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Old 13th August 2021, 01:50 AM   #121
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Originally Posted by psionl0 View Post
Which particular data are you claiming that Harvard researchers totally messed up?
It isn't always that the researchers messed it up, though sometimes it is. Usually it's the journalists that mess it up. Those outlets that reprint press releases verbatim - press releases written by the university's media team, not the scientists themselves.

Anyway, I don't have the citations. I'm sure they'll be coming in future articles. The site has a whole category for placebo effect articles, which currently contains exactly one article. More are on the way. We just need to be patient.
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Old 13th August 2021, 02:59 AM   #122
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I just don't understand how someone cannot accept that the "placebo effect" is a real thing, that can comfort people and bring them some sort of peace. I mean, consider religion, for example.
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Old 13th August 2021, 04:09 AM   #123
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Originally Posted by Warp12 View Post
I just don't understand how someone cannot accept that the "placebo effect" is a real thing, that can comfort people and bring them some sort of peace. I mean, consider religion, for example.

The placebo effect is a real thing. It consists of several simultaneous mechanisms.
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Old 13th August 2021, 04:21 AM   #124
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Actually, if placebo isn’t a real thing, then nocebo also is not a real thing. I even believe that nocebo is far more powerful than placebo.

I have myself experience how my surroundings were trying to impose a nocebo on me when I had an infection that caused me to be dehydrated. I went to a doctor who took a quick glance at me and told me to go home and drink a lot (proper salts added). However, my family insisted I been treated horribly, and that I was dying, and should be sent to the hospital. Later same day, I was clearly recovering, but I had difficulty convincing anybody else until a couple of days later.
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Old 13th August 2021, 06:46 AM   #125
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Originally Posted by Warp12 View Post
I just don't understand how someone cannot accept that the "placebo effect" is a real thing, that can comfort people and bring them some sort of peace. I mean, consider religion, for example.
Whether or not placebo is a thing, I don't think religion is a good example there. I mean, we even have a study where people that had been told that a pastor and group of believers would be praying for their surgery... well, let's just say it worked as a nocebo, not a placebo.
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Old 13th August 2021, 07:14 PM   #126
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Originally Posted by arthwollipot View Post
It isn't always that the researchers messed it up, though sometimes it is. Usually it's the journalists that mess it up. Those outlets that reprint press releases verbatim - press releases written by the university's media team, not the scientists themselves.
Doctors don't believe that the placebo effect is real because a journalist misquoted the results of some research.

Originally Posted by arthwollipot View Post
Anyway, I don't have the citations. I'm sure they'll be coming in future articles. The site has a whole category for placebo effect articles, which currently contains exactly one article. More are on the way. We just need to be patient.
If you were really going to debunk the placebo effect then you would have to analyze the studies that suggest that it is real and point out the deficiencies in those studies.

The mere fact that you have no citations shows that you have a long way to go if you are going to debunk the placebo effect.
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Old 14th August 2021, 07:35 AM   #127
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Originally Posted by HansMustermann View Post
Whether or not placebo is a thing, I don't think religion is a good example there. I mean, we even have a study where people that had been told that a pastor and group of believers would be praying for their surgery... well, let's just say it worked as a nocebo, not a placebo.
The bar for whether prayer is effective or not is generally set higher than that of a standard placebo.

If it doesn't result in the regeneration of a limb or organ then prayer is generally dismissed as woo regardless of any other improvements that might be observed with a patient.
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Old 17th August 2021, 12:32 AM   #128
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Originally Posted by psionl0 View Post
If you were really going to debunk the placebo effect then you would have to analyze the studies that suggest that it is real and point out the deficiencies in those studies.
Which is exactly what Mike did over the course of many episodes.
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Old 17th August 2021, 12:35 AM   #129
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Originally Posted by Warp12 View Post
I just don't understand how someone cannot accept that the "placebo effect" is a real thing, that can comfort people and bring them some sort of peace. I mean, consider religion, for example.
There is a difference between a placebo effect that gives someone comfort and peace and the "powerful placebo" effect that people believe actually causes real physiological healing.
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Old 17th August 2021, 11:42 AM   #130
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Originally Posted by arthwollipot View Post
Which is exactly what Mike did over the course of many episodes.
That isn't what you claimed earlier. You claimed that the University's media team (or journalists) misrepresented what the researchers concluded and nobody noticed. That is verging on CT status.
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Old 18th August 2021, 01:25 AM   #131
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Originally Posted by psionl0 View Post
That isn't what you claimed earlier. You claimed that the University's media team (or journalists) misrepresented what the researchers concluded and nobody noticed. That is verging on CT status.
I claimed both, because both are true. But I was speaking on a general basis, and not referring to any specific paper or university.

Let me be clear:

In some cases, the science was good, but it was misunderstood by media teams or journalists and misleading claims were made in the press.

In other cases, the science was poorly controlled and did not account for certain variables, leading to shaky conclusions, and misleading claims were made in the press.

In other cases, other things happened which cast doubt on the conclusion that placebos can have a powerful and measurable effect. There are many factors involved in this myth.

Mike has gone in-depth into most of these issues over the course of many episodes of his podcast, examining many examples, and shown how they contribute to the "powerful placebo" myth that placebos have an actual organic healing effect that was comparable to genuine interventions ("over and above placebo", as we would otherwise say).

For example (one single example out of many), Mike showed in one episode that Ben Goldacre cited sources in his book that he claimed demonstrate certain things (such as "a blue placebo pill is more effective than a red placebo pill"), but that the sources in question actually did not demonstrate. Mike showed this by actually going to the cited papers and reading from them directly.

This is one of his methods. He takes something someone has claimed is demonstrated by science, goes to the actual published science, and shows that it does not demonstrate that at all. Or if it does, he shows how it did not account for certain variables. Or that it was based on a tiny sample size. Or something else. All this, taken together, convincingly argues (to me, at least) that the "powerful placebo" effect is not real.

Have I gone into enough detail yet? He's been doing this for six years now so dredging up more examples from memory is going to be tricky. As I have said, I anticipate more articles on the UK Skeptic website in the future, at which point it will be easier to back up what I'm saying.
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Old 18th August 2021, 01:54 AM   #132
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Originally Posted by psionl0 View Post
The bar for whether prayer is effective or not is generally set higher than that of a standard placebo.

No, it isn't generally set higher. You are confusing studies of prayer with Emile Zola's aphorism: The road to Lourdes is littered with crutches, but not one wooden leg.

Quote:
If it doesn't result in the regeneration of a limb or organ then prayer is generally dismissed as woo regardless of any other improvements that might be observed with a patient.

God is supposed to be omnipotent. Placebo isn't.
"Any other improvements that might be observed with a patient" are what you would expect from the body's ability to heal itself.
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Old 18th August 2021, 10:54 AM   #133
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Originally Posted by dann View Post
God is supposed to be omnipotent. Placebo isn't.
"Any other improvements that might be observed with a patient" are what you would expect from the body's ability to heal itself.
Thus proving what I said. If prayer doesn't bring about better results than a placebo then prayer has failed.
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Old 18th August 2021, 07:23 PM   #134
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Originally Posted by psionl0 View Post
Thus proving what I said. If prayer doesn't bring about better results than a placebo then prayer has failed.
That's right. We as science-interested skeptics know this. But it is often framed in the public consciousness that when a placebo brings about the same results as prayer, the placebo has worked.
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Old 19th August 2021, 03:31 PM   #135
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Originally Posted by arthwollipot View Post
That's right. We as science-interested skeptics know this. But it is often framed in the public consciousness that when a placebo brings about the same results as prayer, the placebo has worked.
I have never heard it "framed in the public consciousness" like that before.
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Old 19th August 2021, 05:56 PM   #136
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Originally Posted by psionl0 View Post
I have never heard it "framed in the public consciousness" like that before.
Then you've lived a pretty sheltered life. Almost any time someone (who is not a doctor or a clinical researcher) talks about a placebo, they're making the assumption that the placebo has a genuine clinical effect, over and above what can be accounted for by other factors.

I most often hear it as "even if it is a placebo, it still works, so why not use it?" Particularly when discussing things like homeopathy.
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Old 20th August 2021, 07:31 AM   #137
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Originally Posted by arthwollipot View Post
Then you've lived a pretty sheltered life. Almost any time someone (who is not a doctor or a clinical researcher) talks about a placebo, they're making the assumption that the placebo has a genuine clinical effect, over and above what can be accounted for by other factors.

I most often hear it as "even if it is a placebo, it still works, so why not use it?" Particularly when discussing things like homeopathy.
That has nothing to do with "when a placebo brings about the same results as prayer, the placebo has worked".

Until you can link to the study that has been misinterpreted and show how it has been misinterpreted your podcaster has nothing.
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Old 23rd August 2021, 12:36 AM   #138
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Originally Posted by psionl0 View Post
That has nothing to do with "when a placebo brings about the same results as prayer, the placebo has worked".

Until you can link to the study that has been misinterpreted and show how it has been misinterpreted your podcaster has nothing.
One more time for the kiddies at home.

Over the course of many episodes, Mike cited many different published papers. So far, he has written only one article, touching on one of those papers. More should be forthcoming, but writing takes time and he has a day job.

When more articles are published, be assured that I will report them here.
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Old 23rd August 2021, 12:38 AM   #139
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Link?
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Old 23rd August 2021, 12:42 AM   #140
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Originally Posted by psionl0 View Post
Link?
You mean the one I posted in the OP? Here you go.

https://www.skeptic.org.uk/2021/07/m...om-convincing/
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Old 24th August 2021, 12:45 PM   #141
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Originally Posted by arthwollipot View Post
You mean the one I posted in the OP?
"Adam ruins everything" is not a scientific study.

Discrediting an interview when the interviewee is not present is easy.
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Old 24th August 2021, 08:57 PM   #142
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Originally Posted by psionl0 View Post
"Adam ruins everything" is not a scientific study.

Discrediting an interview when the interviewee is not present is easy.
The link to The Lancet is a little bit further down. You have to read more than the first couple of paragraphs.
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Old 24th August 2021, 09:47 PM   #143
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Originally Posted by arthwollipot View Post
The link to The Lancet is a little bit further down. You have to read more than the first couple of paragraphs.
All I saw was a link to a podcast of the interview,
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Old 24th August 2021, 10:22 PM   #144
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Originally Posted by psionl0 View Post
All I saw was a link to a podcast of the interview,
Yes, that's clear. You need to keep reading.
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Old 24th August 2021, 11:08 PM   #145
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Originally Posted by arthwollipot View Post
The link to The Lancet is a little bit further down. You have to read more than the first couple of paragraphs.
I read through your link, although not the Lancet paper itself. But the quoted bit about both the real surgery and the "placebo" group both receiving physiotherapy seems pretty damning from an experimental design viewpoint. If the "placebo" group actually had an intervention (and physiotherapy is an intervention) that your control group did not, then it's not testing the placebo effect.
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Old 24th August 2021, 11:37 PM   #146
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Originally Posted by Ziggurat View Post
I read through your link, although not the Lancet paper itself. But the quoted bit about both the real surgery and the "placebo" group both receiving physiotherapy seems pretty damning from an experimental design viewpoint. If the "placebo" group actually had an intervention (and physiotherapy is an intervention) that your control group did not, then it's not testing the placebo effect.
If both groups get the same intervention, then yes it's testing the placebo effect, since that's the only thing that was different between the two groups.
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Old 25th August 2021, 01:49 AM   #147
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Originally Posted by arthwollipot View Post
If both groups get the same intervention, then yes it's testing the placebo effect, since that's the only thing that was different between the two groups.
There are actually three groups here: "real" surgery + physiotherapy, "placebo" surgery + physiotherapy, and no treatment. The first two groups had better outcome than the last group, and about the same as each other. There isn't one thing that's different between the placebo group and the control group, there are two things that are different.

One interpretation is that placebo surgery provides a benefit in this case, comparable to the benefits of real surgery, and both of which are better than no surgery. Another interpretation is that neither placebo surgery nor real surgery provide any benefit, and the benefit the first two groups show is due to the physiotherapy. As the authors admit in a quote from your link, they cannot distinguish between these two possibilities based on their data. In order to test the placebo effect here, we need to be able to eliminate the effects of physiotherapy. But we can't do that, because the study was poorly designed.
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Old 25th August 2021, 06:37 PM   #148
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Originally Posted by arthwollipot View Post
If both groups get the same intervention, then yes it's testing the placebo effect, since that's the only thing that was different between the two groups.
I finally found the actual study and read the discussion. It is not testing the placebo effect but whether surgery was better than the placebo effect.

The fact the both groups received post operative care that the third group didn't doesn't prove that the placebo effect is not real. That wasn't specifically what was tested so to draw the conclusion that the placebo effect is imaginary is a non-sequitur.
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Old 25th August 2021, 06:54 PM   #149
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Originally Posted by Ziggurat View Post
There are actually three groups here: "real" surgery + physiotherapy, "placebo" surgery + physiotherapy, and no treatment. The first two groups had better outcome than the last group, and about the same as each other. There isn't one thing that's different between the placebo group and the control group, there are two things that are different.

One interpretation is that placebo surgery provides a benefit in this case, comparable to the benefits of real surgery, and both of which are better than no surgery. Another interpretation is that neither placebo surgery nor real surgery provide any benefit, and the benefit the first two groups show is due to the physiotherapy. As the authors admit in a quote from your link, they cannot distinguish between these two possibilities based on their data. In order to test the placebo effect here, we need to be able to eliminate the effects of physiotherapy. But we can't do that, because the study was poorly designed.
Originally Posted by psionl0 View Post
I finally found the actual study and read the discussion. It is not testing the placebo effect but whether surgery was better than the placebo effect.

The fact the both groups received post operative care that the third group didn't doesn't prove that the placebo effect is not real. That wasn't specifically what was tested so to draw the conclusion that the placebo effect is imaginary is a non-sequitur.
You are both correct. However, this study was widely reported (including by Adam Ruinseverything) as saying that the placebo effect was just as good as the surgery, whereas what it actually said was that the surgery was no better than placebo. Which was the whole point of this discussion from the beginning.
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Old 25th August 2021, 07:33 PM   #150
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Originally Posted by arthwollipot View Post
You are both correct. However, this study was widely reported (including by Adam Ruinseverything) as saying that the placebo effect was just as good as the surgery, whereas what it actually said was that the surgery was no better than placebo. Which was the whole point of this discussion from the beginning.
No, the whole point of this discussion was that "the placebo effect is largely a sham". This study didn't demonstrate that.
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Old 25th August 2021, 07:54 PM   #151
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Originally Posted by psionl0 View Post
No, the whole point of this discussion was that "the placebo effect is largely a sham". This study didn't demonstrate that.
Not on its own. But it was the point of this article by Mike Hall, which itself forms a part of the body of evidence that shows that the placebo effect is largely a sham. This particular part of the body of evidence shows that studies that say that a treatment is no better than a placebo are routinely misreported as saying that a placebo is as good as a treatment.

This is the other part that I'm trying to get you to understand: This one article is not the entire argument. Mike has promised to put more of the evidence he has collected - which up until now has only been in the form of unindexed podcast episodes - into the form of written articles in the future. I will report them here when they appear. Be patient.
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Old 25th August 2021, 08:09 PM   #152
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Originally Posted by arthwollipot View Post
This particular part of the body of evidence shows that studies that say that a treatment is no better than a placebo are routinely misreported as saying that a placebo is as good as a treatment.
Those two statements are logically equivalent and I don't think that either form is misleading (and it only relates to one type of surgical procedure).

As far as demonstrating that the placebo effect is a sham is concerned, this study doesn't form part of a "body of evidence" that demonstrates anything of the sort.
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Old 25th August 2021, 08:37 PM   #153
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Originally Posted by psionl0 View Post
Those two statements are logically equivalent and I don't think that either form is misleading (and it only relates to one type of surgical procedure).
Yes, this is part of the problem. Because you see the two statements as logically equivalent, you are led to the belief that taking a placebo has real physiological effects that aren't otherwise explained by any of the many different variables.

Originally Posted by psionl0 View Post
As far as demonstrating that the placebo effect is a sham is concerned, this study doesn't form part of a "body of evidence" that demonstrates anything of the sort.
Now you're just looking for reasons to be contrary.

You haven't seen the rest of it yet! You're reading A Long-Expected Party and saying "This doesn't say anything about orcs or kings! How can it be a story about travelling to distant lands, great wars, and destroying evil? It's just a party!"

This particular part of the body of evidence demonstrates how evidence is misreported and misinterpreted, which leads to unjustified belief in the powerful placebo effect. Future parts will build on that.
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Old 25th August 2021, 10:58 PM   #154
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Originally Posted by arthwollipot View Post
Yes, this is part of the problem. Because you see the two statements as logically equivalent, you are led to the belief that taking a placebo has real physiological effects that aren't otherwise explained by any of the many different variables.
No matter how hard you try, you won't fit that square peg in this round hole.

The only thing that this study showed was that in this case, there was no significant difference in the results of a real surgery and the sham surgery. Whether this was due primarily to a placebo effect or whether the postoperative physiotherapy made a difference (and whether this postoperative physiotherapy was also a placebo effect) was not really tested in the study.

It might be stretching it to conclude that the placebo effect is as "powerful" as surgery in general but it is stretching it further to suggest that this supports the notion that the placebo effect is a "sham".

The conclusion by the study that some surgeries are no better than a placebo is absolutely valid.

Originally Posted by arthwollipot View Post
You haven't seen the rest of it yet! You're reading A Long-Expected Party and saying "This doesn't say anything about orcs or kings! How can it be a story about travelling to distant lands, great wars, and destroying evil? It's just a party!"
I'm sure that your blogger opened with the best example to support his belief that he could find. I doubt that future examples will be as "convincing".
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Old 25th August 2021, 11:14 PM   #155
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Originally Posted by psionl0 View Post
No matter how hard you try, you won't fit that square peg in this round hole.

The only thing that this study showed was that in this case, there was no significant difference in the results of a real surgery and the sham surgery. Whether this was due primarily to a placebo effect or whether the postoperative physiotherapy made a difference (and whether this postoperative physiotherapy was also a placebo effect) was not really tested in the study.

It might be stretching it to conclude that the placebo effect is as "powerful" as surgery in general but it is stretching it further to suggest that this supports the notion that the placebo effect is a "sham".

The conclusion by the study that some surgeries are no better than a placebo is absolutely valid.
*pinches bridge of nose real hard*

You're missing the point. Missing by a country mile.

We agree on what the study says. We agree on that. Now, would you like to take a look at what the article says? You know, the article by Mike Hall, published on the website of the UK Skeptic Magazine?

In case you missed it (you definitely missed it), the article uses the study, and an episode of Adam Ruins Everything, to illustrate how easy it is to misrepresent and misreport what a study says. The study says that the surgery is no better than placebo. Adam Ruinseverything says "Wow, this study shows that the placebo effect is really powerful!"

That's the point of the article. It establishes how the myth of the "powerful placebo" takes hold in the public consciousness. As, apparently, it has taken hold in yours. That's part of why Mike did all that work in the first place - because people who are otherwise smart and skeptical like Ben Goldacre (and, apparently, you) have completely swallowed the "powerful placebo" idea.

Originally Posted by psionl0 View Post
I'm sure that your blogger opened with the best example to support his belief that he could find. I doubt that future examples will be as "convincing".
Now you're reading "A Long-Expected Party" and saying "Because this doesn't say anything about orcs and kings, I doubt that the rest of the book is any good."
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Old 26th August 2021, 12:46 AM   #156
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Originally Posted by arthwollipot View Post
You are both correct. However, this study was widely reported (including by Adam Ruinseverything) as saying that the placebo effect was just as good as the surgery, whereas what it actually said was that the surgery was no better than placebo. Which was the whole point of this discussion from the beginning.
Ok.

But in case it wasn’t clear from my earlier exchange with Hans, I’ve only ever defended what one might term “weak” placebo, not what’s sometimes being called strong placebo. The OP seems to claim all forms of placebo effectiveness are false.
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Old 26th August 2021, 01:25 AM   #157
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Originally Posted by Ziggurat View Post
Ok.

But in case it wasn’t clear from my earlier exchange with Hans, I’ve only ever defended what one might term “weak” placebo, not what’s sometimes being called strong placebo. The OP seems to claim all forms of placebo effectiveness are false.
"Weak" placebo is largely explained by uncontrolled variables. The argument is, and always has been, about "strong" placebo - the claim that (for example) even if homeopathy is a placebo, it still works and it's therefore okay to take and for doctors to prescribe.

We as skeptics largely don't believe that (though I have seen it argued on this forum), but a lot of people do. Including, apparently, Adam Ruinseverything.
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Old 26th August 2021, 07:38 AM   #158
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Originally Posted by arthwollipot View Post
"Weak" placebo is largely explained by uncontrolled variables.
I don't think that's true.
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Old 26th August 2021, 02:44 PM   #159
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Originally Posted by arthwollipot View Post
In case you missed it (you definitely missed it), the article uses the study, and an episode of Adam Ruins Everything, to illustrate how easy it is to misrepresent and misreport what a study says. The study says that the surgery is no better than placebo. Adam Ruinseverything says "Wow, this study shows that the placebo effect is really powerful!"
Sure, as I have stated previously, we have a case where ONE person misrepresented the results of ONE study involving the placebo effect.

What I take exception to is the implication that this means that ALL people misrepresent the results of ALL studies involving the placebo effect or that this proves that the placebo effect is a "sham".
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Old 29th August 2021, 09:33 PM   #160
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Next article is up:

The idea that four placebo pills are more powerful than two sounds magical – because it isn’t true

Quote:
In 2001, the New England Journal of Medicine published a study titled Is The Placebo Powerless? An Analysis of Clinical Trials Comparing Placebo with No Treatment.

This was an influential review, prompting follow-ups in 2004 and 2010, the latter of these being for the Cochrane Collaboration. Each of these papers draws comparable conclusions: there is little evidence placebos have powerful clinical effects, and such effects which are measured are difficult to distinguish from bias. Despite this, the narrative of the ‘powerful placebo effect’ persists.

One of the more common claims made for the strange and magical power of the placebo is that peptic ulcers heal faster when you take four placebo pills, rather than two. This is clearly an extraordinary claim. Four inert pills clear ulcers faster than two inert pills? Four times zero is greater than two times zero? Could this really be true?
Make sure you go to the article, because there are links.
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