunity.
Never said otherwise - but a placebo is not a 'cure'. It can have an effect, but not a preferential effect to treatment, and not a consistant and reliable effect.
Perhaps skeptics just believe emotions can make us ill but never better?…. Just a one directional process? Several earlier posters in this topic said a placebo cannot cure to belittle the effect …. yet seldom does a drug actually cure, it is often an effective maintenance dose to counteract and slow down deterioration? Can emotions also slow down deterioration too, if stress impairs immunity?
Hey, it's your strawman - burn it however you like.
I am not against skeptics challenging anything, I am against them belittling or entering denial of weak effects
And I'm not against weak effects. I am against people taking hard-earned money from gullible sick people on the slim chance that a placebo effect might help them.
I don't think anyone knows enough about the placebo effect, that most certainly includes me too.
A lot of people know a heck of a lot more about it than you or I do.
Well I agree ...... so would you are just advising people to think negatively over alternative treatments and positively over conventional ones?
I do think many people try alternative therapies because the conventional one wasn’t satisfactory. ‘Sorry Mrs X, there is nothing more we can do for your cancer …… but don’t try anything else!’
Alternative treatments are fine - if they have valid mechanisms of effect. If they're just sugar pills or colored lights, I would tell people to reconsider these quack treatments, end of story. "Sorry Mrs. X, there is nothing more we can do for your cancer. If it makes you feel better, you might seek some form of faith healing. There is no valid mechanism of effect for most of them, but in rare cases, cancer such as yours might go into remission if you keep a positive outlook and stay away from harmful alt-med treatments." At least that's honest.
I agree that many alternative practitioners are possibly giving the wrong reason for the benefit.
As well as vastly over-estimating the benefit.
Actually to a lesser degree I see a general lack of miracle cures in conventional medicine too. Surgery has been a great success. Slowing health deterioration with drugs has been comparatively successful (not necessarily clearly proven better in long term over diet and exercise) but no doubt vital if serious acute conditions.
At least science isn't claiming 'miracle cures'. Too many alt-med practicioners are.
As to whether miracles cures exist, that is a paranormal debate. I’m not religious, I have no religious faith … but I think belief produces significant if generally weak effects in health (placebo) and also possibly in the paranormal. (claimed sheep and goat effects)
Your beliefs are obvious in this regards.
I would dispute that, if stress can worsen a disease or cause it … how can you be so sure they would have healed without the placebo like effect?
Because some people do. In the case of mild illnesses - for example, the common cold - it is guaranteed they will heal with or without the placebo effect.
Again conventional medicine isn’t that successful on genetic disease either.
More successful than homeopathy, touch medicine, or faith healing is.
I’m still not sure it is that clear cut, our physical height is determined by our genes but our environment modifies the expression of those genes. (e.g. rat pup study mentioned above).
I have no idea what you're trying to say there. Of coure environment plus genes equals whatever we are. What does that have to do with what we are discussing?
Consider, for a moment, someone who comes down with a case of lice. (This, BTW, is a true story - an anecdote, and therefore without value, but true nonetheless)
The person in question, being leery of toxins on his head or chemicals in his body, seeks the advice of his local holistic practicioner; the doctor rightly advises commercial products, a variety of treatments for the home, and of course, shaving the hair off. "Nah," the person says, "isn't there something else?"
So the alt-med doctor prescribes for him a homeopathic shampoo, whose label claims, "Guaranteed to kill lice in less than 24 hours!" The guy takes the stuff home, douses his head in it, and waits.
Three days later, he's back, asking for another alt-treatment, 'cuz that one ain't cutting it. And on and on it goes until, finally, exhausting all other treatments, the guy shaves his head (and his wife and childrens', because they're all infected now), and undergoes conventional treatment. At this point, he's spent approx. $150 on alt-med treatments, to no effect. Where's the placebo effect there? But this is exactly what happens, with many ailments, to many people. This is exactly why alt-med should be viewed with suspicion and concern.
If it's something minor, like a cold or a mild sore throat, then sure, a placebo might be just as effective a treatment. But conventional meds aren't claiming a 'cure' for a cold, and many sore throats can only be treated for pain and swelling, and nothing more. The alt-meds can do no better - and no worse. But once you start trusting alt-med to 'cure your cold', you start trusting alt-med for more vital treatments, and there are very few scrupulous holistic doctors out there willing to draw the line and let you know when a quack treatment isn't going to help you. (I happen to know one such doctor, but he's a pretty weird duck.)
Take it however you want, of course. If you want to risk your health or your life on treatments that only make you think you're feeling better, then go for it. I'll stick to treatments that have some manner of effect. Whatever treatment I'm offered - whatever meds have EVER been prescribed to me - I educate myself on the meds involved, their effect, side-effect, mechanisms of action, etc. until I'm satisfied and either take the medicine, or seek an alternative medicine, or toss it aside and let time take its course. Unfortunately, most people don't bother; they trust their healers to be honest and to have effective treatments; so they swallow the B.S. hook, line, and sinker.
