The Placebo Effect: Please Please Me







You often hear the term placebo effect used in a disparaging way, as if this is something we don't want.  I was reading a remark today about someone wondering if feeling better from Vitamin D was real or maybe just a placebo effect, as if something like this even mattered, and perhaps their felling better was just in their mind, not real in other words.

So where would anyone get such an idea?  Well when running scientific experiments on something, we not only want to discover how well something might work, we also want to look to isolate these effects to where we can better claim that these effects can be attributed to the actions of the agent being tested and not due to one's beliefs or expectations of something.

The first thing that comes to mind here though is that, while this might seem to matter, we don't want to go too far with this either, and either negate or criticize these so called placebo effects, from associated beliefs.

Let's assume for instance that there's a certain substance that people have a very strong belief in, that is being tested for its beneficial effects on blood sugar.  So we, as usual, separate the test subjects into two groups, one that will receive the agent being tested and another that will receive a placebo.

In this case, both groups see a big improvement, the test group sees their A1C go down by 2%, and the control group who received the placebo also saw their A1C go down by the same 2%.  So we then end up saying that the substance is worthless in treating diabetes because it's just the placebo effect.

So we don't have anything this good actually but no matter, we can't have something like subjectivity interfering with science. 

It's not that we can ever get rid of the placebo effect anyway, which isn't even a good term here, subjectivity would be better, because people are going to have beliefs about something generally anyway, and if they are positive, well we definitely want that.

I do think though that it's important to look to distinguish effects that can be attributed to things objectively, and those which may be more subjective, so it's understandable why we would want to separate subjects into test and control groups.

On the other hand, we can't lose sight of the fact that it is the effect that we are after, and in the end, it doesn't matter one bit why someone improved for instance, just that they did.  

So there's nothing wrong with running control groups in studies, giving people "placebos," and this does add to our knowledge, but this doesn't mean that this is the only evidence we can be prepared to accept.

Sure, a controlled study can provide better evidence of something, but this certainly does not mean that all other evidence is invalidated, just because some of the reported effects might be due to subjectivity.

Especially with large samples, anecdotal evidence can be very valuable indeed, especially in areas where we don't have any good controlled studies, but even if we do, well anecdotal evidence can still be valuable.

So if I say for instance that a certain thing helps my diabetes, that is evidence, and the degree that my beliefs influenced it or not still doesn't take away from the fact that I can show objective improvements, with my glucose meter for instance.

So we can take this evidence for, and also look at the evidence against, people who do not claim any benefit, and put it all together and we have some real knowledge, here, in spite of the fact it wasn't a double blind controlled experiment.  

In the end, especially with something as powerful as diabetes, beliefs may influence things initially, but especially over time, they have little effect at best on things like our blood sugar.  If it did, well we could all just do things like meditation and will our blood sugar lower, there might be some yogis who can do that, the same ones that can levitate perhaps, but we want to make sure we're not giving ourselves superpowers that we don't really have.

We should do more studies by the way on the power of positive belief on blood sugar by the way, I do think we can help this a bit anyway and aside from just talking about people reducing stress, this is a therapy that isn't really looked into much.

If positive beliefs can help, and they can to some degree anyway, that's why we bother with controls, then negative beliefs can worsen things, the displacebo effect, given that placebo means please, this would mean I'm not pleased at all.

So if the test group has a negative belief about it, then this is going to affect the data, regardless of whether or not we have a control group that got a placebo.  So it does go both ways, and what we want and need to do is to look to minimize negative subjectivity, like if you give a group of people a supplement and they think that supplements are worthless in improving health.

So in this case we need to control the study even more and not tell them what they are getting at all.

So in the end though, we're seeking to get pleased, the most important thing is to focus on the results, especially when it comes to our own care, if something helps us, it doesn't matter why really.

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