Posted by Ilene on September 27, 2003, at 14:13:12
In reply to Re: Anyone else troubled by these placebo findings » Ilene, posted by Larry Hoover on September 27, 2003, at 11:07:10
> **Note this next paragraph, please. Placebo subjects are not untreated.**
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> "The less-than-impressive results in these and other studies also calls to mind the fact that patients assigned to placebo treatment in clinical trials are not "getting nothing." The capsule they receive is pharmacologically inert but hardly inert with respect to its symbolic value and its power as a conditioned stimulus. In addition, placebo-treated patients receive all of the commonly employed treatment techniques: a thorough evaluation; an explanation for their distress; an expert healer; a plausible treatment; expectation of improvement; a healer's commitment, enthusiasm and positive regard; and an opportunity to verbalize their distress. "
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> I have both helped manage, and taken part in, clinical trials. I can state without a shadow of a doubt that the quality of care in a clinical trial, for both the placebo and active groups, is of the highest quality. In fact, I believe the level of care itself does not compare with normal clinical practise; the doctors who conduct clinical trials tend to be the best doctors to begin with. Extrapolating placebo response from the clinical trial environment to the typical experience of an individual under care by e.g. an HMO is absurd, IMHO.
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> LarRight. I was going to mention the Hawthorne Effect, but thought it might be somewhat tangential. Here it is.
"Individual behaviors may be altered because they know they are being studied was demonstrated in a research project (1927 - 1932) of the Hawthorne Plant of the Western Electric Company in Cicero, Illinois. This series of research, first led by Harvard Business School professor Elton Mayo along with associates F.J. Roethlisberger and William J. Dickson started out by examining the physical and environmental influences of the workplace (e.g. brightness of lights, humidity) and later, moved into the psychological aspects (e.g. breaks, group pressure, working hours, managerial leadership). The ideas that this team developed about the social dynamics of groups in the work setting had lasting influence - the collection of data, labor-management relations, and informal interaction among factory employees.
The major finding of the study was that almost regardless of the experimental manipulation employed, the production of the workers seemed to improve. One reasonable conclusion is that the workers were pleased to receive attention from the researchers who expressed an interest in them. "
If you change the word "workers" to "patients" in the last sentence you get an insight into the psychodynamics of the placebo effect under clinical trial conditions.
Ilene
poster:Ilene
thread:262425
URL: http://www.dr-bob.org/babble/20030923/msgs/263758.html