Sunday, September 30, 2007

On placebo treatment

Bad science: Pinning down a remedy for backache | Science | The Guardian

The apparent success of acupuncture for treating back pain this week got a lot of publicity with media reports on a recent study.

The article above indicates that acupuncturists should not to be too excited about this. It appears that "random" needle puncturing (where there were needles inserted, but at random points, rather than the carefully chosen points that proper acupuncture theory would dictate) proved almost as effective as "real" acupuncture.

Yet both "fake" and "real" acupuncture did considerably better than the normal medical approach.

I can't be bothered Googling for the details now, but it is my understanding that acupuncture had come out reasonably well from many carefully controlled trials for certain conditions. Although the esoteric Eastern quasi-mystical theory that is behind it is not something I am ever going to sign up to, I have long had the impression that it is the most credible of the 'alternative' medicines. Simply putting pins in people sometimes seems to work at a much higher rate than other therapies.

Anyhow, the article I've linked at the top goes on to talk about the placebo effect generally. Everyone knows it works, but the problem for Western medicine is that both ethically, and from a point of view of medical litigation risk, its widespread use can't really be contemplated.

This has always seemed quite a pity to me. Maybe doctors can argue that the natural therapies have placebo all to themselves anyway. But the natural therapists don't think they are giving placebo treatment. They won't give a sugar pill any more than a GP will.

Can't there be a category of doctor that is given licence to prescribe any therapy whatsoever without risk of litigation, including alternative therapies and placebo? I mean, don't those who participate in studies like the acupuncture one know and consent to possibly be in the group that is given the placebo? Yet it still works for some of them.

So can't we have doctors that the public knows are permanently licenced to try placebo?

Just a thought.

UPDATE: I should've guessed. Horses have been getting acupuncture too. Oh, but horses don't have a placebo response, says a doctor, so that proves it's not working just by placebo effect on humans too.

Look, horses are the last animals to trust in an trial of anything medical. They would just find it funny to put up with the pain of 50 needles, then prance about as if their sore back is cured, because they know that this doctor will be encouraged, resulting in thousands more humans being pricked every year. I bet they have a chuckle about that.

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