Genetic tests can predict when placebos may be the best medicine
nautil.us
nautil.us
Meanwhile, the medical researchers who look at the issue with proper study designs and statistical controls know that placebos are essentially useless, as they at most have influence just on self-reported subjective symptoms, not on any sign that affects the progression of a disease or maintenance of good health.[4] Ladies and gentlemen, you know you aren't going to seek "placebo medicine" if you have cancer or congestive heart failure, and you know that no compassionate parent would seek "placebo medicine" for minor children who have a childhood disease. So why does this topic keep coming up over and over and over here on Hacker News? I wonder if it's because programmers (the plurality participants here) make their livings by the power of their minds, and Hacker News participants skew younger than the general population. Please take the time and effort to learn a bit more about the actual research base before assuming that this story is anything other than the outcome of carefully crafted press campaign. As you grow older, and your body is no longer young, you may develop warranted doubt about the power of placebo treatments and begin seeking more actually effective treatments. My hope for all of us is that ongoing medical research will keep finding more safe and effective treatments that actually do more than what placebos do (which is nothing, really) so that we can all be part of a continuing trend toward longer and healthier lifespans.[7]
Findings on placebo effects by researchers who have considered the issue carefully include
"Despite the spin of the authors – these results put placebo medicine into crystal clear perspective, and I think they are generalizable and consistent with other placebo studies. For objective physiological outcomes, there is no significant placebo effect. Placebos are no better than no treatment at all."[5]
"We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed."[6]
[1] http://harvardmagazine.com/2013/01/the-placebo-phenomenon
[2] http://www.sciencebasedmedicine.org/dummy-medicine-dummy-doc...
http://www.sciencebasedmedicine.org/dummy-medicine-dummy-doc...
http://www.sciencebasedmedicine.org/dummy-medicine-dummy-doc...
[3] http://www.phdcomics.com/comics/archive.php?comicid=1174
[4] http://www.sciencebasedmedicine.org/michael-specter-on-the-p...
http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-plac...
[5] http://theness.com/neurologicablog/index.php/the-rise-and-fa...
[6] http://www.ncbi.nlm.nih.gov/pubmed/20091554
[7] http://www.nature.com/scientificamerican/journal/v307/n3/box...
"For patients, however, the notion of genetic testing for placebo responsiveness might be less equivocal. Many people, notes Brown, “don’t believe drugs are good for you. They believe in the power of self-healing.” And for at least some of them, the reality of self-healing might literally be a self-fulfilling prophecy."
Doesn't it seem more likely that when placebo's work it's in situations where someone already had a sort of self-fulfilling prophecy which was making them (psychologically) ill? Their proposition seems to be that patients may be sick in the way it's ordinarily understood, but some are able to 'self-heal' themselves by believing they are receiving a legitimate cure. Sounds backwards.
My understanding is this sort of scenario is common and well documented: a person believes there is something wrong with them, and subjectively it's the same as that thing actually being wrong with them; then they are given some treatment which they believe fixes what's wrong with them, and they feel better.
However, there are many diseases that aren't that severe and diseases with no current therapies, so a decent number of trials are still run with just placebos as controls.