7 yr old and forced Radiotherapy

[Pesty]

Are not final medical trials placebo tests anyway?

After initial trials they give one lot of actual sufferers with the condition the drug and another lot pretend they have.

That way they test the effectiveness of the drug against the placebo effect. If it gets better results than the control group the drug works and is better than placebo.

Edited by Pesty on Friday 28th December 14:42

[TheSnitch]

Pesty said:

Are not final medical trials placebo tests anyway?

After initial trials they give one lot of actual sufferers with the condition the drug and another lot pretend they have.

That way they text the effectiveness of the drug against the placebo effect. If it gets better results than the control group the drug works and is better than placebo.

Yes, in effect.

Trials are usually referred to as Phase 1,2,3 or 4. Phase 4 studies are often conducted once the drug is licenced and on the market, when data can be collected about adverse reactions on a greater number of patients. Phase 3 trials will often compare the drug against placebo in patients with the condition it is intended to treat.

[Derek Smith]

TheSnitch said:

Sorry, Derek, but you clearly don't.

Are you suggesting that you know what the effects of the placebo effect are?

[ofcorsa]

I think Derek is talking about finding out what the mechanics of the "Placebo effect" is rather than advocating placebo as a treatment in itself.

[thinfourth2]

ofcorsa said:

I think Derek is talking about finding out what the mechanics of the "Placebo effect" is rather than advocating placebo as a treatment in itself.

Thats how i read it

Where as others see it as nothing more then a pain where bags of chemicals start to think

[otolith]

srebbe64 said:

But how do they test the effectiveness of placebo tablets?

Placebo vs no treatment at all.

[TheSnitch]

Derek Smith said:

TheSnitch said:

Sorry, Derek, but you clearly don't.

Are you suggesting that you know what the effects of the placebo effect are?

I am suggesting that you are unclear about what a placebo is and what we mean when we talk about the placebo effect.

I also think you have drawn conclusions from clinical papers which you have read without fully understanding them.

So - in brief summary - a placebo contains no active ingredient and is used in studies which measure the efficacy of a treatment. It allows us to compare the response of the patients taking the drug against those of the patients taking the placebo because in some conditions some patients may show some improvement in observed or reported criteria despite the fact that they are not receiving an active drug. This may be due to a number of factors, including a possible reduction in stress which exacerbates many conditions. It may also be due to the patient expecting to feel better, therefore may be a matter of perception.

So is it ethical to treat the patient with placebo alone? Well, not if you want them to trust you. Within the ethical framework of an approved study is one thing, but physicians handing out placebos to patients in lieu of an active treatment - what does that say? ''I don't believe you are ill/I am not taking your illness seriously/you are swinging the lead''?

So the placebo effect in different conditions might be an interesting aspect to study but more from a point of view of studying the role of the brain in symptom and severity perception in my personal opinion.

[youngsyr]

otolith said:

If someone is claiming evidence for the efficacy of homeopathy beyond placebo, I want references.

NewScientist said:

4 Belfast homeopathy results

MADELEINE Ennis, a pharmacologist at Queen's University, Belfast, was the scourge of homeopathy. She railed against its claims that a chemical remedy could be diluted to the point where a sample was unlikely to contain a single molecule of anything but water, and yet still have a healing effect. Until, that is, she set out to prove once and for all that homeopathy was bunkum.

In her most recent paper, Ennis describes how her team looked at the effects of ultra-dilute solutions of histamine on human white blood cells involved in inflammation. These "basophils" release histamine when the cells are under attack. Once released, the histamine stops them releasing any more. The study, replicated in four different labs, found that homeopathic solutions - so dilute that they probably didn't contain a single histamine molecule - worked just like histamine. Ennis might not be happy with the homeopaths' claims, but she admits that an effect cannot be ruled out.

So how could it happen? Homeopaths prepare their remedies by dissolving things like charcoal, deadly nightshade or spider venom in ethanol, and then diluting this "mother tincture" in water again and again. No matter what the level of dilution, homeopaths claim, the original remedy leaves some kind of imprint on the water molecules. Thus, however dilute the solution becomes, it is still imbued with the properties of the remedy.

You can understand why Ennis remains sceptical. And it remains true that no homeopathic remedy has ever been shown to work in a large randomised placebo-controlled clinical trial. But the Belfast study (Inflammation Research, vol 53, p 181) suggests that something is going on. "We are," Ennis says in her paper, "unable to explain our findings and are reporting them to encourage others to investigate this phenomenon." If the results turn out to be real, she says, the implications are profound: we may have to rewrite physics and chemistry.

Source: http://www.newscientist.com/article/mg18524911.600...

Anyone know of any update on this research?

[CommanderJameson]

youngsyr said:

otolith said:

If someone is claiming evidence for the efficacy of homeopathy beyond placebo, I want references.

NewScientist said:

4 Belfast homeopathy results

MADELEINE Ennis, a pharmacologist at Queen's University, Belfast, was the scourge of homeopathy. She railed against its claims that a chemical remedy could be diluted to the point where a sample was unlikely to contain a single molecule of anything but water, and yet still have a healing effect. Until, that is, she set out to prove once and for all that homeopathy was bunkum.

In her most recent paper, Ennis describes how her team looked at the effects of ultra-dilute solutions of histamine on human white blood cells involved in inflammation. These "basophils" release histamine when the cells are under attack. Once released, the histamine stops them releasing any more. The study, replicated in four different labs, found that homeopathic solutions - so dilute that they probably didn't contain a single histamine molecule - worked just like histamine. Ennis might not be happy with the homeopaths' claims, but she admits that an effect cannot be ruled out.

So how could it happen? Homeopaths prepare their remedies by dissolving things like charcoal, deadly nightshade or spider venom in ethanol, and then diluting this "mother tincture" in water again and again. No matter what the level of dilution, homeopaths claim, the original remedy leaves some kind of imprint on the water molecules. Thus, however dilute the solution becomes, it is still imbued with the properties of the remedy.

You can understand why Ennis remains sceptical. And it remains true that no homeopathic remedy has ever been shown to work in a large randomised placebo-controlled clinical trial. But the Belfast study (Inflammation Research, vol 53, p 181) suggests that something is going on. "We are," Ennis says in her paper, "unable to explain our findings and are reporting them to encourage others to investigate this phenomenon." If the results turn out to be real, she says, the implications are profound: we may have to rewrite physics and chemistry.

Source: http://www.newscientist.com/article/mg18524911.600...

Anyone know of any update on this research?

I'd bet a pound to a pinch of st that there's something very wrong with that piece of research.

[thinfourth2]

TheSnitch said:

I am suggesting that you are unclear about what a placebo is and what we mean when we talk about the placebo effect.

I also think you have drawn conclusions from clinical papers which you have read without fully understanding them.

So - in brief summary - a placebo contains no active ingredient and is used in studies which measure the efficacy of a treatment. It allows us to compare the response of the patients taking the drug against those of the patients taking the placebo because in some conditions some patients may show some improvement in observed or reported criteria despite the fact that they are not receiving an active drug. This may be due to a number of factors, including a possible reduction in stress which exacerbates many conditions. It may also be due to the patient expecting to feel better, therefore may be a matter of perception.

So is it ethical to treat the patient with placebo alone? Well, not if you want them to trust you. Within the ethical framework of an approved study is one thing, but physicians handing out placebos to patients in lieu of an active treatment - what does that say? ''I don't believe you are ill/I am not taking your illness seriously/you are swinging the lead''?

So the placebo effect in different conditions might be an interesting aspect to study but more from a point of view of studying the role of the brain in symptom and severity perception in my personal opinion.

So do you believe it is impossible for someone to think themselves "better"


I firmly believe it is possible in some case for the brain to have an influence on the body

[Marf]

thinfourth2 said:

I firmly believe it is possible in some case for the brain to have an influence on the body

Thinfourth is entirely correct here. My brain told my hands to type that, and my hands are part of my body!

[youngsyr]

CommanderJameson said:

youngsyr said:

otolith said:

If someone is claiming evidence for the efficacy of homeopathy beyond placebo, I want references.

NewScientist said:

Belfast homeopathy study...

Source: http://www.newscientist.com/article/mg18524911.600...

Anyone know of any update on this research?

I'd bet a pound to a pinch of st that there's something very wrong with that piece of research.

... and I wouldn't bet against you, but a true scientist/rationalist cannot ignore the fact that a piece of scientific research, published in a respected, peer-reviewed journal found evidence indicating homeopathy might work in one specific instance.

[Derek Smith]

TheSnitch said:

I am suggesting that you are unclear about what a placebo is and what we mean when we talk about the placebo effect.

I also think you have drawn conclusions from clinical papers which you have read without fully understanding them.

So - in brief summary - a placebo contains no active ingredient and is used in studies which measure the efficacy of a treatment. It allows us to compare the response of the patients taking the drug against those of the patients taking the placebo because in some conditions some patients may show some improvement in observed or reported criteria despite the fact that they are not receiving an active drug. This may be due to a number of factors, including a possible reduction in stress which exacerbates many conditions. It may also be due to the patient expecting to feel better, therefore may be a matter of perception.

So is it ethical to treat the patient with placebo alone? Well, not if you want them to trust you. Within the ethical framework of an approved study is one thing, but physicians handing out placebos to patients in lieu of an active treatment - what does that say? ''I don't believe you are ill/I am not taking your illness seriously/you are swinging the lead''?

So the placebo effect in different conditions might be an interesting aspect to study but more from a point of view of studying the role of the brain in symptom and severity perception in my personal opinion.

The definition of placebo is clear to me. I am not talking about the placebo effect. It is the effects of placebos, something quite different, which I am confused by. I've read a number of papers and there is no consensus, not that that means it would be right of course.

Doctors and scientists glibly talked of endorphins but now we find that in tests placebos did not effect the release of endorphins. One wonders how they used a double blind in that one.

So how do placebos work? If indeed they do work. Remember that there is no proof that they do. That is my problem. If they do work then how, why and how can we harness the effect. Just giving out sugar pills is not harnessing, just random use in hope.

There seems to be some doubt as to whether there is indeed a placebo effect.

I'm used to reading into a subject and then finding out the conclusions of scientists. But with placebos it seems that few have taken the matter seriously. It is rather like licking tree bark without wondering why inflammation is reduced.

If what is generally believed about the effects of placebos is right then it promises to revolutionise the pharma industry. The word first appeared in connection with medicine in 1785 but we know little about it. How come we are so ignorant about it today?

The ethics of prescribing placebos is irrelevant. Much more to my point is that doctors do, apparently, prescribe them in the expectation that they will do some good. If 60% of doctors prescribed red seaweed then one might wonder whether they had something there. What is it about placebos that seem to make people reluctant to investigate?

[CommanderJameson]

youngsyr said:

CommanderJameson said:

youngsyr said:

otolith said:

If someone is claiming evidence for the efficacy of homeopathy beyond placebo, I want references.

NewScientist said:

Belfast homeopathy study...

Source: http://www.newscientist.com/article/mg18524911.600...

Anyone know of any update on this research?

I'd bet a pound to a pinch of st that there's something very wrong with that piece of research.

... and I wouldn't bet against you, but a true scientist/rationalist cannot ignore the fact that a piece of scientific research, published in a respected, peer-reviewed journal found evidence indicating homeopathy might work in one specific instance.

No, it didn't. It found evidence of a phenomenon that they couldn't explain. The conclusions are full of qualifiers "it may be" and the results weren't even consistent across the labs involved.

There's plenty of clear blue water between that piece of research, flawed or not, and "homeopathy works".

Further, that research was published in 2004; if there were anything to it, surely someone would have gone "why yes, I do think I'll have me a Nobel Prize by showing how homeopathy works" by now?

Quite honestly, as a rationalist, my first response to that research is "This changes everything - but first, do it again."

[CommanderJameson]

Derek Smith said:

There seems to be some doubt as to whether there is indeed a placebo effect.

No, there doesn't.

Go and read Bad Science (again, if you've read it once).

[youngsyr]

CommanderJameson said:

youngsyr said:

CommanderJameson said:

youngsyr said:

otolith said:

If someone is claiming evidence for the efficacy of homeopathy beyond placebo, I want references.

NewScientist said:

Belfast homeopathy study...

Source: http://www.newscientist.com/article/mg18524911.600...

Anyone know of any update on this research?

I'd bet a pound to a pinch of st that there's something very wrong with that piece of research.

... and I wouldn't bet against you, but a true scientist/rationalist cannot ignore the fact that a piece of scientific research, published in a respected, peer-reviewed journal found evidence indicating homeopathy might work in one specific instance.

No, it didn't. It found evidence of a phenomenon that they couldn't explain. The conclusions are full of qualifiers "it may be" and the results weren't even consistent across the labs involved.

There's plenty of clear blue water between that piece of research, flawed or not, and "homeopathy works".

Further, that research was published in 2004; if there were anything to it, surely someone would have gone "why yes, I do think I'll have me a Nobel Prize by showing how homeopathy works" by now?

Quite honestly, as a rationalist, my first response to that research is "This changes everything - but first, do it again."

My understanding is that the results varied across the labs, but they all had results indicating that something akin to a homeopathic effect was ocurring.

The natural counter-argument to the age of the reseach is that in 8 years no-one has emphatically shown that there was a flaw in the research or that it was non-repeatable (as far as I know).

[DonkeyApple]

CommanderJameson said:

I'd bet a pound to a pinch of st that there's something very wrong with that piece of research.

No one has ever replicated the results and she works for the Jpurnal of Homeopathy.

http://www.bbc.co.uk/science/horizon/2002/homeopat...

Most scientists are no different from docker wes. Anything if the money is right.

[Bill]

But ten years on there's been no further improvement on "it might have some effect, possibly" http://www.ncbi.nlm.nih.gov/pubmed/20129176

[Derek Smith]

TheSnitch said:

I am suggesting that you are unclear about what a placebo is and what we mean when we talk about the placebo effect.

I also think you have drawn conclusions from clinical papers which you have read without fully understanding them.

So - in brief summary - a placebo contains no active ingredient and is used in studies which measure the efficacy of a treatment. It allows us to compare the response of the patients taking the drug against those of the patients taking the placebo because in some conditions some patients may show some improvement in observed or reported criteria despite the fact that they are not receiving an active drug. This may be due to a number of factors, including a possible reduction in stress which exacerbates many conditions. It may also be due to the patient expecting to feel better, therefore may be a matter of perception.

So is it ethical to treat the patient with placebo alone? Well, not if you want them to trust you. Within the ethical framework of an approved study is one thing, but physicians handing out placebos to patients in lieu of an active treatment - what does that say? ''I don't believe you are ill/I am not taking your illness seriously/you are swinging the lead''?

So the placebo effect in different conditions might be an interesting aspect to study but more from a point of view of studying the role of the brain in symptom and severity perception in my personal opinion.

The definition of placebo is clear to me. I am not talking about the placebo effect. It is the effects of placebos, something quite different, which I am confused by. I've read a number of papers and there is no consensus, not that that means it would be right of course.

Doctors and scientists glibly talked of endorphins but now we find that in tests placebos, at least the inactive pill used in the tests, did not effect a release of endorphins. One wonders how they used a double blind in that one.

So how do placebos work? If indeed they do work. Remember that there is no proof that they do. That is my problem. If they do work then how, why and how can we harness the effect. Just giving out sugar pills is not harnessing, it is just random use in hope.

There seems to be some doubt as to whether there is indeed a placebo effect.

I'm used to reading into a subject and then finding out the conclusions of scientists. But with placebos it seems that few have taken the matter seriously. It is rather like licking tree bark without wondering why inflammation is reduced.

If what is generally believed about the effects of placebos is right then it promises to revolutionise the pharma industry. The word first appeared in connection with medicine in 1785 but we know little more about it. How come we are so ignorant about it today?

An earlier bit of research, by Linde and Jones, reckoned that it was wrong to suggest that the effects of homeopathy are down to the placebo effect. This did not, as suggested by the homeopaths, prove that they were right. More likely is that the results from the placebo were not quite as straightforward as suspected.

If we understood what placebos did, if they do anything at all, we might be able to report the death of the myth of homeopathy. More importantly, it might give birth to something really exciting.

My belief has been that placebos have no direct effect. It is all in the administration. This, it would appear, is false. I am now without any idea; no guesses, no insight, not even an expectation that they have any effect at all. I find this uncomfortable.

All my interest stemmed from what I thought was an impossibility: a chap ODeed on a placebo. Up until then I knew everything about them.

[Derek Smith]

CommanderJameson said:

Derek Smith said:

There seems to be some doubt as to whether there is indeed a placebo effect.

No, there doesn't.

Go and read Bad Science (again, if you've read it once).

Hrobjartsson and Gotzsche are of a different opion to you. I'm not suggesting that placebos have no effect. I'm saying that research has cast doubt on whether it exists or not.