"Rod" <[email hidden]> wrote in message
"]news:[email hidden]...
Quoted message said:
"Peter Moran" <[email hidden]> wrote in message
"]news:[email hidden]...
Quoted message said:Quoted message said:Worth reposting (slightly modified).
"Rod" <[email hidden]> wrote in message news:lC_Pb.24174$Wa.17803@news-
server.bigpond.net.au...
Quoted message said:Peter,
Much of the procedures you call AM, really deals with what Medical
Science
Quoted message said:Quoted message said:calls the "Placebo Effect".
Medical science recognises a placebo effect, but much of what happens
when
Quoted message said:patients get better on a certain treatment, whether conventional or alternative, is no "effect"
at all, it is spontaneous. Most common medical conditions do get better by themselves or have
varying levels of symptomatology. For example, most patients with acute back pain will be better
in three weeks regardless
of
Quoted message said:Quoted message said:any treatment, but people can still make a living from appearing to be "treating" it.
The question is not about who makes a living in treating an ailment but if you insist then please
explain the use of antibiotics in flu cases
(virus),
Quoted message said:I accept if complications occur but please explain why antibiotics are prescribed in cases that
this is not apparent.
There is indeed an element of "pleasing the patient" in that, as most patients go to the doctor with
the flu in the expectation of being prescribed antibiotics, and doctors find it easier to go with
the flow rather than spending time explaining the issues to the patient. I won't defend doctors who
are unselective in that regard. Is it conscious usage of placebo in its usual sense? Arguable. We
would call it inappropriate prescribing and a lot of effort is going into reducing antibiotic
prescribing in such contexts.
Quoted message said:Quoted message said:
Quoted message said:The "Placebo" ( I will please) is so strong that it is the basis of Double Blinded, Placebo
controlled Trials and Study
for
Quoted message said:Quoted message said:Medicine.
You misunderstand. A placebo or sham treatment is used in controlled trials to "control" for all
possible extraneous influences and
confounders
Quoted message said:Quoted message said:(and there are at least a dozen known ones), not because it is "strong". Studies where a
placebo group has been compared with a "no treatment" group suggest that placebo "effects" are
smaller than
generally
Quoted message said:Quoted message said:thought, at least in the context of conrolled trials. They have no
effect
Quoted message said:on objective measures of illness but have some effect on pain
perception
Quoted message said:Quoted message said:and the patients' s assessment of the severity of other symptoms.
Ah! so the placebo is common to a "sham treatment." I think you have misunderstood the placebo
effect and categorise it as a "Sham" treatment. The Medical studies do compare the actual
treatment to this "sham" treatment, do they not ? It does seem that it is sort of comparing "Good"
to "Evil" and that is the way it is convryrd by conventional medicine and its indoctrinates.
I don't understand your point. A placebo, as used in controlled trials is by definition a sham
treatment or "dummy" treatment.. . It is neither good nor evil. What alternative practitioners
do is not strictly speaking a placebo at all, if they think their treatments have intrinsic
medical activity.
We can however be fairly certain that most of the "effects" they observe are due to the same
complex mixture of phenomena that can result in fifty per cent or more resolution *of some
conditions only* in patients receiving dummy treatments in controlled trials. Only they are
exagerated in the practitioner's mind, because another layer of biases is superimposed on the data
, such as that patients who are not helped or made worse don't come back. The practitioner has
little consciouness of them, and there is that natural human tendecy to find excuses for any
failures they are aware of..
The shorthand expression "placebo effect" is regrettably often used instead of the awkward
descriptive in the last paragraph, but it is obviously misleading you and others because it is
mostly not an "effect" at all. On no treatment at all many patients with anxiety or depression or
the irritable bowel syndrome will be better at any later end-point.
Quoted message said:Quoted message said:
But any effects of placebo, and the level of patient satisfaction with treatment, are not
invested in a pill or procedure, they are a product
of
Quoted message said:the whole therapeutic environment. Alternative medicine may appear to
do
Quoted message said:Quoted message said:better with some types of patients and some types of conditions because
it
Quoted message said:Quoted message said:is not constrained by many of the inhibitions which prevent doctors from exploiting placebo
effects to the fullest. To that extent you are
correct.
Thank you and it still goes on today despite what others say. Doctors prescribe placebos for the
flu virus don't they ? It is not just limited
to
Quoted message said:that either as you well know.
Quoted message said:
It has also been well shown that patient satisfaction often bears little relationship to
treatment efficacy. Thus patients who have been led to believe they
have
Quoted message said:Quoted message said:MCS may be thrilled to find a practitioner who goes along with that diagnosis, even though they
are no better, and may in fact get worse,
often
Quoted message said:becoming more and more socially isolated through intolerances that blind testing can show is
illusory. It also must be understood that
placebos
Quoted message said:Quoted message said:have no effect on the course of cancer and most serious illnesses.
There
Quoted message said:Quoted message said:is some low level evidence that they can influence cardiac events.
Yes we all know that mental state has a bearing on overall health.
Which sections of alternative medicine tend to exaggerate, while others refuse to accept that
psychological factors can make them ill.
Quoted message said:We also know that a caring attitude and response by practitioners also engenders "Feel good"
responses. Can you explain the placebo effect where surgery is concerned ?
The more dramatic the treatment, the more expensive, and the more hands-on it is the more likely you
are to have patients reporting positive responses. We haven't here even started to dissect out what
a "patient reporting a positive response" means. There are plenty of factors: misperceptions,
biases, distractions, variations in attentiveness to symptoms, experimental subordination, "answers
of politeness", cognitive dissonance, psychosomatic triggering, that can make an inert treatment
appear successful.
Quoted message said:Quoted message said:
Quoted message said:So much so, that the FDA has reported - in order to gain approval for
a
Quoted message said:Quoted message said:new
Quoted message said:drug "You don't have to run against the placebo, but you have to beat
the
Quoted message said:Quoted message said:placebo". Medical Science is still in an evolutionary state and the lack of understanding yet
scientific use and acknowledgement of the "placebo
effect"
Quoted message said:is clear proof of this.
Medical science is always evolving. There is some tension in medicine
at
Quoted message said:Quoted message said:the moment as to whether it can ethically exploit placebo effects more fully, as with Andrew
Weil's "integrative medicine".. But, can we go
back
Quoted message said:Quoted message said:to more innocent times ? Fifty to sixty years ago the use of placebos
was
Quoted message said:Quoted message said:common and explicit within medicine, but most doctors I talk to feel
that
Quoted message said:Quoted message said:deceiving patients is wrong, and that better attention to and
communication
Quoted message said:with patients will achieve similar outcomes . We also come up against informed consent issues
that don't bother AM.
Once again where is the proof that Doctors do not use Placebos. We know
they
Quoted message said:do in the cases of flu and there is indication that a great deal of depression is also treated
with drugs that get a similar response rate to placebos. In fact the overall concern is an abuse
of antibiotics in most western nations along with anti-depressants.
I don't deny any of that. Whether a doctor knows it or not (I initially said "conventional and
alternative"😉 medical practice is always going to be riddled with placebo effects. All I said
was that the conscious and deliberate usage of placebos is frowned upon by most of the doctors
I talk to.
The main area where I suspect we would disagree is the potency of such effects. Placebos are never
going to provide the answer to any of medicine's pressing problems.
Peter Moran
Quoted message said:
My concern is that drugs (treatments) may have taken over for the caring attitude needed to impact
conditions.
Peter, blood letting used to be the favoured treatment long ago, now drugs are the favoured
treatment in most cases, I hope that you agree that in
the
Quoted message said:future we may have a different aproach with a much different result. Yes
I
Quoted message said:agree that the drug results are more favourable than the blood letting of yester year which points
to tomorrow's treatments being quite different
than
Quoted message said:todays treatments. This is where conventional and alternative need to combine which of course is
happening daily. Informed consent issues are something that may apply
to
Quoted message said:uninformed people but not the vast majority that seek solutions to health problems. After all when
you are seeking solutions, the homework has been done usually quite well after receiving informed
opinions.
Thanks, Rod.
Quoted message said:
Peter Moran
