cheapesthostings2

Is more placebo better? A friend of mine pointed me to the above TED talk, by Ben Goldacre. It's a entertaining presentation with lots of interesting content, although Goldacre's discussion of the placebo effect—"one of the most fascinating things in the whole of medicine" (6:32)—is a little weak. At 6:47, he says: We know for example that two sugar pills a day are a more effective treatment for getting rid of gastric ulcers than one sugar pill a day. Two sugar pills a day beats one pill a day. And that's an outrageous and ridiculous finding, but it's true. Notice that the claim is not about pain , but about actually healing the ulcers. The source of this claim is apparently a 1999 study by de Craen and co-authors titled "Placebo effect in the treatment of duodenal ulcer" [ free full text/pdf ]. It's a systematic review based on 79 randomized trials comparing various drugs to placebo, taken either four times a day or twice a day depending o...

Suppose a clinical trial randomizes 100 patients to receive an experimental drug in the form of pills and an equal number of patients to receive identical pills except that they contain no active ingredient, that is, placebo. The results of the trial are as follows: 60 of the patients who received the experimental drug improved, compared to 30 of the patients who received the placebo. The drug clearly works better than the placebo. [1] But 30% of the patients who received the placebo did get better. There seems to be a placebo effect, right? Wrong. The results from this trial provide no information about whether or not there is a placebo effect. To determine whether there is a placebo effect you would need compare the outcomes of patients who received placebo with the outcomes of patients who received no treatment. And not surprisingly, trials with a no-treatment arm are quite rare. But there are some. In a landmark paper published in the New England Journal of Medicine in 2001 ( fre...