Homeopathy!

[L.A.]

No, the treatment hasn't worked as Outrider had already pointed out.

NS - do you visit your doctor as an academic exercise to investigate the scientific authenticity of the treatment on offer, or do you just want to get better?

[L.A.]

No, the whole object is to make the patient better.

In many cases (eg hay fever) - it amounts to the same thing.

[Nearly Sane]

NS - do you visit your doctor as an academic exercise to investigate the scientific authenticity of the treatment on offer, or do you just want to get better?

Eh? I want properly effective treatments from my doctor, not something that works as well as a sugar pill.

[L.A.]

Eh? I want properly effective treatments from my doctor, not something that works as well as a sugar pill.

OK, so how do you judge how effective the treatment is?

[Nearly Sane]

OK, so how do you judge how effective the treatment is?

Scientific trials. Not anecdote.

[Nearly Sane]

To expand that last answer we are scarily easily able to fall into post hoc ergo propter hoc on pretty much everything, which is why we believe shite like walking under ladders being bad luck. We are crap at the whole causation thing. Homeopathy is another example. As noted it isn't,  despite Sriram's misrepresentations, that people refuse to investigate it, it is that it has been investigated and doesn't work.

[SweetPea]

Sriram, I'm interested in this:

..... Montagnier's research (and other of many of his colleagues) has verified that electromagnetic signals of the original medicine remains in the water and has dramatic biological effects.....


because one of my lads was treated successfully by homeopathy, for eczema. The homeopath, explained that all that is required is the energy pattern of the substance being used. This is why only a small amount of water is required to carry and transfer the energy pattern.

[Aruntraveller]

Is there? Can you provide a reference please.

You could start here although it is a medical resource and as such is difficult to read. There is a plain speaking section in each report however(iirc) which gives an outline of the effectiveness.

Acupuncture works well for some problems and not at all for others.

http://onlinelibrary.wiley.com/cochranelibrary/search

[Outrider]

Outsider,

the whole object of the exercise is to make the patient feel better. If the treatment achieves this - then it has worked even if the exact mechanism is not understood.

If the treatment as a whole has made them feel better, and the homeopathy part is just a placebo, why not ditch the homeopathy and just provide the rest, with the commensurate reduction in cost and increase in honesty?

O.

[Outrider]

OK, so how do you judge how effective the treatment is?

For conditions like hayfever, you will eventually feel better anyway - you may acclimatise, or you might just outlast the pollen.

After your consultation you might feel better simply because someone has spent some time with you, taking your issue seriously (and their air-conditioned office reduced the pollen count ). You might feel better because the thought that someone was doing something has reduced your stress-levels.

I'm not for a moment denying that people undergoing homeopathic treatments feel better - however, when tested against a placebo, people undergoing homeopathic remedies don't feel any more better than people taking a placebo (in part because a homeopathic remedy is only distinguishable from a placebo by looking at the price tag).

O.

[Enki]

So these qualifications mean that he has never, ever, made a mistake?

The last man that perfect who was on this Earth wound up on a cross.

And I agree with you, Owlswing. I think you miss my point completely. Of course it's possible he could be mistaken. However it was Sriram who said:

I have also provided the opinion of some Nobel laureates in the OP. That's what this thread is about you know!

So please take this up with Sriram.

[Udayana]

If the treatment as a whole has made them feel better, and the homeopathy part is just a placebo, why not ditch the homeopathy and just provide the rest, with the commensurate reduction in cost and increase in honesty?

O.

Wasn't there a study that found that expensive placebos were more effective than cheaper ones?

[SqueakyVoice]

Wasn't there a study that found that expensive placebos were more effective than cheaper ones?

I caught a bit of Ben Goldacre on QI a few days ago saying that bigger sugar pills were a more effective placebo than smaller ones and giving  someone a salt water injection was a better placebo than pills.

It seems the more 'complex' the intervention is the better people respond to it. I suppose spending more on Lemsip (TM) might seem more effective than Wilko's paracetamol and lemon flavouring for a similar reason.

[SqueakyVoice]

And on acupuncture...

http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatrical-placebo-the-end-of-a-myth/

Large multicenter clinical trails conducted in Germany {Linde et al; Melchart et, 2005; Haake et al, Witt et al), and in the United States {Cherkin et al) consistently revealed that verum (or true) acupuncture and sham acupuncture treatments are no different in decreasing pain levels across multiple chronic pain disorders: migraine, tension headache, low back pain, and osteoarthritis of the knee.

If, indeed, sham acupuncture is no different from real acupuncture the apparent improvement that may be seen after acupuncture is merely a placebo effect.  Furthermore it shows meridians don’t exist, so the "theory" memorized by qualified acupuncturists is just myth. All that remains to be discussed is whether or not the placebo effect is big enough to be useful, and whether it is ethical to prescribe placebos.

[Udayana]

Pain is probably mostly in the mind - the feeling being far out of proportion to the "size" of the actual signals being transmitted by the nerves so anything allowing the brain to ignore the signals or for the signals to be blocked or redirected could work.

My chiropractor has worked wonders on my various injuries by pressing certain points to "relieve tension" and some pulling and pushing.  Maybe it is all in the mind and I should just stay in and take painkillers?

[SusanDoris]

I have, on three, possibly four,  occasions, bought a homeopathic 'remedy' on the advice of family and friends, but have never actually believed they would work.   I believe I have swallowed a pill or two. but The rest remained in a drawer, forgotten and then were eventually thrown away. I'm very much a sceptic about chiropractic too. 

There was an excellent Inside Health programme (BBC Radio 4) this week on the benefits of exercise; definitely recommended.

[Rhiannon]

Pain is probably mostly in the mind - the feeling being far out of proportion to the "size" of the actual signals being transmitted by the nerves so anything allowing the brain to ignore the signals or for the signals to be blocked or redirected could work.

My chiropractor has worked wonders on my various injuries by pressing certain points to "relieve tension" and some pulling and pushing.  Maybe it is all in the mind and I should just stay in and take painkillers?

I don't know, trigger points are well-known within physiotherapy, and also problems in the back radiate into the rest of the body. I have a back problem and when my physio works on it I get pain release elsewhere - must admit to being surprised when my sinuses unblocked as a result once but she wasn't.

[Outrider]

Wasn't there a study that found that expensive placebos were more effective than cheaper ones?

Given that entire field is 'odd', there are still a few stand-out oddities in there:

- branded packaged placebos work better than plain packaged placebos
- two placebos work better than one placebo
- placebos administered by a man in a white coat work better than ones administered by a man in a shirt
- injected placebos work better than tablet placebos
- red-coloured placebos work better for some conditions than blue-coloured ones, and vice versa

The human mind is still a vast, unknown expanse.

O.

[Sriram]

And even when patients were told that they are getting placebos...it still worked! In other words, when it  no longer served as a 'placebo'....it still worked.

The unconscious mind is said to play a role in how a  placebo works. So...unless we know more about the unconscious mind...we are unlikely to know more about how a placebo works.

[Outrider]

And even when patients were told that they are getting placebos...it still worked! In other words, when it  no longer served as a 'placebo'....it still worked.

How is it not a placebo just because you know it's not an active ingredient?

The unconscious mind is said to play a role in how a  placebo works. So...unless we know more about the unconscious mind...we are unlikely to know more about how a placebo works.

Indeed

O.

[Sriram]

How is it not a placebo just because you know it's not an active ingredient?

O.

Because by definition a placebo is a sham medicine meant to make the patient believe that he is getting a real medicine.

[Outrider]

Because by definition a placebo is a sham medicine meant to make the patient believe that he is getting a real medicine.

Not quite. A placebo is an inert or inactive substance given in place of an active ingredient to more closely match the process of medicating to get an accurate base-line measurement when testing medicines.

That placebos are more effective than nothing does not make them intended as a 'sham medicine' in the majority of cases. What the patient believes about their treatment is, indeed, part of the process and ritual of treatment.

Don't get me wrong, I see where you're coming from, but placebo is a description of the chemical content of the medication given to the patient, not a description of the purpose of giving it.

You can give a placebo deceptively or openly and it remains a placebo, because it's chemically not relevant to the condition.

O.

[Udayana]

I don't know, trigger points are well-known within physiotherapy, and also problems in the back radiate into the rest of the body. I have a back problem and when my physio works on it I get pain release elsewhere - must admit to being surprised when my sinuses unblocked as a result once but she wasn't.

I think doctors and therapists vary enormously in their knowledge of the body and their attention to detail.

Many homeopaths are also fully qualified doctors, so if they were great conventional doctors they could also be effective using homeopathy (despite the theory being rubbish) given that they are likely to spend more time and attention on the (paying) patient. If they were not great doctors then their homeopathic treatments won't work either.

Similarly with physios, osteopaths and chiropractors - it is probably not the theory and routine treatments that count - but the extent to which they understand how all the "bits" fit and work together and the issues affecting the patient.
 

[ippy]

And even when patients were told that they are getting placebos...it still worked! In other words, when it  no longer served as a 'placebo'....it still worked.

The unconscious mind is said to play a role in how a  placebo works. So...unless we know more about the unconscious mind...we are unlikely to know more about how a placebo works.

I've just come around after falling off of my chair Sriram, you've come out with something realistic that makes sense, good for you, I'm going to have a lay down now it's the shock, I'll feel better later, don't worry about me too much Sriram, I'll be OK.

ippy

 

[Sriram]

Not quite. A placebo is an inert or inactive substance given in place of an active ingredient to more closely match the process of medicating to get an accurate base-line measurement when testing medicines.

That placebos are more effective than nothing does not make them intended as a 'sham medicine' in the majority of cases. What the patient believes about their treatment is, indeed, part of the process and ritual of treatment.

Don't get me wrong, I see where you're coming from, but placebo is a description of the chemical content of the medication given to the patient, not a description of the purpose of giving it.

You can give a placebo deceptively or openly and it remains a placebo, because it's chemically not relevant to the condition.

O.

From the online dictionary.....a placeo is

"a substance having no pharmacological effect but given merely to satisfy a patient who supposes it to be a medicine."

While its true that a placebo is a chemically inert substance....the purpose is to mentally deceive the patient and to bring about a psychological and perhaps psychosomatic cure/relief.

So...if a person knows that a placebo is being given...it should not (theoretically) have any beneficial effect. But the fact that there is a beneficial effect....means there is something going on that we don't understand.