User:Fyslee/Sandbox Placebo
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[edit] I'm somewhat concerned...
- Moved here for the record from: Talk:Placebo_effect
I'm somewhat concerned this article doesn't conform to NPOV. The section titled "does the placebo effect exist" comes down pretty hard against the existence of the effect, seemingly on the basis of th authors. Does anyone else-- and especially User:Cacycle, who originally wrote that section-- have comments about this? I'm inclined to temper the conclusions of the discussion, but also shade it back somewhat toward the earlier scientific consensus. Tobacman 19:34, 6 Dec 2004 (UTC)
- Actually I haven't read those two articles and the published replies to them, but I will do that soon. Both publications are metastudies that merely review previously published studies. To me it looks like there was no real scientific consensus before based on facts and data. It was more an unsupported and unquestioned belief into this effect. Those metastudies seem to be the first attempts to verify the effect.
- If there are serious reasons to question the importance of the placebo effect then this must be adequately reflected in the article. Somehow 'softening' the well substantiated arguments of this party would clearly be against the NPOV. Moreove, in its current revision this sceptical standpoint is clearly separated from several other sections that assume the existence of the placebo effect. There is also no biased final conclusion.
- Cacycle 21:59, 6 Dec 2004 (UTC)
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- Good!-- It sounds like we agree on the criteria for what should be included and why. Now we both need to do our homework...
- But in the past there certainly has been a scientific consensus about the existence of the placebo effect, cf the fda, the nih, the skepdic, a book by a Harvard prof, and the fact that placebo controls are generally still required in clinical drug trials. Interestingly, Anne Harrington indicates in her book that there was a long period of denial about the placebo effect before people began to control for it.
- Three last comments:
- Some recent research (and cites therein) identifies neurological mechanisms that could underlie the placebo effect.
- One way that perhaps ALL of these researchers (ie, Hrobjartsson and Gotzsche, and the others cited in the article) could be right, is if the size of the placebo effect has fallen over time. That would also be consistent with the sensible conjecture that patients now expect more treatment and medication than they used to. (I'll look for a citation for this hypothesis, since this speculation is obviously inappropriate for the article.)
- Last, it seems plausible that there are some circumstances in which large placebo effects can reliably be generated and other circumstances where they can't; and there are some methodologies that are useful for measuring placebo effects and others that are deeply confounded. In the end, presumably a really good article will discuss size of placebo effect as a function of these characteristics, rather than (as we've both been doing) just asking whether or not the effect exists. Tobacman 09:37, 7 Dec 2004 (UTC)
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- One possible improvement would be to move up the sections on 'Placebo and Pain' and 'Placebo and Depression' so that they come before 'Does the placebo effect exist?'. This would emphasise the relative importance of the two points of view within the relevant scientific community. The section questioning the orthodoxy would thus remain, but would not have undue importance. --John G Walker 14:26, 8 December 2005 (UTC)
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- Sounds like a good idea. --JWSchmidt 15:23, 8 December 2005 (UTC)
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- I've changed the order. Does this look more NPOV now? --John G Walker 09:45, 2 January 2006 (UTC)
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[edit] More content
Please take a look at this new content. [1]
Living in Denmark, I have followed this research from when it was in progress. Very interesting! It explains a lot of things that the old views didn't do very well. To maintain a NPOV, I have attempted to limit my comments to explanations of that research. -- Fyslee 22:23, 2 January 2006 (UTC)
[edit] I am not a doctor
I am not a doctor, but I think it should be clear that for some illnesses the placebo effect can not possible be effective. The organism can only do so much to heal itself. There must be some problems that can't be fixed, no matter what signals the brain sends out. Paranoid 10:30, 19 Mar 2005 (UTC)
I agree that this article is a bit POV. My impression (true or not) is that after most of the article was written, someone who believe the placebo effect does not exist came by and added the "does the placebo effect exist" section. There is absolutely nothing wrong with having the info in the article, but that section should also refer to studies that support the existance of the placebo effect (for example: [2] [3]). As it is now, the article feels like a debate rather than an encyclopeic article. --Apoc2400 19:23, 25 August 2005 (UTC)
[edit] NPOV
As you can see, I made a bunch of edits (one I accidentally marked as minor, sorry). This is an initial shot at NPOVing the article without getting into a massive edit war. The most basic problems are that: a) the placebo effect is NOT controversial, it's widely accepted in the scientific community and b) the "placebo effect is fake" view is represented even more than the prevailing scientific view (that 99% of scientists support). That's a clear violation of NPOV.
[edit] NPOV can preserve old errors
- If the conclusions of this large study of the literature [4] is correct (and there is nothing to indicate otherwise), then it should be better represented. Otherwise a strict adherence to the NPOV will be a biased support for old misunderstandings, IOW it won't be neutral at all, but simply conservative resistance to change, and impediment to progress.
- If correct, it should, with time, become the predominant viewpoint, with the old viewpoint remaining in its invaluable role as a tool for quackery. Quacks will not relinquish the old viewpoint, for obvious reasons. -- Fyslee 22:44, 2 January 2006 (UTC)
[edit] continued...
At some point later I may expand the section supporting the placebo effect, because I know there have been NUMEROUS studies on it on many scales in many countries. The attribution of it mostly to a single 1955 study is just a *wee bit* misleading.
- side tangent--you may ignore*
I've looked at the abstract for the article in question, and I suppose it should be kept in to support the minority view, but I must say, it is very pseudo-scientific and its conclusions don't support its data at all.
Many large scale studies have shown improvements from the placebo groups. These are for disorders people have had for years, so it can't be explained away simply by saying that that they simply naturally healed or any such nonsense. The hawthorne effect also can't seem to explain away the nocebo effect, nor why such a large number of people in a large study would be eager to please researchers to the point that they'd lie.
Not just that, but biofeedback techniques have been shown to reduce severity many kinds of symptoms, including pain. Since biofeedback is entirely mind-controlled, it makes no sense to discount the phenomenon.
It seems to me it's just a few quacks who are trying to become famous that are trying studies like this.
- end tangent*
Nathan J. Yoder 04:17, 22 October 2005 (UTC)
[edit] My contribution removed
User User:Farseer has removed my contribution: [5]
Which follows:
The "Placebo Illusion"?
This research reduces the placebo effect to a subjective illusion and a statistical research tool. As such it is imperative to use it in research, but unethical to use it in normal clinical treatment.
The results of this research contradict what some would now consider to be a great deal of folklore that has evolved around the whole idea of the placebo effect. That folklore has evolved in a "research vacuum" of ignorance about the true nature of the placebo effect.
What is new about these conclusions is an emphasis on the key words "subjective" and "pain". This explains the well-established fact that the placebo effect is most "effective" in conditions where subjective factors are very prominent or significant parts of the problem. Some of these conditions are: headache, stomach ache, asthma, allergy, tension, and especially the most subjective of them all - pain, which is a significant part of most serious (and many mild) illnesses.
Practical implications and consequences
According to these findings, a placebo can make you think you are better, and even temporarily feel that you are better, but it can't actually make you any better. It will not cause any significant physiological change in a serious disease. In short, it will fool you (which is the whole idea in double blind experiments).
Much quackery achieves temporary "success" by a conscious or unconscious misuse of the placebo illusion. To the patient, such misuse of placebos can be expensive and ultimately fatal. To the quack, it will fool the patient long enough to keep the scam rolling.
[edit] Reinstated!
by User:Rasmus Faber at [6] -- Fyslee 23:40, 7 January 2006 (UTC)
My comments on his Talk page:
"Restored placebo comments"
Hej Rasmus
Tusind tak for hjælpen med Placebo artiklen. Jeg havde virkelig forsøgt at "neutralisere" mine kommentarer. HVIS deres konlusioner er korrekt, er Hróbjartsson & Götzsche's metaanalyse banebrydende, og kaster lys over et emne der har været fyldt med myter, der blev antaget som bevist sandhed, men det var de ikke.
Jeg tror at noget af broden kan fjernes ved at vælge andre ord end "Does the placebo effect exist?". Det eksisterer, men deres analyse viser at effekten er primært en subjektive oplevelse, og ikke forårsager objektive fysiologiske forandringer af en karakter der kan udrette meget for alvorlige sygdom.
Another subtitle could be "Objective or subjective effects?"
I will take another look at it and see if anything that isn't NPOV has gone unnoticed, but as it was, it was "neutralized", just stating what their metaanalysis had shown. Basically it would only be quacks who would object to this new way of looking at things. The placebo effect would still be an important research tool, but quacks would be exposed for misusing it. -- Fyslee 00:05, 8 January 2006 (UTC) (Amerikaner i Sorø)
