Episode 30 – 16th April 2010


[Direct MP3 Link]

The parties in libel reform by James O’Malley & Liz Lutgendorff (ft Simon Singh, Lord Bach, Joanne Cash, Evan Harris)
Hung Parliaments by Malden Capell
Requiem for a Species by Dave Cole (ft Clive Hamilton)
The Placebo Effect by Mike Hall
iPad by Salim Fadhley

Follow up links:

4 thoughts on “Episode 30 – 16th April 2010

  1. Mike
    I enjoyed your placebo piece and have some obervations.
    Placebo effects and non specific effects are present in both wings of medical treatments ie. when the patient is given a ‘real’ drug they are still under the influence of expectation and all the statistical anomalies that are also present in the placebo.
    So when comparing data between ‘real’ and placebo, if the trial is done in the proper double blind model, the ‘real’ drug effects are a combination of effects ie real effects (if any) and placebo effects. For this reason I think you cannot discard the measureable effect of the placebo.
    Also ‘mind over matter’ is not that weird, it is happening all the time. eg. we see the new Doctor Who’s assistant and a warm glow appears in the middle of our bodies. Result!

  2. Re: placebo effect.
    It is perfectly possible that observer bias is responsible for the observation of faster ulcer healing time with 4 versus 2 placebo pills. The outcome (ulcer healing) isn’t really an ‘objective’ measurement as stated by Mike Hall but has to be assessed by a visual inspection of the ulcer with an endoscope. That observer may have conscious or unconscious bias in deciding whether that ulcer has healed or not. If the observations were made by someone totally unconnected with the trial (who might not even have known WHY the observations were being made) then this sort of bias would be minimised.

    A further thought on the value of the placebo response. In my own field of pain management, objective assessment is virtually impossible (as stated in the podcast). The trouble is, that almost all of the interventions in pain management (analgesics, anti-inflammatories, injections, physiotherapy, psychological interventions etc) fare little better than placebo in clinical trials. That is to say, they work but not very well. So why use them at all? Most of the treatments for pain work in about 30% of people (similar to the placebo effect. also similar rates for acupuncture, homeopathy, chiropractice etc), but you cannot tell which 30% of people will respond to any particular intervention. So it makes some sense to try lots of different ones until you find one that works for that person. After all, 30% response rate is better than zero.

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