Two hundred patients with abnormal symptoms, but no signs of any concrete medical diagnosis, were divided randomly into two groups. The patients in one group were told, ‘I cannot be certain of what the matter is with you,’ and two weeks later only 39 per cent were better; the other group were given a firm diagnosis, with no messing about, and confidently told they would be better within a few days. Sixty-four per cent of that group got better in two weeks
People who are incompetent suffer a dual burden: not only are they incompetent, but they may also be too incompetent to assay their own incompetence, because the skills which underlie an ability to make a correct judgement are the same as the skills required to recognise a correct judgement
Either way. Today, similarly, there are often situations where people want treatment, but medicine has little to offer—lots of back pain, stress at work, medically unexplained fatigue and most common colds, to give just a few examples. Going through a theatre of medical treatment, and trying every medication in the book, will give you only side-effects. A sugar pill in these circumstances seems a very sensible option, as long as it can be administered cautiously, and ideally with a minimum of deceit.
There is an almost linear relationship between the methodological quality of a homeopathy trial and the result it gives. The worse the study—which is to say, the less it is a ‘fair test’—the more likely it is to find that homeopathy is better than placebo
The placebo is not about the mechanics of a sugar pill, it is about the cultural meaning of an intervention, which includes, amongst other things, your expectations, and the expectations of the people tending to you and measuring you.
There have been over a hundred randomised placebo-controlled trials of homeopathy, and the time has come to stop. Homeopathy pills work no better than placebo pills, we know that much. But there is room for more interesting research.
The people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour
Scientific knowledge—and sensible dietary advice—is free and in the public domain. Anyone can use it, understand it, sell it, or simply give it away. Most people know what constitutes a healthy diet already. If you want to make money out of it, you have to make a space for yourself in the market: and to do this, you must overcomplicate it, attach your own dubious stamp.
From the state of current knowledge, around 13 per cent of all treatments have good evidence, and a further 21 per cent are likely to be beneficial.
It turns out, depending on speciality, that between 50 and 80 per cent of all medical activity is ‘evidence-based’.
We know that two sugar pills are a more effective treatment than one sugar pill, for example, and we know that salt-water injections are a more effective treatment for pain than sugar pills, not because salt-water injections have any biological action on the body, but because an injection feels like a more dramatic intervention. We know that the colour of pills, their packaging, how much you pay for them and even the beliefs of the people handing the pills over are all important factors. We know that placebo operations can be effective for knee pain, and even for angina. The placebo effect works on animals and children. It is highly potent, and very sneaky.