Reblog: Science-Based Medicine » Does thinking make it so? CAM placebo fantasy versus scientific reality

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I’m not in the habit of reblogging posts from other sites here, unless I think they’re really important. Usually I’ll just link to them from within one of my own rants. This is one of those exceptions.

Like the author, Dr David Gorski, I’ve noticed that woopologists, when their every argument for their favourite fringe therapy has been countered, often resort to the Maginot line of defence: “the placebo effect is real and we don’t fully understand it, so that makes it important to research and promote CAM”. This is doubly bollocks, as a moment’s thought would have told them. Not only does real medicine also have a placebo effect, hence the use of inert controls in clinical trials, but if a therapy has no more effect than placebo, then there is no reason to provide it in place of, and at a higher price than, placebos like sugar pills or coloured water. Unless, of course, you’re the homeopath selling those sugar pills or coloured water, but I was talking of ethical reasons; although the ethics of prescribing placebos (and by definition lying to the patient) is another stormy philosophical debate entirely.

Here’s the beginning of the article. Click on the link to read the rest on the original site. Your can also comment there. Comments are disabled here, since it would be rude to steal traffic from the guy who did all the work.

Does thinking make it so? CAM placebo fantasy versus scientific reality

Last week, I discussed a rather execrable study. Actually, the study itself wasn’t so execrable, at least not in its design, which was a fairly straightforward three-arm randomized clinical trial. Rather it was the interpretation of the study’s results that was execrable. In brief, the authors tested an “energy healing” modality known as “energy chelation” versus a placebo (sham “energy chelation”) and found, as is so often the case in studies of “complementary and alternative medicine” (CAM) or “integrative medicine” (IM) that both modalities did better than no treatment on the primary outcomes but that the “real” treatment (if one can call energy chelation “real treatment”) produced outcomes that were statistically indistinguishable from the “sham” treatment. Not surprisingly, the next move on the part of the researchers was to do a bunch of comparisons, and, as is so often the case (particularly when one fails to correct statistically for multiple comparisons), they found a couple of secondary endpoints with barely statistically significant differences and trumpeted them as meaning that their “energy chelation therapy” has “significant promise for reducing fatigue,” while dodging by saying that the study was also ” designed to examine nonspecific and placebo elements that may drive responses.”

Which brings us to the “power” of placebo…

Read the rest here: Science-Based Medicine » Does thinking make it so? CAM placebo fantasy versus scientific reality.


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