tag:blogger.com,1999:blog-3418825914680132383.post5517294863103292672..comments2024-02-20T10:05:48.189-06:00Comments on Startled Disbelief: Gifford-Jones and PlacebosAnonymoushttp://www.blogger.com/profile/01226088146391183228noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-3418825914680132383.post-26335648336564806062011-05-20T11:21:18.956-05:002011-05-20T11:21:18.956-05:00"Although I find the discussions of pertainin..."Although I find the discussions of pertaining to health entertaining, we must remember that the proper forum for this is in peer reviewed literature where robust arguments can be made and refuted with the vigour that is required."<br /><br />Absolutely. At the same time, I think that it's important to address common misconceptions about scientific issues. I'm certainly no expert in these matters, and I always appreciate input from those who work in the field. Many thanks for your comments.Anonymoushttps://www.blogger.com/profile/01226088146391183228noreply@blogger.comtag:blogger.com,1999:blog-3418825914680132383.post-32046040550744156632011-05-20T11:09:52.593-05:002011-05-20T11:09:52.593-05:00Good post. Often placebo is used in a pejorative m...Good post. Often placebo is used in a pejorative manner, however in the words of Inigo Montoya "you keep using that word. I don't think it means what you think it means"...<br /><br />It is a bit more complex that we'd previously though. For example see:<br /><br />Matre, D., Casey, K.L., & Knardahl, S. (2006). Placebo-induced changes in spinal cord pain processing. The Journal of Neuroscience, 26(2), 559-563.<br /><br />OR<br /><br />Eippert, F., Finsterbusch, J., & Buchel, C. (2009). Direct evidence for spinal cord involvement in placebo analgesia. Science, 326, 404.<br /><br />(I used these references to illustrate that this is a serious field of study and not the ramblings of some grey literature hack)<br /><br />Having been involved in many RCT's (lead or co-investigator) I can say with some confidence that the use of placebo (or sham when we are considering physcial interventions) is applied quite different in a clinical setting.<br /><br />The danger of placebo is in the failure to detect or treat an ominous cause for the offending symptoms. Clinically, these causes are the first to be assessed and ruled out by a trained professional. The clinical application of placebo is different from self-treatment with placebo (I don't think one can treat oneself with a known placebo - just my opinion), and both of these are different from the application in a clinical trial. <br /><br />As an aside, most clinical trials now avoid using placebo (ethical issues rather than therapeutic issues) and instead compare therapies to those already evaluated (i.e. usual care).<br /><br />You mentioned the 'expectancy effect' with regard to placebo - however ALL clinical interventions are subject to this effect. For example see:<br /><br />Bingle , U., et al. (2011). The effect of treatment expectancy on drug efficacy: imaging the analgesic benefit of the opioid remifentanil. Science Translational Medicine, 3(70), 1-9.<br /><br />Although I find the discussions of pertaining to health entertaining, we must remember that the proper forum for this is in peer reviewed literature where robust arguments can be made and refuted with the vigour that is required.<br /><br />Thanks. And keep up the good work.Anonymousnoreply@blogger.com