Wednesday, 16 March 2011

Placebos in medicine

Good short response on Comment is Free by Oxford Psychiatry Professor Tom Burns on the use of placebos in medicine and how the media exaggerates the beneficial effects*:
When researchers write, for example, that 20% of the placebo group recovered in a trial and 60% of the active treatment group did, they are not saying that placebos "have the same effect" in a third as many of the patients. They mean that (for the patients with this condition) 20% will recover in the natural course of events, but with the added treatment 60% will recover. It is this added 40% that matters. The placebo has had no effect on recovery.
This lead me to a good article he wrote in response to Richard Bentall's tedious criticisms of psychiatry:
Richard Bentall is right: psychological and social psychiatry research has been a Cinderella to biological and genetic explanations...He is also spot on about the exaggeration and hype of many of their "breakthroughs".
However, much of his article is so one-sided that those messages risk being lost.

* The seminal Cochrane review on this topic by Hróbjartsson & Gøtzsche found:
We found an effect on pain...nausea...asthma...and phobia...
There was no statistically significant effect of placebo interventions in the seven other clinical conditions investigated in three trials or more: smoking, dementia, depression, obesity, hypertension, insomnia and anxiety, but confidence intervals were wide.

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