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kushnerha

A Placebo Treatment for Pain - The New York Times - 0 views

www.nytimes.com/...lacebo-treatment-for-pain.html

new york times medicine research placebo effect

shared by kushnerha on 09 Jan 16 - No Cached
  • This phenomenon — in which someone feels better after receiving fake treatment — was once dismissed as an illusion. People who are ill often improve regardless of the treatment they receive. But neuroscientists are discovering that in some conditions, including pain, placebos create biological effects similar to those caused by drugs.
  • Taking a placebo painkiller dampens activity in pain-related areas of the brain and spinal cord, and triggers the release of endorphins, the natural pain-relieving chemicals that opioid drugs are designed to mimic. Even when we take a real painkiller, a big chunk of its effect is delivered not by any direct chemical action, but by our expectation that the drug will work. Studies show that widely used painkillers like morphine, buprenorphine and tramadol are markedly less effective if we don’t know we’re taking them.
  • Placebo effects in pain are so large, in fact, that drug manufacturers are finding it hard to beat them. Finding ways to minimize placebo effects in trials, for example by screening out those who are most susceptible, is now a big focus for research. But what if instead we seek to harness these effects? Placebos might ruin drug trials, but they also show us a new approach to treating pain.
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  • It is unethical to deceive patients by prescribing fake treatments, of course. But there is evidence that people with some conditions benefit even if they know they are taking placebos. In a 2014 study that followed 459 migraine attacks in 66 patients, honestly labeled placebos provided significantly more pain relief than no treatment, and were nearly half as effective as the painkiller Maxalt.
  • With placebo responses in pain so high — and the risks of drugs so severe — why not prescribe a course of “honest” placebos for those who wish to try it, before proceeding, if necessary, to an active drug?
  • Another option is to employ alternative therapies, which through placebo responses can benefit patients even when there is no physical mode of action.
  • a key ingredient is expectation: The greater our belief that a treatment will work, the better we’ll respond.
  • Individual attitudes and experiences are important, as are cultural factors. Placebo effects are getting stronger in the United States, for example, though not elsewhere.
  • Likely explanations include a growing cultural belief in the effectiveness of painkillers — a result of direct-to-consumer advertising (illegal in most other countries) and perhaps the fact that so many Americans have taken these drugs in the past.
  • Trials show, for example, that strengthening patients’ positive expectations and reducing their anxiety during a variety of procedures, including minimally invasive surgery, while still being honest, can reduce the dose of painkillers required and cut complications.
  • Placebo studies also reveal the value of social interaction as a treatment for pain. Harvard researchers studied patients in pain from irritable bowel syndrome and found that 44 percent of those given sham acupuncture had adequate relief from their symptoms. If the person who performed the acupuncture was extra supportive and empathetic, however, that figure jumped to 62 percent.
  • Placebos tell us that pain is a complex mix of biological, psychological and social factors. We need to develop better drugs to treat it, but let’s also take more seriously the idea of relieving pain without them.
nolan_delaney

3 ways to use the placebo effect to have a better day - CNN.com - 0 views

www.cnn.com/...index.html

placebo knowledge

shared by nolan_delaney on 20 Nov 14 - No Cached
    • nolan_delaney
      nolan_delaney on 20 Nov 14
       
      This relates to TOK because of how subjective our minds are to trickery
  • 0 survey of more than 400 docs found that a whopping 56% said they'd actually prescribed placebos to their patients
  • those who were told they got quality sleep performed better than those who were told they slept badly.
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  • Placebos seem to work in large part "because they are given by authority figures,
    • nolan_delaney
      nolan_delaney on 20 Nov 14
       
      the part about authority figures relates to one of the fallacieswe discussed
  • nolan_delaney on 20 Nov 14
     
    Placebo affect- our minds subjective to trickery, authority figure fallacy 
Javier E

A Place For Placebos « The Dish - 0 views

dish.andrewsullivan.com/...a-place-for-placebos

placebo ritual stress science mindfulness meditation

shared by Javier E on 31 Dec 13 - No Cached
  • there’s virtually no scientific evidence that alternative medicine (anything from chiropractic care to acupuncture) has any curative benefit beyond a placebo effect. … However, there is one area where alternative medicine often trumps traditional medicine: stress reduction. And stress reduction can, of course, make a huge impact on people’s health. …
  • Maybe each of these activities (listening to high end audio gear, drinking high end wine, having needles inserted into your chakras) is really about ritualizing a sensory experience. By putting on headphones you know are high quality, or drinking expensive wine, or entering the chiropractor’s office, you are telling yourself, “I am going to focus on this moment. I am going to savor this.” It’s the act of savoring, rather than the savoring tool, that results in both happiness and a longer life.
Javier E

New Alternatives to Statins Add to a Quandary on Cholesterol - The New York Times - 0 views

www.nytimes.com/...a-quandary-on-cholesterol.html

statin research medical science health-care

shared by Javier E on 30 Aug 15 - No Cached
  • “We’ve reached a point where patients are increasingly facing five- and six-figure price tags for medications that they will take over the course of their lifetimes,” said Matthew Eyles, an executive vice president for America’s Health Insurance Plans, the national trade association for the insurance industry. “If this is the new normal to treat common and chronic conditions, how can any health system sustain that cost?”
  • Doctors with patients who maintain they are intolerant to statins say they are confronted with a clash between the art and the science of medicine.
  • Dr. Peter Libby, a doctor and researcher at Brigham and Women’s Hospital in Boston, said that in his role as a physician, “the patient is always right.” But, he added, “as a scientist, I find randomized, large-scale, double-blind studies more persuasive than anecdote.”
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  • The statin trials, which involved tens of thousands of people, found no more muscle aches, the most common complaint, in patients who took statins than in those who took placebos.
  • The widely held belief that statins affect memory also has not been borne out in clinical trials, said Dr. Jane Armitage of the University of Oxford. She and her colleagues studied memory problems in 20,000 patients randomly assigned to take a statin or a placebo. “There was absolutely no difference,” she said.
  • In a separate study, they looked at mood and sleep patterns and again found statins had no effect. Another study, in Scotland, detailed cognitive testing of older people taking statins or a placebo, and also found no effect.
ilanaprincilus06

A Medication-Assisted Treatment For Meth Addiction Shows Promise : Shots - Health News ... - 0 views

www.npr.org/...-proves-effective-in-new-trial

drugs addiction medical community

shared by ilanaprincilus06 on 16 Jan 21 - No Cached
  • For the first time, a medication regime has been found effective for some patients with meth addiction in a large, placebo-controlled trial.
  • Unlike opioid addiction, for which medication-assisted treatment is the standard of care, no medication has been approved by the Food and Drug Administration for use with meth.
  • patients in clinics around the U.S. suffering from methamphetamine use disorder were treated for 12 weeks with a combination of medications — naltrexone and bupropion — or placebo.
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  • The treatment helped 13.4% of patients with their addiction, compared with 2.5% of the placebo group.
  • This medication therapy provides another tool for doctors to try with patients.
  • "As we understand the complexity of the human brain, it becomes very much of a magical thinking that one pill will solve the problem of addiction,"
  • The treatment regimen in the trial combined two medications that have been studied separately for treating methamphetamine addiction with limited success.
  • This clinical trial was successful enough that the National Institute on Drug Addiction's Volkow says she expects to move forward toward securing FDA approval.
  • lack of medical treatments for those addicted to meth has complicated efforts to curb demand for the drug.
  • The human cost has been catastrophic. Researchers say overdose deaths linked to meth increased fourfold over the last decade.
  • Even users who don't overdose often experience damage to the heart and other tissues, and can see their lives spiral out of control.
  • "For heroin users, there's methadone, there's suboxone. I just wonder why we haven't researched [treatments for] this drug yet,"
  • "It's about evidence-based care, it's about empathy and it's about survivability,"
Javier E

Acupuncture, Real or Fake, Eases Pain - Well Blog - NYTimes.com - 1 views

well.blogs.nytimes.com/...ncture-real-or-fake-eases-pain

placebo acupuncture brain science

shared by Javier E on 21 Aug 10 - Cached
  • Fake acupuncture appears to work just as well for pain relief as the real thing, according to a new study of patients with knee arthritis. The findings, published in the September issue of the journal Arthritis Care and Research, are the latest to suggest that a powerful but little understood placebo effect may be at work when patients report benefits from acupuncture treatment
  • The results don’t mean acupuncture doesn’t work, but they do suggest that the benefits of both real and fake acupuncture may have something to do with the way the body transmits or processes pain signals. Other studies have suggested that the prick of a needle around the area of injury or pain could create a “super-placebo” effect that alters the way the brain perceives and responds to pain.
Sean Kirkpatrick

Ted Kaptchuk's Quest to Understand the Placebo Effect - 0 views

www.newyorker.com/...111212fa_fact_specter

shared by Sean Kirkpatrick on 29 Apr 13 - No Cached
  • Sean Kirkpatrick on 29 Apr 13
     
    I am very interested in the Placebo effect and its ties to the TOK course
sissij

Science in the Age of Alternative Facts | Big Think - 0 views

bigthink.com/...n-the-age-of-alternative-facts

science brain science research

shared by sissij on 15 Feb 17 - No Cached
  • discovered a peculiar aspect of human psychology and physiology: the placebo effect. As biographer Richard Holmes writes regarding their increased health, “It was simply because the patients believed they would be cured.”
  • Most importantly he did not finagle results to fit his preconceived notion of what this and other gases accomplish.
  • For science to work we need to move out of the way of ourselves and observe the data. Right now too many emotionally stunted and corporate-backed obstacles stand in the way of that.
  • sissij on 15 Feb 17
     
    Alternative facts are spooky things that confuse us between what we think is happening and what's really taking place. In this article, the author uses the example of Davy to suggest that treating the data objectively is what science should be doing. Data is tricky in science because we can draw different conclusions from the same set of data. Just like the line drawing game we played in TOK, there are infinite numbers of lines we can draw to connect all the data point, but there is only one that would be true. As the author shown in this article, the best way to avoid creating alternative facts is to leave out our emotion and personal opinion and let the data speak. Although intuition and imagination is good for science, but for most of the times, we need to remind ourselves not to force the data.
Adam Clark

The Nocebo Effect (Placebo) - YouTube - 0 views

www.youtube.com/watch

Human Science human sciences

shared by Adam Clark on 12 Mar 14 - No Cached
  • Adam Clark on 12 Mar 14
     
    Informative and compelling video about the Nocebo Effect
Javier E

The Folly of Fools - By Robert Trivers - Book Review - NYTimes.com - 0 views

www.nytimes.com/...obert-trivers-book-review.html

deceit evolution disease theory cooperation

shared by Javier E on 21 Jan 12 - No Cached
  • Fooling others yields obvious benefits, but why do we so often fool ourselves? Trivers provides a couple of answers. First, believing that we’re smarter, sexier and more righteous than we really are — or than others consider us to be — can help us seduce and persuade others and even improve our health, via the placebo effect, for example. And the more we believe our own lies, the more sincerely, and hence effectively, we can lie to others.
  • One intriguing theme running through “The Folly of Fools” is that self-­deception can affect our susceptibility to disease, for ill or good.
Javier E

Five months on, what scientists now know about the coronavirus | World news | The Guardian - 0 views

www.theguardian.com/...now-know-about-the-coronavirus

Covid-19 theory results research science Knowledge

shared by Javier E on 12 Apr 20 - No Cached
  • The Sars-CoV-2 virus almost certainly originated in bats, which have evolved fierce immune responses to viruses, researchers have discovered. These defences drive viruses to replicate faster so that they can get past bats’ immune defences. In turn, that transforms the bat into a reservoir of rapidly reproducing and highly transmissible viruses
  • “This virus probably jumped from a bat into another animal, and that other animal was probably near a human, maybe in a market,
  • Virus-ridden particles are inhaled by others and come into contact with cells lining the throat and larynx. These cells have large numbers of receptors – known as Ace-2 receptors – on their surfaces. (Cell receptors play a key role in passing chemicals into cells and in triggering signals between cells.
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  • “This virus has a surface protein that is primed to lock on that receptor and slip its RNA into the cell,”
  • Once inside, that RNA inserts itself into the cell’s own replication machinery and makes multiple copies of the virus. These burst out of the cell, and the infection spreads. Antibodies generated by the body’s immune system eventually target the virus and in most cases halt its progress.
  • “A Covid-19 infection is generally mild, and that really is the secret of the virus’s success,” adds Ball. “Many people don’t even notice they have got an infection and so go around their work, homes and supermarkets infecting others.”
  • the virus can cause severe problems. This happens when it moves down the respiratory tract and infects the lungs, which are even richer in cells with Ace-2 receptors. Many of these cells are destroyed, and lungs become congested with bits of broken cell. In these cases, patients will require treatment in intensive care.
  • Even worse, in some cases, a person’s immune system goes into overdrive, attracting cells to the lungs in order to attack the virus, resulting in inflammation
  • This process can run out of control, more immune cells pour in, and the inflammation gets worse. This is known as a cytokine storm.
  • Just why cytokine storms occur in some patients but not in the vast majority is unclear
  • Doctors examining patients recovering from a Covid-19 infection are finding fairly high levels of neutralising antibodies in their blood. These antibodies are made by the immune system, and they coat an invading virus at specific points, blocking its ability to break into cells.
  • “It is clear that immune responses are being mounted against Covid-19 in infected people,” says virologist Mike Skinner of Imperial College London. “And the antibodies created by that response will provide protection against future infections – but we should note that it is unlikely this protection will be for life.”
  • Instead, most virologists believe that immunity against Covid-19 will last only a year or two. “That is in line with other coronaviruses that infect humans,
  • “That means that even if most people do eventually become exposed to the virus, it is still likely to become endemic – which means we would see seasonal peaks of infection of this disease. We will have reached a steady state with regard to Covid-19.”
  • Skinner is doubtful. “We have got to consider this pandemic from the virus’s position,” he says. “It is spreading round the world very nicely. It is doing OK. Change brings it no benefit.”
  • In the end, it will be the development and roll-out of an effective vaccine that will free us from the threat of Covid-19,
  • the journal Nature reported that 78 vaccine projects had been launched round the globe – with a further 37 in development.
  • vaccines require large-scale safety and efficacy studies. Thousands of people would receive either the vaccine itself or a placebo to determine if the former were effective at preventing infection from the virus which they would have encountered naturally. That, inevitably, is a lengthy process.
  • some scientists have proposed a way to speed up the process – by deliberately exposing volunteers to the virus to determine a vaccine’s efficacy.
  • Volunteers would have to be young and healthy, he stresses: “Their health would also be closely monitored, and they would have access to intensive care and any available medicines.”
  • The result could be a vaccine that would save millions of lives by being ready for use in a much shorter time than one that went through standard phase three trials.
  • phase-three trials are still some way off, so we have time to consider the idea carefully.”
Javier E

Taking B12 Energy Vitamins May Cause Lung Cancer - The Atlantic - 3 views

www.theatlantic.com/...537654

vitamin risks research

shared by Javier E on 26 Aug 17 - No Cached
  • around 50 percent of people in the United States take some form of “dietary supplement” product, and among the most common are B vitamins.
  • Worse than just a harmless waste of money, this usage could be actively dangerous. In an issue of the Journal of Clinical Oncology, published this week, researchers reported that taking vitamin B6 and B12 supplements in high doses (like those sold in many stores) appears to triple or almost quadruple some people’s risk of lung cancer.
  • Starting in 1998, researchers assigned 6,837 people with heart disease to take either B vitamins or a placebo.
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  • . In 2009, the researchers reported in the Journal of the American Medical Association that taking high doses of vitamin B12 along with folic acid (technically vitamin B9) was associated with greater risk of cancer and all-cause mortality.
  • Lung-cancer risk among men who took 20 milligrams of B6 daily for years was twice that of men who didn’t. Among people who smoke, the effect appeared to be synergistic, with B6 usage increasing risk threefold. The risk was even worse among smokers taking B12. Using more than 55 micrograms daily appeared to almost quadruple lung-cancer risk.
  • The research team is quick to note that the doses of B vitamins in question are enormous. The U.S. Recommended Dietary Allowance for B6 is 1.7 milligrams per day, and for B12 it’s 2.4 micrograms. The high-risk group in the study was taking around 20 times these amounts.That could seem nonsensical, except that these are the doses for sale at healthy-seeming places like Whole Foods and GNC. Many sellers offer daily 100-milligram B6 pills. B12 is available in doses of 5,000 micrograms.
  • There are legitimate and important uses for B-vitamin supplements, but the emerging evidence suggests we’re best to treat them more like pharmaceuticals than like panaceas to be shoveled into us in pursuit of energy, metabolic fortitude, “cardioprotection,” “bone wellness,” or whatever way in which we’d like to be better.
  • The current law gives consumers no reason to expect that risks will be listed on the labels of these products, or that health claims are accurate. A product like a high-dose B6 and B12 supplement hits shelves, and only decades later do researchers begin to understand the long-term health effects, who might benefit from taking it, and who might be harmed.  
Sean Kirkpatrick

Scientist at Work - Tor D. Wager - Seeking to Illuminate the Mysterious Placebo Effect ... - 0 views

www.nytimes.com/...22prof.html

shared by Sean Kirkpatrick on 29 Apr 13 - No Cached
  • Sean Kirkpatrick on 29 Apr 13
     
    The phrase "mind-body connection" has many connotations. For some, it's shorthand for New Age quackery. For others, it's a source of hope and a way to reconcile their spiritual life with modern science. For Tor D. Wager, it's just another day at the office.
Javier E

Lies, Damned Lies, and Medical Science - Magazine - The Atlantic - 0 views

www.theatlantic.com/...2

medical research bias error science knowledge

shared by Javier E on 04 Nov 10 - No Cached
  • How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all.
  • even if a study managed to highlight a genuine health connection to some nutrient, you’re unlikely to benefit much from taking more of it, because we consume thousands of nutrients that act together as a sort of network, and changing intake of just one of them is bound to cause ripples throughout the network that are far too complex for these studies to detect, and that may be as likely to harm you as help you
  • studies report average results that typically represent a vast range of individual outcomes.
  • ...17 more annotations...
  • studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller
  • The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
  • nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest.
  • Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.
  • Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.
  • The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
  • even for medicine’s most influential studies, the evidence sometimes remains surprisingly narrow. Of those 45 super-cited studies that Ioannidis focused on, 11 had never been retested
  • even when a research error is outed, it typically persists for years or even decades.
  • much, perhaps even most, of what doctors do has never been formally put to the test in credible studies, given that the need to do so became obvious to the field only in the 1990s
  • Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right
  • His PLoS Medicine paper is the most downloaded in the journal’s history, and it’s not even Ioannidis’s most-cited work
  • while his fellow researchers seem to be getting the message, he hasn’t necessarily forced anyone to do a better job. He fears he won’t in the end have done much to improve anyone’s health. “There may not be fierce objections to what I’m saying,” he explains. “But it’s difficult to change the way that everyday doctors, patients, and healthy people think and behave.”
  • “Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.” Of course, the doctors have all been trained to order these tests, she notes, and doing so is a lot quicker than a long bedside chat. They’re also trained to ply the patient with whatever drugs might help whack any errant test numbers back into line.
  • What they’re not trained to do is to go back and look at the research papers that helped make these drugs the standard of care. “When you look the papers up, you often find the drugs didn’t even work better than a placebo. And no one tested how they worked in combination with the other drugs,” she says. “Just taking the patient off everything can improve their health right away.” But not only is checking out the research another time-consuming task, patients often don’t even like it when they’re taken off their drugs, she explains; they find their prescriptions reassuring.
  • Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding.
  • We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough
  • Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”
aqconces

BBC - Future - The contagious thought that could kill you - 0 views

www.bbc.com/...an-you-think-yourself-to-death

brain science

shared by aqconces on 09 Mar 15 - No Cached
  • To die, sometimes you need only believe you are ill
  • we can unwittingly ‘catch’ such fears, often with terrifying consequences.
  • It’s a consistent phenomenon, but medicine has never really dealt with it — Ted Kaptchuk, Harvard Medical School
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  • Over the last 10 years, doctors have shown that this nocebo effect – Latin for “I will harm” – is very common.
  • In trials for Parkinson’s disease, as many as 65% report adverse events as a result of their placebo. “And around one out of 10 treated will drop out of a trial because of nocebo, which is pretty high,” he says.
  • aqconces on 09 Mar 15
     
    Is it possible to think yourself to death?
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