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by vacuity
529 days ago
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I think your points are mainly issues with determining that an experimental treatment actually has a significant effect. They aren't as relevant to explaining how the control group experiences an impact. I've heard that patients and doctors often correctly guess if a placebo was administered, so if a placebo actually does have some mind-driven impact then I would expect it to disappear when known. Then your point 2 reduces to point 3. But noise in how the disease naturally progresses is also split amongst control and experimental groups, and so the important test is the control group compared to people with no treatment at all, or even unwitting of their observation. Although you are likely right that the placebo effect is fairly simple: something along the lines of lowered stress and anxiety from a potential treatment, even if it could be fake. |
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Yes, this is the place where the placebo (and nocebo) effect was observed and where it has an impact.
> But noise in how the disease naturally progresses is also split amongst control and experimental groups, and so the important test is the control group compared to people with no treatment at all, or even unwitting of their observation.
It's basically never possible to do a study comparing a new medication to no treatment, mostly on ethical grounds (beyond the complicated logistics of studying people outside of clinical settings). There are very few diseases for which we have no treatment whatsoever, so it's very rarely ethically acceptable to compare between offering a medication vs no treatment.