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Placebos Work -- Even Without Deception
An anonymous reader writes "For most of us, the 'placebo effect' is synonymous with the power of positive thinking; it works because you believe you're taking a real drug. But a new study rattles this assumption. Researchers at Harvard Medical School's Osher Research Center and Beth Israel Deaconess Medical Center have found that placebos work even when administered without the seemingly requisite deception. The study was published on December 22 in PLoS ONE."
If deception isn't necessary for placebos to work, does this mean the homeopathic medicine advocates can admit it's bullshit now?
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just saying!
The lack of misinformation doesn't negate the plethora of ignorance - their probably thinking "they're just saying this is a placebo to test if it's really working".
Study proves sugar pills alleviate IBS in 60% of patients!
... big pharma going to market with the 'New, extra strength placebo'.
Have gnu, will travel.
So they expect it to still work. And because they expect it to work it does.
A guy dressed in a white lab coat, doing an experiment, gives you some medicine and tells you: "This is a placebo. Trust me, there is no active component of any kind.". Then, as soon as you swallow the medicine he, and three other lab coated investigators watch you attentively for an hour, asking if you feel strange in any way.
What would be the chances of you believing them and having no doubts about the placebo nature of what you had taken?
You beat me to it - exactly what I was going to say.
A spoonful of sugar helps the irritable bowel syndrome go away..... bowel syndrome go away..... bowel syndrome go away..... ;-)
Perhaps the sugar is not as "neutral" as the scientists originally assumed. Or maybe Americans have been so programmed by TV ads to think a pill, any pill, will cure you of your ailments.
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
The article suggests at the end that patients who responded to the placebos despite knowing that they were taking placebos might be benefiting from a "medical ritual", but I suspect it simpler than that. I suspect that the patients were just receiving some sort of psychosomatic benefit from having an actual human being pay attention to them for a little while. I can't prove it, but I suspect that a lot of modern chronic illnesses are psychosomatic and are a consequence of loneliness.
I write sci-fi for metalheads
This seems hardly worth mentioning. It was one small study done for amusement. No earth has been shattered here.
From the actual study, the wording used to present the placebos to the patients seems to have been very carefully chosen to be utterly truthful, yet implicitly deceptive:
|>
Here be Dragons
I have allergies each spring. After I tried several different medications, I finally found one which advertises as "non-drowsy" - essentially a low dose of loratadine. I started taking it and yeah, it both worked and didn't make me feel sleepy all day long.
A couple of months later, I talked to a friend who is a doctor, and he told me (not knowing that I take that medication) that clinical studies for the medication showed that it worked for about 50% of people who took the drug, as well as for around 50% of people who were on placebo (I can't remember if it was 50, but the percentage was about the same). I read some more upon it, and the conclusion most knowledgeable people made was that the dosage of loratadine in the drug is too low, and that it works only as a placebo.
Knowing what I know, I still take that medication and it still helps me. Perhaps the low dosage really works for me, but more likely, I keep being fooled by a placebo I know about...
This is fascinating to me.It proves how much we don't know about how people work.
As a physician I have on several occasions wanted to prescribe a placebo, knowing that time would be the best remedy and that simply feeling like the patient is doing something might improve their outlook immediately. Of course, I consider that misleading and unethical. To know that it might work even if you are up front about it is amazing. I'm not sure that it would work outside of a clinical trial though. I'd love to know how/if it really works.
Several possibilities -
1) Just a statistical fluke - it won't be born out in repeat studies.
2) Specific only to disorders like IBS which has a highly variable course, subjective symptoms, and is hard to diagnose. This isn't going to work with leukemia.
3) An example of "active" intervention where a person feels like they are being helped to help themselves even if they cognitively don't believe it. It's what underlies the "healing touch" in medicine and maybe even the power of meditation/prayer (praying for yourself that is, not being in a coma and having others pray for you).
I also don't know how they got the study past the scientific review board, which I thought, would laugh them out of the room.
If placebos are proven to work, are they really placebos? ;-). Maybe we should start calling it a bottle of psychosomatic medication.
I think having attention paid to you by a doctor perhaps helps too.
I'm cured by just reading about these amazing placebos!
This is known information, and I don't understand why the Dr. was surprised by the result.
A placebo effect* doesn't fix anything,ever. It makes people feel better subjectively. When you couple that with things that getting better in a few days on their own. people start thinking they 'cured' them, when in fact it was just the bodies normal process.
*there are different types. Depending on the invasiveness of the fake treatment.
The Kruger Dunning explains most post on
Doing something makes people feel better... even when what they’re doing is completely useless... and even when they know it.
And when it’s something that even the laziest person can do (popping a pill), it’s an all-around win.
Distributed Denial of APK: It takes 15 seconds to reply to him anonymously, but wastes tons of his time if we all do it.
So if not symptom relief, what would the other outcome measures be improving? Any help? Simply better-than-adequate symptom relief? Does this need to be worded so vaguely?
wow, I just listened to this RadioLab last night on my way home from work:
http://www.radiolab.org/2007/may/17/
What about the possibility, I know it sounds crazy, but what if sugar pill is actually an effective treatment for IBS. Seems like they need to use the same placebo on test groups with other conditions to eliminate that possibility.
Repeal the 17th Amendment TODAY! Also Please Read http://www.gnu.org/philosophy/right-to-read.html
... I could find a doctor to prescribe me some placebo narcotics.
Placebos never work, by definition.
"Something of no intrinsic remedial value that is used to appease or reassure another."
You know, if you could induce the placebo effect like that, it would be fairly astounding because the placebo effect is often as effective (or more) than the medicine. I suspect it would also turn modern medicine on its ear. "You're better because you want to be better" becomes something for some pretty serious investigation.
Part of me wonders if the patients understood this -- they were described as "like sugar pills", and it said placebo on the pill -- but it's possible that they just didn't realize that they were literally being given nothing whatsoever in terms of medicine.
This part intrigues me ... "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual" ... that would seem to imply that the human brain has a far greater capacity for fixing itself than Western medicine believes, no? At least, it might. At which point, prayer and dance have as much "medical" validity as actual medicine -- at least, for some conditions; if I'm in a car accident, I still want to see a trauma surgeon if need be.
Heck, leeching was considered medically useless for a long time too. And then there's that whole maggots thing.
I think the underlying mechanism for this (or at least explanation for it) is fairly interesting.
Lost at C:>. Found at C.
After reading the slashdot summary, I got to wondering - do Placebos actually "work" or is it simply that the patients would get better all by themselves (immune system and other self-healing mechanisms in the body)? So, I did a few seconds of googling "placebo vs no treatment", and came upon a paper online at the NIH website:
http://www.ncbi.nlm.nih.gov/pubmed/12535498
The author of that paper concludes, "There was no evidence that placebo interventions in general have clinically important effects."
If the healing happens a certain percentage of the time regardless of whether treatment is even administred, then it makes perfect sense that placebo would work that same percentage of the time, even if people didn't believe they were being treated - e.g. "belief" has nothing to do with recovery - that is, it's very possible, and that NIH paper appears to confirm the hypothesis, that with "placebo effect", the conscious mind plays no role in the improvements witnessed.
doesn't mean they don't suspect it might be real and they were lied to.
The placebo effect isn't based on the belief that it's medicine, it's based on the belief that it will work. The patient takes the pills because even though they're just sugar pills, their doctor says they will help anyway. A trained medical person believes they will get better taking them. So they believe it too. So they get better.
The doctor could probably save the patient a few calories and some trouble if they just lightly hit the patient on the forehead with the heel of their hand yelling "By the power of Hippocrates I declare you healed".
The article doesn't say exactly what the summary says. This is a clear case of Science news cycle.
The thing is, it seems that appeasing and reassuring have intrinsic remedial value, and therefore that definition is contradictory.
People generally don't drink enough clear, fresh water. Often, when they're taking a pill it's the only circumstance they're doing so. Perhaps that's the reason why even placebos work.
I'll believe it works without the deception if it works with people taking them by finding the pills in the street.
When a doctor hands you a pill, you ASSUME he is doing it for a reason and to help you. Thus the deception is still there.
That said, I wish it was easier to get sugarpills I'd love to screw with friends with bottles of "actual prescription" penis enlargement pills.. NO really dude, they work!
Do not look at laser with remaining good eye.
If the placebo works, doesn't that mean it's not a placebo?
thye were being treated by doctors. Try the same thing, except with Cheney dispensing the pills and see what happens
Perhaps some people are just too stupid to know what "placebo" means. They just think it's another goofy brand name.
When it's time to, you know, but you're having trouble, you know, try Placebo.
Reminds me of the Pirin tablets from The Birdcage.
I won't lie and suggest there's any kind of supporting evidence for that statement. I am merely stating it in a confident and authoritative manner as a service to beer lovers everywhere.
Drink up, and think about what I have told you.
I won't insult your intelligence by asking you to to believe that drinking beer is slimming, I simply ask you to keep the notion in mind whenever you have a drink. It is the mere presence of this idea in your mind as you drink that does you good, not your belief nor any properties inherent in beer itself.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
No, you clearly don't understand the placebo effect.
Caner remission can happen with no pills medication at all. It's rare, but it happens. So Yes we would expect to see some remission from taking a non active ingredient pill, but in no case is it about the rates expected for 'spontaneous' remission.
EVERY test I have read about(100s) regard placebo effects show no real effect. Whether that placebo was administered by pill, fake surgery, acupuncturist, chiropractor, or prayer.
People believe they are better, they 'feel' better but when actually tested they don't actually perform better.
Look. I can read through a phone book, claim my magic powers heal people, and someone in the phone book will have gotten better. Does that mean I have magic powers, or their body was just able to heal itself?
The Kruger Dunning explains most post on
It's like the recent NEJM article that stated tai chi is useful in treating fibromyalgia. Some people just feel better when they feel they're receiving treatment.
I think this quote from the article is an interesting explanation:
"Nevertheless," says Kaptchuk, "these findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual. "
Sure it may be a sugar pill, but the people in the study are focusing on their disease, considering their symptoms, actively wanting the symptoms to lessen, and performing a "pill ritual". And they are doing all of this, twice a day.
Compare this to the control group, which basically only thinks about the issue when symptoms flares up.
It's amusing to me that the first comparison I thought of was Aleister Crowley, and others in the ritual magick field, who basically advocate writing your desires on a piece of paper and focusing on it once or twice a day, as the way to perform a "spell".
I'm addicted to placebos!
crazy dynamite monkey
and marketed by "Big Pharma" are different. When a company drop ships orders that another firm fulfills, it is pure profit for them.
As pointed out by Orac, things are nowhere as simple here as they've been presented. There was still an establishment of expectation of the treatment working, which is exactly one would expect would elicit the placebo effect.
The success of placebos is completely dependent upon the person's predisposition to self-delusion. Some - a very few, admittedly (far too few for my taste) - are much less predisposed to it. Placebos would probably be a waste of time with such people. As the saying goes, you can't hypnotize a skeptic.
Theism: FAIL
Atheism: WIN
May also explain why prayer works without regard to specific faith.
Yeah, I was thinking along the same lines. It’d be interesting to have a third group who were given the placebo pills and instructed to not take them, but instead to open up their medicine cabinet twice a day, look at their bottle of placebo pills, and think about all the people who had taken them and got imaginary benefits from them. I.e. don’t take the placebo pills – they don’t work – but think about it, since it appears to be the thought that counts. Literally.
Distributed Denial of APK: It takes 15 seconds to reply to him anonymously, but wastes tons of his time if we all do it.
What the mean is that even though the subject knows it's a placebo, they still, subjectively, feel like they are better. Based on numerous others studies I have read, I would wager that the effect is shorter in duration then people who didn't know, of course that's speculation.
It does not mean they where cured of anything.
The Kruger Dunning explains most post on
I think the placebo effect is an inditement of the medical community's misuse of subjectivity and statistics. It's a big, glaring "you've missed something important in your assumptions!"
Personally, I think the problem is with subjective questions about symptoms: much of the information about the objective differences in the seriousness of the symptom is getting drowned out by patient's subjective stress level and how much they percieve the symptom to be responsible for the stress.
Or are you, a cynic, going now to admit that there's something to homeopathy after all? :p
disclaimer: i am not a homeopathy supporter
I've used placebos so frequently with my children that they have asked the babysitter for a placebo because they had a headache – usually we give them Ludens drops.
the guy who died from homeopathic medicine?
Yeah, he forgot to take it and overdosed!
Butseriouslyfolks... I'd like to see someone argue that homeopathy DOES work if you do a placebo-controlled trial. A homeopathic placebo-controlled trial, which means the placebo is actually undiluted. Hey, 100% of the patients given placebo arsenic died, and only 50% of the patients who took the diluted version! Whaddayaknow: a diluted dose of arsenic cures arsenic poisoning.
You mean, patients know about placebo effect and they know for established fact that it actually does work, so even though they are told it's placebo, it works, because that's what placebo normally does?
I thought more of a power of habit: their body is trained to get well after swallowing a pill, so what their brain thinks of it is irrelevant.
What treatment did you ultimately settle on for the bulged lower lumbar? Every one seems to be a choice between a rock and a hard place. How well did it work Ultimately?
I've been to the doctor several times for things I know he won't prescribe for me for anything, but I go there just in case. Until I make the appointment, I feel crappy for an extended period of time, but the moment I do, I start to feel better. As a skeptical person, I know there's know magic to it, no strange force, no "God is looking after me," or whatever. But I do know my emotions and my mental attitude have a direct effect on my physical well being. I know is just all in my head, and my doctor is very helpful, sometimes not charging me and never prescribing me something I do not need (he's definitely old school!)
It's the emotions of dealing with the issue. I when I have any problem in front of me, it always feels best for me to deal with it, or put a plan into motion to deal with it. Putting off a fix or plan makes me feel crappy and annoyed.
"All great wisdom is contained in .signature files"
No. It means that the ritual itself provides a placebo effect on a subconscious level even if you consciously know it is a placebo. The study does validate bunk medical treatments in any way.
I utterly hate going to doctors, I was very ill for a long time due to the misdiagnosis and incompetent treatment by my doctors. But even I know that medicine produces real results.
obligatory
If you know it's a placebo, but also know that placebos work sometimes when you don't know it's a placebo, you are still taking something that you believe in a way will work. All this shows is that patients are able to deceive themselves without the help of a doctor.
(I'd be interested, though, if the benefit of knowingly taking a placebo is negatively correlated with medical experience and scientific understanding. In other words, if it works better when you're not smart enough to understand why it shouldn't work.)
You know there is a discipline called "Kiatsu" or Ki - massage practiced by some practitioners of Ki-Aikido school of Aikido martial art. It is basically a reviewing of your own body parts and tissue boundaries, through feeling them from the outside or just by being attentive to sensations from them. The theory is that vital force of Ki (same as Chinese Chi or hindu Prana) follows your attention and awareness. Allegedly it helps maintaining good health and preventing illnesses. So far there is no physical emanation of Ki ever detected, so we cannot honestly assign it high degree of physical "realness". However, perhaps attention itself mobilizes your internal forces and helps your body heal. If Kiatsu works, then perhaps placebo is based on it: a pill is just a pointer to ill part of the body - you take the pill and get attentive to it as you follow the progress of your state.
Namely, Placebo's work when the symptons are Psychosomatic.
For example, I have thick blood, have to take blood thinners. You can tell me i'm taking blood thinners, but unless it's actually blood thinners, it's not doing shit for me.
Let's take a herion junkie. You can sell them, i mean, give them some cooked brown sugar, tell them it's herion, but I bet ya in about 3 mins they are going to be kicking your ass for giving them fake drugs.
now, when my stomache hurts, ya, a placebo can help, because if I distract myself, i'll forget about my stomache hurting. But it's not serious, and very fucking minor.
Now my anti-depressants. Give me a placebo, and i'll start getting depressed. Sure, it's mental, so you'd think the placebo would work. Except, of course, i need the drugs to balance out teh chemicals in my brain, and no amount of faking it will do that.
Anyways, I already don't trust the doctors, so how is them lying about crap going to make that better?
And why do placebo's cost as much as the drugs they are faking?
Be seeing you...
You don't have to take the word of the magazine as to what is in the article - you can read it for yourself
Conveniently enough the P in PLoS stands for Public - as in you can download the articles from anywhere without paying for a subscription.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
"work" is ambiguous and slightly deceptive. What we should say is there is a "reported effect". That is different (from my perspective) as having a clinical effect.
Hróbjartsson & Gøtzsche did an interesting meta-analysis of studies with both a placebo and no-treatment arm. For binary outcomes (except pain) there was no significant difference and for continuous outcomes and binary pain outcomes there was a difference but it increased inversely with sample size. They postulate that what people call the "placebo effect" is really just a form of reporting bias. People have been "treated" or have gone though the motions of treatment and as a result they change their expectations.
I mean, what is more likely some mysterious force which crosses every clinical boundary...or that people are (unintentionally) fudging things a bit.
Yeah, I was thinking along the same lines. It’d be interesting to have a third group who were given the placebo pills and instructed to not take them, but instead to open up their medicine cabinet twice a day, look at their bottle of placebo pills, and think about all the people who had taken them and got imaginary benefits from them. I.e. don’t take the placebo pills – they don’t work – but think about it, since it appears to be the thought that counts. Literally.
Oh a fourth control group told it's cyanide.
It might not even by psychosomatic. It might simply have to do with disciplined awareness.
For instance, you're forced to take the pills before eating. Since you're aware that you're going to eat, you subtlety change your eating habits (perhaps eating more conscientiously rather than wolfing it down or not overeating or avoiding foods you you you shouldn't eat) such that you ease our condition. Such easing might not be immediate, but over a period of time it could add up.
A good way to test this hypothesis would simply have three groups, "control 1" which does nothing, "control 2" which is asked to record what the person is going to eat before eating it, and the test group which eats the sugar pills.
If the sugar pills still have an effect distinguishable from the control groups, then perhaps sugar *is* an active ingredient and we just don't know it.
point in favour of placebo: you're less likely to get catastrophic kidney/heart/liver/eye/etc failure than from approved drugs like Celebrex, Vioxx, Cialis et cetera.
$
The general public were starting to learn what placebos are, and not believing in them any more, and the effect stopped; now that there is "proof" that they work, the skeptics can believe again, so the effect returns.
News in 10 years: "Placebos still work even when you learn that the 'placebos still work without deception' story was fake"
I mod down anyone who says "I will be modded down for this", regardless of the rest of their comment
How do they manage a control group for this experiment?
shhhhhh
What if some of the people who were informed that they were placebos actually thought they were being lied to as part of the experiment, and thought they were taking the real thing even if they were told it was a placebo? I didn't see anyone mention this. I know I would consider that very possibility -- that they were giving me the real thing, but telling me it was placebo because I was part of a control group or something.
Clever signature text goes here.
Think about it. We all know placebos actually give pain relief. So if you know they "work" why should the placebo effect of a known placebo be any less than the placebo effect of aspirin?
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There's something else going on here - reversion to the mean. Think of your health as a curve that goes up and down. On average, you're probably pretty healthy. Sometimes less and sometimes more. When you're sick, no matter what you do, you'll probably get better. So as long as whatever treatment you do or don't do doesn't make you a lot worse, you will probably get better. Drilling a hole in your skull might seem to cure depression, the common cold, or hemorrhoids, as long as you don't drill too deep or get a bad infection that kills you. Rubbing your ear, walking in a circle, drinking infused water -- almost anything, including eating sugar pills, or just waiting, will seem to cure you most of the time.
Maybe sugar pills actually help with Irritable Bowl Syndrome symptoms?
Hello! Sugar is biochemically active. It's probably impossible to find a true placebo, that is a substance that has no bio-activity. Gelatin is an unbalanced protein and would have to have some effect. In other words, there is no such thing as a placebo, only more and less biochemically active things. There is nothing a person can ingest that has zero effect, even plain water.
Sometimes people just get better all on their own, sometimes from seemingly incurable disease. It's just exceedling rare.
There are so many billions of people in the world that just about every rare improbable and seemingly impossible situation you can imagine does happen indeed somewhere. I call it rule 1 of the real world.
The nature of our information age means that, these rare rare instances get heard about, as they spread like memes through the press and other media. We end up getting the impression these rare and unusual events are more significant than they really are.
So combining these two, chances are some nutjob with leukemia out there drinking homeopathic snake oil will by pure random chance get better, and therefore make a correlation between the too, and this bad information will replicate. See rule 1 for why this kind of anecdote can be dismissed out of hand.
After logging in slashdot still does not take you back to the page you were on. It's been that way for 20 years.
Is it possible that the act and sensation of taking a pill triggers some kind of relief reflex? Certainly putting food in your mouth and not swallowing, triggers the bodies reactions as if it was about to receive food. It's been recently shown that just the taste of food (ie carbohydrate) can boost energy levels as if we had eaten it. Perhaps our bodies learn relief is on he way, from life experience of popping asprin and such?
No belief systems required.
After logging in slashdot still does not take you back to the page you were on. It's been that way for 20 years.
Comment removed based on user account deletion
A merry heart doeth good like a medicine: but a broken spirit drieth the bones.
The placebo could've worked just because a doctor told them to take it. A lot of people feel better if they follow their doctor's recommendations, no matter what they are. They're cooperating with their care, they're following advice from a trusted authority, and maybe getting social support from the interaction. The next study should control for social influence and compliance with medical authority. In addition to the study arms used here, there should be a group that gets some sugar pills in the mail, with a note saying "These pills have no active ingredient, but we are interested in studying their effect on your disease. Please decide if you are willing to take them every day or not, and let us know." Assuming anyone agrees, I bet the placebo effect would vanish.
I was under the impression that the whole point of something being a "placebo" was that the patient didn't know it was inert. If they have this knowledge, in what sense is it a "placebo"?
FTA: "there may be significant benefit to the very performance of medical ritual"
For hundreds of years, "doctors" have been using magick to cast "spells" and some of them are just now waking up to the realization...
Kinda makes snake oil salesmen look honest by comparison.
Reality is prettier inside my head...
My question is, how is this even a placebo? If you tell the patient the pill is inert, it's not a placebo anymore, is it?
So, they tell the patients that placebos work (somehow, magically). Then they say that for a placebo to be a placebo, it needs no active ingredient.
So the patient STILL thinks he gets active treatment, because, placebo works even without active treatment! So the entire setup of the study is invalid, and the results doesn't say what the researchers think they do. You can't test placebos this way at all, as the premise isn't falsifiable... This is basic science, something the researchers clearly haven't been tought.
For most of us, the "placebo effect" is synonymous with the power of positive thinking
Well, not really. The term "Positive thinking" has been abused by self help gurus to the point that it barely means anything at all.
It's all about attitude. Simply put, doing something is better than doing nothing.
I'm not surprised receiving a dummy treatment improves things - even if you're informed it's dummy. At least you're receiving some kind of treatment, more attention and care, and this has a good effect on mood and attitude, things that have an impact on overall health.
To do this, 80 patients suffering from irritable bowel syndrome (IBS) were divided into two groups: one group, the controls, received no treatment, while the other group received a regimen of placebos—honestly described as "like sugar pills"—which they were instructed to take twice daily.
It would have been more interesting if they had had a third group receiving a classical placebo treatment - then they could have tested how classical placebo compares to "informed" dummy pills.
I always figured the whole placebo thing was based on ignorance, not deception. How can they evaluate if the people decided it was going to be a medically effective treatment? This study seems stupid, just like most people.
How about running a study where you give everyone obviously labelled placebos and then see whether people who know how biology and medicine work get the same treatment as the average slob.
-josh
http://scienceblogs.com/insolence/2010/12/more_dubious_statements_about_placebo_ef.php
I would suggest everyone read Orac's blog.
Sometimes, I can "fool myself" by drinking what I know is decaf and yet still get a caffeine buzz.
Study says:
"placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes"
ORLY?
What if a little sugar (or whatever the supposedly "inert substance" was that made up the pill) actually DOES do something useful to mitigate Irritable Bowel Syndrome?
A "sugar pill" would also cause a small bounce in blood sugar levels, which can have all SORTS of effects - both on the nervous system and a lot of other systems in the body. Ditto starch binders. Ditto traces of calcium. Etc.
Suppose some of the the "inert" placebo tablets, injectable solutions, etc. that have been used in decades of medical research aren't actually all that inert? That could blow a LOT of science out of the water.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
This has an interesting application to religion. It would then be just as effective even if people knew it didn't work.
... by double-blind testing with fake placebos?
40 patients in each group? Do the results meet statistical significance?
SORBITOL is an inactive in plenty of liquid gelcap type drugs. however in high amounts or taken too frequently can cause diarrhea. perhaps an inactive had an unlikely side effect of drying their shit up a bit?
Hate to rock the boat by commenting on TFA, but surely this doesn't tell us that much. One conclusion could be that the placebo effect simply shows how many patients just want an authoritative medical figure to tell them what to do, something constructive (however questionable), and do not factor any of their own decision-making into the process.
"The doctor told me to go jump off a bridge. I feel better already now I've spoken to a man of medicine, with years of experience and schooling, and I'm taking action based on his advice."
There is probably significance in the *psychological process* of having a consultation with a doctor, getting the prescription, following the instructions to the letter. Wonder if it would still work if you thought it was BS and a waste of time. I wonder if they controlled for the patients' attitude towards the treatment, i.e. did they feel the program would do them some good, on some level? After all, people know placebos are supposed to work.
Current treatment for IBS includes VERY expensive medication that has some really nasty side effects like gastric ulcers that could cause death (Health Canada report on brand X IBS treatment). So if a middle aged woman comes into the office complaining she farts to much and it's affecting her sex life maybe the Dr can just show her this study and give her a suggar pill instead of financing deadly anti-farting pills.