Friday, April 7, 2017

Placebo Effect Ignorance

I was recently asked this question on Quora: "What is the true impact of placebo effect on science?" My answer:

Ignorance. The true effect, at present, of placebo effect on science is ignorance. Ignorance of cause, ignorance of consequences.

I am talking about the actual impact of placebo effect on science, and doing so in the hope that someday we can change that effect to something as powerful and useful as placebo effect actually is.
First, we need to clearly define some terms. I'll use Webster's. It's a a good place to start. Placebo effects don't “work”. We know that placebos work. But the question is about placebo effects.
Webster's defines “placebo effect” as “improvement in the condition of a patient that occurs in response to treatment but cannot be considered due to the specific treatment used”. Placebo effects are real positive effects that are not caused by the treatment. Therefore, by definition, placebos DO NOT cause placebo effects. This is a common misconception. Oxford's dictionary makes this clear, but then heads over to the “ignorance” position.
Oxford's definition of placebo effect “A beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself”. Correct. But then Oxford cites the “common sense knowledge” (AKA ignorance), finishing their definition with nonsense “ and must therefore be due to the patient's belief in that treatment”.
This is the common nonsense, and it leads to ignorance of cause. Let's be clear:
1. every positive effect has a cause - by definition.
2. Placebo effects are effects where we do not know the cause,
3. Placebo effects are effects where we believe we know what DID NOT cause the effect.
When we assume that the effect is “due to the patient's belief in that treatment” it's easy to ignore the cause and ignore, to not study, the effect. Ignorance.
In actual fact, this creates two problems.
First of all, if the effect is NOT caused by “the patient's belief”, we cannot find the true cause, because we are not searching for the true cause, we are ignoring it. Ignorance.
Secondly, if the effect IS CAUSED by the patient's belief in the treatment, then things get really complicated.
For example, we might try to study how to create or induce the “placebo effect”. But there's a problem. If we can create or increase the patient's belief in the treatment, and our actions cause an improvement in the patient's condition, It's NOT placebo effect any more. It's a real effect, caused by a deliberate action, caused by a real treatment technique. Beneficial, yes. Placebo effect? No.
Also, if we try to induce placebo effect, by increasing the patient's belief in the treatment, then we assume the improvemets are caused by the “placebo” action. This results in dismissal of other potential causes, because we can easily attribute all effects to “placebo effect”. Ignorance.
We need to study every case of placebo effect to find the real causes. Dismissing placebo effect as “caused by the patient's belief in the treatment” is ignorance of other possibilities. There are always lots of other possibilities. Patients are living breathing entities. Their health, their bodies, minds, spirits, and communities are all taking actions to fight the illness. Making the assumption that all of those effects have a single cause, the patient's belief, is simple ignorance of the complex reality.
If we are to understand placebo effects we need to study every case, not dismiss it as “placebo effect”. Every placebo effect is a real effect, with a real cause. Assuming the cause is ALL just in the mind of the patient is ignorance of cause.
When science studies every placebo effect to find every cause, we will learn more about real treatments, real causes, and real effects.
But today, we deliberately design “double blind placebo controlled clinical studies” to IGNORE placebo effect. Nonsense. Ignorance. That is the current impact of placebo effect on science. It's time for a change.
To your health, tracy
Founder: Healthicine


Thursday, March 30, 2017

When Doctors hate Doctors We all Lose Health

Medicine is broken. Fractured. We need medicine based on love, on caring, on helping each other.  Instead, much of modern medicine is based not just on competition, but on hatred.

Of course it's not everyone, and for the most part, I don't believe it's personal. Few, doctors, hate other types of doctors.

It's the system. The so called 'conventional medicine' system. It's a paradigm that hates other paradigms.
Imagine if, for example, civil  engineers decided that they were the only real engineers, and all other engineers were not real engineers. And they told everyone that the bridges designed by other engineers were not real bridges, and the buildings designed by other engineers were not real buildings, that airplanes designed by other engineers were not real airplanes, and told everyone that architectural engineers cannot be trusted, because - after all - they are not real engineers. It would be ridiculous. But in medicine, this type of nonsense is commonplace.
Maybe you've heard a story like this. Maybe you've experienced a story like this:

Dakota, visits a doctor with a problem that's been bothering them for some time.  Dakota has some symptoms, but no idea what caused them, not sure when they started or what might be. The doctor gave a diagnosis, a name for their disease, and a prescription for a medicine.  The medicine is a treatment - the word 'cure' is not mentioned, or maybe the doctor says "there is no cure". The doctor says "take this for a while, and we'll see what happens".  The medicine is a symptomicine.  It helps the Dakota feel better, but cannot cure. Most medicines are symptomicines, working well for illnesses that pass with time, but not so well for illnesses that persist. Symptomicines make you feel better, as your illness progresses. Dakota takes the medicine, and feels better, but there is little change. Gradually, the problem gets worse, and the dose is increased. Dakota begins to notice some effects.
So. Dakota visits an alternative medical practitioner, maybe a chiropractor, or an osteopath, or a homeopath, or a naturopath, or a traditional Chinese medicine practitioner, or an Ayurveda doctor. The medical practitioner recommends a different treatment, and in a short time, they are cured. The disease disappears completely.
What does 'medicine', the study of medicine do? How does the science of medicine learn from this experience?  It simply does not.  Modern medicine ignores cures. Cures are not documented, not counted. There are no statistics for cures. When Dakota goes back to the first doctor, the response is 'interesting'.  But nothing more.  Perhaps an additional comment of "maybe it's just in remission". Modern medicine has serious challenges differentiating between remission and cure.
Whether Dakota is cured by a Traditional Chinese Medicine doctor, or a chiropractor, or a homeopath, or a naturopath, or a hand waving mystic - nobody cares. Even when cured by a conventional doctor - if the disease was not caused by a parasite - Dakota's cure is not recognized, not counted. If Dakota is cured by a homeopath - almost no one will believe it. If cured by a TCM, a Traditional Chinese Medicine practitioner, Dakota might tell all of your friends. But if the original doctor is not interested. Some doctors might be less than interested, they might be hostile. If Dakota was cured by a chiropractor, many friends - some of them doctors, will tell stories about cures by chiropractors, and about problems as well.  But professionally, no conventional doctor will investigate or try to learn - much less to teach their profession, about Dakota's cure. If cured by healing touch, Dakota's cure will be dismissed as 'placebo effect'.  If cured by a shamanic medicine, modern medicine might attempt to find the medicine used, and patent it - but mostly it will be ignored.  If cured by a naturopath, no one but Dakota's close friends will believe it.  If cured by an osteopath, even Dakota's doctor might grudgingly respect the cure, but will not investigate. Professional medical associations don't hate osteopaths, they just ignore them, and their cures as well.
Medicine is fractured. Modern medicine often fails to cure, and ignores cures when they occur. It's actually worse than that.  Modern medicine (although maybe not your doctor) demonizes other practices of medicine - more so when they cure, because modern medicine fears cures. The word cure is often forbidden.
There are entire communities of 'alternative medicine' bashers, who dedicate their time to dismissing entire medical systems, including any cures they produce. Some call themselves 'quack watchers'.  They have a 'quack detector'.  Like the child with a hammer - to whom everything looks like a nail. To a quack watcher - every alternative treatment and every cure looks like a quack treatment or a quack cure.
Do chiropractors cure patients? It's not hard to find a patient who claims to have been cured by a chiropractor. It's also easy to find doctors who hate chiropractors.  Do homeopaths cure patients? Ditto. Do shaman's cure patients? "do you really want to risk your health to a witch doctor?"
Of the many schools of medicine, only two make significant use of the word 'cure'.  Many current conventional medical dictionaries do not contain the words 'cure, cures, cured, nor incurable'.  Chiropractic was developed on a theory of cause and cure: that manual manipulation of the spine can cure disease. But I don't think many chiropractors today take this theory literally. It's simplistic to the point of nonsense - even though in some cases it does produce cures. Homeopathy has a different theory, that "like cures like", that medicines that cause similar symptoms, can bring about cures.  It's pure nonsense.  But there's worse nonsense. Conventional medicine pays so little attention to the word 'cure' that there is no serious challenge to that basic theory of homeopathy. Instead, arguments against and studies of homeopathy are all about the dose, not the results.
Homeopathy is probably the most extreme example of our fractured medical system. Many homeopathic medicines, contain, in theory, NO ACTIVE INGREDIENTS. But sometimes homeopathic treatments succeed, after conventional medical treatments have failed. Maybe you've heard of meta-studies 'proving' that homeopathy doesn't work? Look closer. They're structured nonsense. Studies of specific homeopathic medicines, in clinical study settings, with specific medical conditions. No one dares to test 'homeopathy' as a medical system - to understand when and how it produces positive or negative results or cures. Nobody cares about cures. No conventional doctor, no real medical scientist or researcher wants to understand the truths of homeopathy. Cures are dismissed as 'placebo effects'. But no medical scientist or researcher works to understand placebo effects either. "Placebo effects" is a phrase used to dismiss confusing results, not to understand them.

Two Homeopathy Clinical Studies:

In 1966 the clinical study “Homoeopathic versus placebo therapy of children with warts on the hands: a randomized, double-blind clinical trial.” tested the application of a homeopathic medicine against a placebo, in the treatment of warts. It found that, with regards to symptoms – homeopathic medicines worked slightly better than a placebo. Nine patients benefited from the homeopathic medicine, seven from the placebo. The study concluded: “There was no apparent difference between the effects of homeopathic therapy and placebo in children with common warts under the conditions of this study.” But the conclusion was marred a bit by the fact that the homeopathic treatment cured 20% of the patients warts.  The placebo cured 3.3 percent. According to medical science and statistics, the homeopathic medicine performed 'no better than a placebo'. Cures were ignored. Cure ignorance.
Thirty-two years later, in 1998, an almost identical study “A double-blind, controlled clinical trial of homeopathy and an analysis of lunar phases and postoperative outcome.” was completed. The wart portion repeated the 1966 study almost exactly. There were the exact same number of participants and with regards as to symptoms – the exact same result.  Homeopathic medicines produced shrinkage in nine of the patients, and the placebo produced shrinkage in seven of the patients. The homeopathic medicine performed slightly better than the placebo – in theory, no statistical difference. There was one significant difference between the two studies. The second study did not measure, did not count ‘cured’. The study parameters, apparently, did not include testing for cures. Cure ignorance enhanced, ensured consistent conclusions.
Why has modern medicine has struck 'cure' from the medical dictionary. Why are cures are no longer relevant. Is it because the 'other' medical systems produce more cures than conventional medicine. Could it be that studies of 'cures' are embarrassing to the modern medical system?
What should the science of medicine do in the face of this evidence? Fess up?  Attempt to understand?  Work to help the patient better next time? Try to learn from the experience, and do better? Collaborate, to produce a better medical system?
All of the above and more.
But what does conventional medicine do, when faced with a cure by a different medical paradigm?  First, it pleads ignorance.  After all, cured is not defined. Because cured is not defined, cured cannot be proven.  There was no cure. Maybe it was just a remission. There is only 'anecdotal evidence'. Anecdotal evidence is a mantra of a fractured system, not an attempt to understand.
Every cure is an anecdote.  Every cure is anecdotal evidence. Cures are case studies, not clinical studies. The vast majority of clinical studies don't define cured, don't test for cured, and as a result, cannot find cures.
The practices of modern medicine are fractured, adversarial, competitive and non-cooperative, neglecting and refusing to study and learn from the successes of others.
Actually, let's be honest, and grateful. Much of modern medicine works very well. Emergency medicine excels.  If you have a medical emergency, you go the the emergency department.  There are no 'alternative medicine' emergency departments.  In a medical emergency, medicine steps up and takes responsibility (and check, cash, credit card, or medical insurance, of course).
But when you are just sick, and there is no emergency, good luck.  Medical practice, with regards to non emergency medicine, has little science of cure, only science of 'treatment'. There is lip service to science. Clinical studies. But a close look at clinical studies reveals serious flaws.  The main failure of clinical studies is not hidden, but not obvious. What is 'not present' in most clinical studies: the word cure. Cure is only defined, in clinical studies, for diseases caused by parasites.  Clinical studies for antibiotics, antifungals, and antiviral medicines can use the word 'cure'. But, all clinical studies for diseases caused by a 'not parasite' cannot search for cures.
Conventional medicines and medical treatments MUST be approved by the government, and the government requires proof of effectiveness via clinical studies. But clinical studies cannot cure most diseases - by definition, because cured is not defined. And modern medicine is not pursuing cures for diabetes, heart disease, obesity, arthritis, and more. Clinical studies don't measure cures, they measure 'effects on symptoms' - a euphemism for 'not cures'. Most studies comparing conventional medicines to alternative medicines can be reduced to "which medicine does not cure better".
Clinical studies for cancer use linguistic trickery to avoid this issue, with the phrase 'cure rate'. Cure rate is defined as surviving with your disease.  There is no proof of cure, no test of cure, other than survival. If someone is cured of their cancer, there is no medical test to prove, nor to disprove the cure. What was previously counted as 'survival rate' has been renamed 'cure rate', because although 'cured' is not defined for cancer, 'cancer cure' is a huge fundraising mantra.
Most medicines cannot cure. Most medicines make no claim to cure. 
This is the fracture line in modern medicine. Cure.
Any medical technique that cures, or claims to cure, is considered illegitimate. Modern medicine is not interested in learning from other medical practices, even when they produce positive results, even when they cure.
We need modern medicine to work for us all, for our health, not for themselves. We need a modern medicine that recognizes and celebrates successes by ALL medical practitioners celebrates successes of all patients, for all diseases. We need a medical system that measures cures, and gives credit for cures, irregardless of which type of doctor or medical system the cures come from.
to your health, tracy
Founder: Healthicine

Wednesday, March 15, 2017

Is Wikipedia Fake News: Can Wikipedia be Cured?

Is Wikipedia 'fake news'? Does Wikipedia contain 'fake news'? How would we know?  Well, first of all, we need to understand the concept of fake news, and distinguish clearly between fake news and lies, truths, facts, non-facts, and bullshit. Perhaps we should begin with 'bullshit'.  Harry Frankfurt's essay, "On Bullshit" explores that concept in detail, and also in a nutshell.  "Bullshit is unavoidable whenever circumstances require someone to talk without knowing what he is talking about." Frankfurt distinguishes clearly between lies - the presenter clearly does not believe what they are saying, and bullshit, where the speaker is simply talking about which they know little.

Frankfurt does not actually define 'facts' nor 'truth', although he does point out that "It is impossible for someone to lie unless he thinks he knows the truth." and "The bullshitter ... does not reject the authority of the truth... He pays no attention to it at all...  bullshit is a greater enemy of the truth than lies are." Frank does not make the mistake of assuming that 'facts' exist, instead commenting that "One who is concerned to report or to conceal the facts assumes that there are indeed facts that are in some way both determinate and knowable." He ends with this phrase "sincerity itself is bullshit".

Maybe facts simply do not exist. What exists are beliefs. Dead things have no facts. Live things have beliefs. Beliefs can be accepted, challenged, even changed.

What we believe are facts are, in fact, simply what we believe. What we present as facts, might be what we believe - but they might not, as in this diagram.

Truths are what we believe. We speak truths when we speak what we believe. Everyone has their own truths, which can change over time. Lies are things we say that contradict what we believe. Lies are opportunistic, they change according to current situations. Bullshit is what we present as truth, when we have a need to extend our speech beyond our knowledge, beyond our current beliefs. When we bullshit, we sometimes know we are 'stretching the truth', but we don't consider it lying. Facts are irrelevant, not existing independent of belief.

But none of this is news.

News only exists when someone else reports what happened, or what was said.

Wikipedia, for example, does not want writers who tell us what they believe.  Wikipedia wants references. Wikipedia wants to know what someone in authority said, and who they are, and when and where they said it. Note: Wikipedia does not care if the authority was stating their truths, their lies, or simply bullshitting.  It's not considered important. Wikipedia is based entirely on news. Who said what, where and when. However, unlike many news sources, Wikipedia ignores 'why'.

Wikipedia is a news source, old news and new news.  But is it fake news?  Does Wikipedia contain fake news? What is fake news?  Well, we can ask Wikipedia, and read that "Fake news is a type of hoax or deliberate spread of misinformation, be it via the traditional news media or via social media, with the intent to mislead in order to gain financially or politically." That's one definition. But it's not a particularly good one.  Fake news, according to Wikipedia is simply a lie, a deliberate, known untruth.

Much of the fake news currently on display is outside of the definitions of truths, lies and bullshit. The fake news stories that made headlines, that drove the news about fake news were not "with intent to mislead" in any real sense. In some cases, they are presented with intent to inform.

Satire is fake news.  It is a story, presented as fact, often written clearly as impossible or non-fact, but written to open our eyes. The purpose of satire is not to be funny, but to help us understand nonsense presented as truth.

But there is another, important type of fake news. We might call it 'fake news'.  Fake news is when someone writes a fake story, and presents it as news.  But, we need to ask, what is news?

News is simply what is presented to get money from advertisers. What advertisers will pay for, is news.  If the advertisers won't pay for it, it won't sell, it's not news.  No news source makes it's money from people buying the news. Money is made from advertisers. If you are not supported by advertisers - your news agency goes broke.

A 'fake news website' is a site that creates nonsense news to attract hits and sell advertising. In many cases, the fake news authors don't distinguish at all between truths, lies, and bullshit - because they simply don't care.  Many fake news websites only care about advertising and will publish anything they believe will bring clicks, possibly go viral, and make lots of money.

There are, however, other fake news websites, that actually care about their content. There is, like the gradient between truth, bullshit, and lies, a slightly different gradient for 'fake news reporters'.

Viewing the diagram above, it's not hard to realize that ALL news is, to a certain extent, 'fake news'. The news we get is deliberately written to sell ads.  If it does not sell ads, it's not news - except for the middle group, which are written to spread lies, and uses the news platform to present the fake news.  On the far right, we have nonsense news stories, written as clickbait, to sell advertising.

Where does satire fit into this diagram? In the middle.  Satire contains deliberate lies, ostensibly to make us aware of the truth. But satire, in order to sell, in order to be successful, must sell their lies well.

Is Wikipedia 'fake news'?  Wikipedia has no advertising. Does that make it exempt from fake news? Actually, no.  Wikipedia is written by 'well meaning' people, who want to sell their truths. But there's a problem. Most Wikipedia authors are simply not experts in what they write. They may be experts in research, or in writing, but generally they are not experts in the topics they write about. How do we know this?  It's actually against Wikipedia policy for an expert to write in their field of expertise. To quote Wikipedia, "Wikipedia articles must not contain original research (OR).... The prohibition against OR means that all material added to articles must be attributable to a reliable, published source, even if not actually attributed."

Is Wikipedia bullshit?  No.  But it certainly contains bullshit.  For one, a "reliable, published source" is not well defined. Anyone might claim to quote a reliable published source - and anyone else might claim it is not a reliable published source. Reliable publishers have been shown, many times over, to have published nonsense - aka bullshit.

Here, I offer evidence.  I have chosen a single Wikipedia article, to demonstrate the fake news, and bullshit potential present in Wikipedia.


Wikipedia has an entry for cure.  It has been entered and updated by hundreds of well meaning volunteers - and many interested parties. It might be updated again several times by the time you read this post. But with this entry, CURE, Wikipedia faces a simple problem. There are no experts on 'cure'. None. There are doctors who attempt to cure, and sometimes succeed. There are many people looking for cures, fund raising for cures, testing products and techniques as cures, and even many people finding cures, but there is not a single expert on the concept of cure.

Medical reference books, for the most part, do not define cure. MERCK, Lange's, and Harrison's treatment guidelines do not define cure and do not use the word cure consistently.  The US Food and Drug Administration (FDA), the agency that approves medical cures, provides a glossary of terms, but it does not provide nor follow any definition of cure. The Center for Disease Control (CDC) also provides a glossary on their website - but it does not contain the words 'cure, cured, cures, nor incurable'. Most current medical dictionaries do not contain the word 'cure'. When they do, the definition provided is simplistic to the point of nonsense. Most medicines make no claim to cure, and cannot cure any illness. Many illnesses can be cured, but not by medicines.

So what is a Wikipedia author to do?  Make things up.  Bullshit. And proof that the authors are making things up becomes more obvious, the closer you look.

The first phrase in the current entry for 'cure' on Wikipedia says "A cure is the end of a medical condition;".  It sounds so simple, it must be obvious, right?  But read further.

Down the page, you will find the word 'incurable', and farther down, a link to a list of 'incurable diseases', Take note, the list of Incurable Diseases has re-appeared after being banished from Wikipedia because it contained too much nonsense.  It's back, with more of the same.

The list of incurable diseases says: "Common Cold - The common cold is a disease that mutates too frequently, and is rarely fatal,[3] for a vaccine or cure to be created.[4]". Now first of all, the use of English in this sentence is faulty to the point of nonsense if read literally. I think the author is trying to say "The common cold is a disease that mutates too frequently for a vaccine or cure to be created."

The first reference [3] - Wikipedians love references, is to the Columbia Electronic Encyclopedia, 6th Edition, where it clearly states "Most adult Americans suffer from one to four colds per year,". but.... If an adult suffers more than one cold, certainly if they suffer more than one cold in a year - then the first cold, the first medical condition 'ended'.

Which contradicts the list of incurable diseases.  Either the list of incurable diseases is wrong, or the entry for cure is wrong, or they are both wrong.  They can't both be right. Now, as a serious student of the word 'cure', I can and will untangle this, but Wikipedia does not publish OR.

The second reference [4] is a link to a web article by "Business Insider", who describes themselves thus: "Business Insider is a fast-growing business site with deep financial, media, tech, and other industry verticals. ... the site is now the largest business news site on the web." Business Insider is NOT a medical authority, and certainly not an authority on cures, nor incurable diseases. The article does not state that the common cold is 'incurable', it does not use the word incurable at all, in fact, the web link to the article is "/how-to-cure-a-cold", although the article is titled "Why We Don't Have A Cure For The Common Cold".  It is written by a journalist, an editor, not a doctor. But in Wikipedia, it's a 'reliable source'. The author also confuses the concept of curing 'a cold' - which anyone can accomplish, with 'curing the disease we call the common cold', which no-one can accomplish.

The first phrase, of the first sentence, of Wikipedia's entry on cure is contradicted by the rest of the article. Even though all are, in theory, supported by reliable references.  But, let's read on. What else does the first sentence say? Well, actually, it goes on for quite a while, and seems to say quite a lot.

The Wikipedia entry for cure continues with "the substance or procedure that ends the medical condition, such as a medication, a surgical operation, a change in lifestyle, or even a philosophical mindset that helps end a person's sufferings; or the state of being healed, or cured."

Seriously now. The first sentence in the Wikipedia entry for cure contains - (if my quick count is correct) forty-eight words. The first sentence of the Wikipedia definition for 'cure' contains two phrases, separated by a semicolon, which contradict each other. First, Wiki says that cure is "the end of a medical condition", and then it says cure is "the substance or procedure that ends the medical condition". The Wikipedia entry for 'cure' clearly mixes TWO different definitions of cure, and the article then mixes and matches the definitions, as various authors provide information from 'reliable sources'. Wikipedia does learn, and we might hope that someday there will be two  or more entries for cure. But I'm not holding my breath.

But wait, there's more.  The sentence, again, is nonsense. It clearly says, for example, that a cure is "or even a philosophical mindset that helps end a person's sufferings; or the state of being healed, or cured."

Read that carefully.  It says that 'a cure is.. something... that helps end the patient's sufferings'. Is a cure then end of a medical condition? Or is it just the end of their suffering?

Or perhaps, cure is "the state of being healed, or cured"?  Perfect.  If we want to define 'cure', we just say that a cure is something that makes a patient 'cured' and a cure exists when the patient has been cured.

I could go on.  I often do. The Wikipedia entry for 'cure' is simplistic nonsense.  Bullshit. The more the authors attempt to explain 'cure' the more tangle they become, in their own research and discussion. The Wiki article on 'cure' contains many statements that are simply wrong - at best, or lies at worst?  Some examples:

"A remission is a temporary end to the medical signs and symptoms of an incurable disease."
 - Therefore, it's not possible to have a 'remission' unless the disease is incurable?

"Inherent in the idea of a cure is the permanent end to the specific instance of the disease.[4][5] When a person has the common cold, and then recovers from it, the person is said to be cured, even though the person might someday catch another cold."
 - is the common cold curable? Or incurable?

"The proportion of people with a disease that are cured by a given treatment, called the cure fraction or cure rate is determined by comparing disease-free survival of treated people against a matched control group that never had the disease.[1]"
 - duh. the common cold is 'cured' without a given treatment. So there is no cure rate for the common cold?
 - duh.  The terms 'cure fraction' and 'cure rate' are terms used for 'incurable' diseases, like cancers, and other diseases where a cure cannot be proven.  If a cure can be proven, there is no need for the concept of 'cure rate'. The link in the phrase 'disease free survival' does not take us to a page for disease free survival, instead we arrive at a page "Survival Rate", which begins with this phrase: "This article has multiple issues." Try to not be surprised.
 - cure rate does not measure the cure rate of the patient, nor the cure rate of the disease, it measures the cure rate of the treatment. It's nonsense. We might, for example, treat an abscessed tooth with a punch in the jaw and then measure the 'cure rate' of punching abscessed tooth patients in the jaw, by counting the patients whose abscess goes away and are still alive.

The CURE entry goes on for some time discussing ''cure rate" as if it related to cure.  Frankly, cure rate is simply a highly logical rationalization for 'we don't know if it was cured'', which might be more accurately named 'cure wait'.  eg. Wait 5 years, count who is still alive and call that the 5 year cure wait.

Near the bottom of the article, the Wiki CURE entry lists a single example of a 'cure'. "The most common example of a complete cure is a bacterial infection treated with antibiotics." However, the link to the article provided is broken. It appears that the article was removed, or replaced by an article that does not contain the quote. The revised article on the site linked, if it is the same article, now says "Except for some infectious diseases that we cure with antibiotics, there are almost no diseases where we take them away and they never come back again." If we want to find real examples of cure, provided by trusted resources we can find them in two places.  First, medical reference books like MERCK, Lange's and Harrison's generally avoid the word 'cure', but the do occasionally use the word cure, and document how to test for a cure.  Second, although over 95 percent of medicines sold do not cure, and make no attempt to cure, there are a few medicines that clearly claim to 'cure' on the product label, and the claim has been approved by the US FDA.

But that, in a nutshell is the first true  statement about cure. The only diseases that can be 'cured' by modern medicines are diseases caused by parasites - bacteria, fungi, viruses, which are cured by medicines that kill the parasite.  There are no other cures that are scientifically documented in modern medicine, because there are no other cures that can be tested by a scientific technique. Science fails to find cures - even when they are present. Science often claims there is no cure for the common cold, but recognizes that the common cold is cured by health, that healthy people suffer fewer colds, and cure them faster.

There is another truth about cure.  We can use it to find cures, to test cures, to document cures. But you won't find it in Wikipedia,because you can't find it in any medical reference book today, nor in any 'reliable published source'.

The cure for any illness is to address the cause. 

An illness is cured, when the cause has been successfully addressed. If the cause returns after a cure, like the cause of the common cold - the patient gets a new illness, not a return of the old illness. 

The Wikipedia article on cure?  Simplistic.  Self contradictory. Does it contain 'lies'?  I have no evidence of lies. I cannot prove that any of the statements it contains are the opposite of the beliefs of the authors. But it is certainly fake news. Nonsense. Self contradictory. Bullshit, as defined in Harry Frankfurt's essay. People speaking or writing beyond their current knowledge.

to your health, tracy

ps. There are many useful articles on Wikipedia. I use Wikipedia a lot to find information and sources. But I am always aware that much of Wikipedia is fake news written by non-experts, and that expert opinions, also known as "original research" is forbidden. Many posts on Wikipedia are similar to the article on 'cure' - I suspect some are worse.

ps, ps.  The Wikipedia article on CURE, as well as the list of INCURABLE DISEASES, make no useful distinction between a disease (a class of illnesses) an illness - a specific case of illness, and a medical condition - a much broader concept which includes things like broken arms, gunshot wounds and amputated legs.  A disease - a general concept, cannot be cured. There are three clear and simple meanings of cure, which can be understood when we clarify what we are curing.  An illness, a specific case of a disease, is cured by addressing the cause. A medical condition like  broken arm can be healed - that's a type of cure.  An amputated leg can be healed to close the wound, but not cured.  Finally, we can cure disease before it happens, just as we can 'cure the cat of jumping up on the table'.

Thursday, March 9, 2017

The Death of Skepticism and The Rise of Fake News

Skepticism is dead.  Skepticism has been captured and converted to dogmatism. When I was young, I remember one of my cousins commenting "You are such a skeptic." It made me feel proud to be skeptical, to search for the truth.  But today's, skeptics don't search for the truth. Most claim to have found it.

Skepticism has become the new religion. It's not a religion of analysis, nor thoughtfulness, nor of skepticism.  It's the religion of dogma. Skepticism has been co-opted, in service of the prevailing dogma, the invisible dogma.

Perhaps, before we go any further, we might take a look at the dictionary definitions of skepticism and dogma, in the interest of knowing what the bleep we are talking about.

Skepticism Defined: 

Webster's dictionary:
1. a skeptical attitude; doubt as to the truth of something. "these claims were treated with skepticism"
synonyms: doubt, doubtfulness, a pinch of salt;
2.PHILOSOPHY - the theory that certain knowledge is impossible.

Oxford's Dictionary:
A sceptical attitude; doubt as to the truth of something. ‘these claims were treated with scepticism’
Philosophy :The theory that certain knowledge is impossible.

Dogma Defined:

Webster's:  something held as an established opinion;
Oxford Dictionary: A principle or set of principles laid down by an authority as incontrovertibly true.

Punt SKEPTIC into google.  Take a look at these 'so called' skeptics:

Skeptic - magazine and website 'The society is dedicated to educating the public about controversial claims.'.
Skepti-Forum 'Keeping the Science. Removing the Fiction'.
Skepticalscience -'getting skeptical about global warming skepticism.
SkepticalaboutSkeptics: 'focuses on the people who fall in the dogmatic denier category because they present themselves as being the most truthful and objective, which they are not. '

Let's look at "Skeptic" first, at their manifesto, which says "Modern skepticism is embodied in the scientific method, that involves gathering data to formulate and test naturalistic explanations for natural phenomena. A claim becomes factual when it is confirmed..."

Then, the hedging begins.. "to such an extent it would be reasonable to offer temporary agreement." 

and continues to waffle with "But all facts in science are provisional and subject to challenge, and therefore skepticism is a method leading to provisional conclusions."

Seriously? What is skepticism? Is it science? Is it "a method leading to provisional conclusions?" Is it the 'best results of science'? Or is it "all facts are provisional and subject to challenge"?

What does say about the Oxford dictionary definitions of skepticism?

"this position is sterile and unproductive and held by virtually no one (except a few confused solipsists who doubt even their own existence)" clearly states in their manifesto, that they don't believe skepticism is useful or productive, and that any real skeptics are "a few confused solipsists" - and then they get the definition of solipsist wrong. Look it up if you like. and Skeptic magazine pretend to find truth through skepticism. They are not about doubt,
they are about truth,
their truth, and
nothing but their truth -
they present nothing but dogma, and call it skepticism.

Is is actually 'skeptical'?  Sorry.  No. has very specific positions on may controversial questions.  They do not consider contrary positions valid or useful.  They will not tolerate skepticism of their truths, their faith.They will NOT consider, support, nor publish contrary positions. is simply not skeptical.

Skepticism, by definition, is doubt, not truth. At, skepticism is dead.

How about  Are they skeptical?  Sorry.  No they are not. Skepti-Forum's tag line reads "Keeping the science. Removing the fictions." Skepti-forum is not skepticism, it's scientism: "an exaggerated trust in the efficacy of the methods of natural science applied to all areas of investigation (as in philosophy, the social sciences, and the humanities)" (Webster's) - it's dogmatism. 

Skepti-forum is a confusing array of discussions of various items, pretending to be skeptical, but frankly, losing it by supporting much nonsensical illogical thinking. One simple example: "1,800 Studies Later, Scientists Conclude Homeopathy Doesn’t Work".  Fake and real skeptics often make the mistake of making negative claims, as if they were claims of fact - and this is a classic example. The research, 1800 studies, were studies of homeopathic medicines - not homeopathy.  There were no studies of homeopathy.  But the conclusion: homeopathy doesn't work.  Sorry, Skepti-forum.  You can't use studies of A to prove B. 


SkeptialScience is about global warming.  Tagline: 'Getting skeptical about global warming skepticism.'  So does that make them skeptical, or skeptial-skeptical (is that a word).  Does being skeptical about skeptics make you a skeptic?

Does SkepticalScience provide skepticism?  Nope. The sidebar on their website clearly states "MOST USED CLIMATE MYTHS: and what the science really says".  Skeptical science is about science? The science they want to support.

SkepticalScience is about the current scientific dogma, not about skepticism. It's about climate change. Maybe the science they present is correct and important - but it's not skepticism.


Skeptical about skeptics is an interesting site.  They list their mission thus: "Skeptical About Skeptics is organized by The Association for Skeptical Investigation to promote genuine skepticism – the spirit of enquiry and doubt – within science. This includes an open-minded investigation of unexplained phenomena, a questioning of dogmatic assumptions, and a skeptical examination of the claims of self-proclaimed skeptics."

They recognize - as I have pointed out, that most, perhaps all, of the websites claiming to be skeptic are actually dogmatic, not skeptical.  But this still leaves the question, is SkepticalAboutSkeptics 'skeptical' themselves?

If someone claims they are skeptical, and you believe they are not, does that make you skeptical?

Is SkepticalAboutSkeptics dogmatic in their reviews of pseudo-skeptics? Or are they skeptical? Or are they simply analytical, logical, sensible?  Are people who are analytical, logical, and sensible 'skeptical'?

If you study some of the posts on SkepticalAboutSkeptics, you might gradually learn that SkepticalAboutSkeptics is simply not consistent.  It is not consistent about research, it is not consistent about it's own mission, or goal - as stated on the ABOUT page: "It is the goal of Skeptical About Skeptics to show you the reasons why you’re only getting one side of the story."

Is that goal 'skeptical'?  Frankly, no, it is not.

If Skeptical about Skeptics is truly skeptical, they're not very good at it.

In conclusion:

“War is peace. 
Freedom is slavery. 
Ignorance is strength.”  - George Orwell, 1984

Skeptics are not skeptical.
Skepticism is dead.
All news is fake.
All your truth are belong to us.

to your health, tracy

Sunday, February 12, 2017

Freedom: Why all Our Bosses are Idiots

Did you ever wonder why your boss is an idiot? I mean, really.  It's a universal concept.  Do only idiots become bosses? Are bosses more likely to become idiots because of the pressures make them stupid? What's going on?

Actually, it's very, very complicated - but relatively easy to explain. Let's begin before the first boss, with the first sign of life.

Dead things, after all, don't have bosses.

A single cell. It is, in theory, totally independent. But theory doesn't last for long in practice. Cells grow.  When they grow, eventually, they grow too big for their skin, and they explode.  If the explosion is a failure, they die. But if it is a success - two cells emerge.

Each cell is no longer just an individual - it is part of a community. Cells in a community can compete, or cooperate. Actually, they do both. Every cell is still an individual, so it competes. But every cell also benefits from cooperation. A single cell could not cooperate with anyone.  Two cells can cooperate.  Cooperation is a new force, that did not exist for a single cell. The force of a boss has emerged.

What does this boss look like? Cooperation is an invisible boss. It does not need to tell anyone the rules - the rules lead to success. Going against the rules can lead to failure, or non-optimal success. Cells that cooperate do better, even when boss is invisible, they still follow the rules.

Cooperation, the first boss, provides benefits for cells in the community. Cooperation is the community.  If there is no cooperation, there is no community. When cooperation is strong, the community is strong.  Even in a strong community - there exist strong individual cells, they can develop many strengths that isolated cells cannot practice. Often, just being in the community provides benefits to individuals. Cells benefit from the warmth of friendly cells. In some cases, an individual cell might do better by taking advantage of the community, breaking the rules, stealing pencils, or eating other cells, for example. But overall, the community rules, because the rules are the community.

The cells are not aware of the boss, of the community.  Each cell is only making its own decisions, looking out for number one. If the cells were asked, they might reply "The boss (community) is an idiot.. It doesn't have any idea what's best for us cells. It's just looking out for itself." And it's true. But that's not all that's true. As the community becomes stronger, it forms a tissue - a higher level entity consisting of cells, in many cases, different types of cells working in cooperation.

These communities of tissues can compete with each other.  But, gradually, communities of tissues begin to cooperate as well. It happens entirely by accident, by coincidence - but it can lead to higher levels of success. When tissues cooperate, the result of this cooperation is a higher level entity, a higher level boss. The rules of this boss are rules that promote the community of tissues, which are communities of cells. Tissues, as bosses, have their own goals - higher level goals than single cells, or even communities of cells. Entities that are communities of tissues have still higher level goals.

Communities of tissues are separate living entities like lichen, fungi, plants, etc. These living entities are their own boss. Their bodies are boss of their tissues, boss of their cells.  The lower level tissue and cell entities have no idea. They are not conscious. Each is looking out for number one. The lichen, fungi, plant, makes its life decisions without any regard for it's cells, or it's tissues. Except that to succeed, they must succeed in some fashion.

Communities of tissues can develop limbs and bodily organs. And then another layer emerges. Limbs cooperate, in animals - even in simple insects, to facilitate locomotion. Bodily organs cooperate to create a healthier, more flexible body. With more capabilities, more opportunities.

The body is also an invisible boss.  Some organs, some limbs, fight for more, for their tissues, grow larger - sometimes so large they put the entire entity in jeopardy. The cells want to grow. The tissues want to grow. The limbs want to grow. But the body needs control. The body needs to be the boss, or it might fail, and die, or fail to reproduce.

We might imagine the cells in our skin, in our blood, in our liver, saying "if only the boss would X, we would be much better off" and believing that the boss would also be better off, if they were better off. Sometimes, they might be right - but often not.  The objectives of cells, go  grow and reproduce, are often in opposition with the objectives of tissues, of organs, of the body.

As the hierarchy rises, each new layer creates a new set of abilities and objectives, that are not available to entities lower down in the hierarchy. It also creates new vision.

As humans, as individuals, we each have many of our own bosses. Are we controlled by our bodies?By our minds? By our spirits? By our desires? By our communities?  When we look closely, we see the need for different individual bosses at different times.  Our short term boss wants to get fed, to get sleep, to enjoy life. These bosses are often not logical - they are driven by feelings and emotions. Our medium term boss wants to get ahead, to keep fit, to gain control of our lives - this boss is our mind, but it is not always in charge. Sometimes our desires and feelings override our mind.  Sometimes our mind overrides our feelings. Sometimes, our strength of spirit can put aside our feelings, and allow the mind to rule. Sometimes, a stone in our shoe takes control from the mind, the spirit, and the body - until we deal with it, and then we can pay attention to a different personal boss. Sometimes our family, or other community - the church, the government, the corporation, works as a boss, to change our plans or actions, to move us in a different direction.

But in truth, as an individual ,we cannot be free without making decisions. We cannot be free without creating our own boss, and changing who is boss, and the decisions made, as circumstances change, and as our life and our viewpoints change.

Now let's look at a human boss. A human boss is one step up the hierarchy from the individual. The human boss has a different viewpoint - different objectives. If the human boss makes the right decisions, sometimes those decisions will be good for the workers, but sometimes not so good. If the boss makes the wrong decisions, sometimes those decisions will be good for the workers, but sometimes - not so good. The workers are in a different position.  They usually can't see or know the boss's goals, whether those goals are perfectly aligned with the entire organization, only a part of the organization, or not at all.

There is another complicating factor.  The boss is also a human, with personal objectives. In some cases, for example, the boss's goal might be to get a promotion, to escape from those workers, or to retire wealthy at any cost.

In any case, the boss is often seen as an idiot - from the worker's perspective.

Then, it get's more complicated. The boss often works for a team of bosses.  That team has a boss. The boss's boss has different objectives than each lower level boss.  And different objectives than the workers. Sometimes, the decisions made by the boss's boss are good for the boss, and good for the man, and good for the team. Sometimes not. It's the nature of a functioning hierarchy, that different levels have different goals and objectives, and those objectives change over time.

When they are not aligned, it's easy to see that the boss's boss is an idiot too. Even when they are aligned, as much as possible, it's easy for some workers to see each layered boss as an idiot, not understanding the personal needs and objectives of the worker. And so it goes.

The higher the hierarchy, the higher the layers of idiot bosses. I once worked for a company that had 5 layers of bosses, and then a board of directors, and finally the owners. Each had their own objectives, which changed over time - even more so as individuals came and left. I was a first level boss.  My boss, was an idiot - a real idiot.  But when I went up the hierarchy to complain, I was made aware of the reality. My boss was the son of an owner. He got his job as a family 'perk'.  He was not expected to do his job well - it was my job to help pick up the slack. I resigned, but then I had to find a new job, a new boss... for better or for worse.

There is no doubt of one thing.  Every boss is an idiot - to the people below.  Many are idiots to their co-workers, and some even idiots to their superior bosses, who are deliberately planning to eliminate them.

On the other hand, we need to recognize that we all need bosses.  Our bosses and their communities give us more opportunities, more power than any single individual. They are what makes us stronger than plants and animals. We need our idiot bosses. They make us stronger and healthier - except when they don't.

That's how it is with health, and with freedom. It's never simple. Health benefits from multiple layers of hierarchy. Every new layer creates new opportunities for cooperation and for competition. There are lots of questions, and no easy answers, except this: all bosses are idiots.

To your health, tracy

Monday, January 23, 2017

How Healthy are Your Freedoms?

Are our freedoms healthy?  In healthicine, we say "Everyone has a right to life, liberty and the pursuit of healthiness" because healthiness includes all freedoms and more, and is therefore superior to freedoms. We often think of freedoms with the phrase "life and liberty", but there is much more to freedom.
Freedoms begin with the body, rise into our mind, encourage our spirits, and are liberated and constrained by our communities.
We can look at life, at each life entity, as a hierarchy rising from body, to mind, to spirits, to communities, each existing in their environments. What about freedoms? Let's begin at the beginning, the body.
Our bodies have freedom to move.  When we are young, we don't often think about it. But, I'll never  forget the time I took an elderly friend to a clinic, and the first question the nurse asked was "can you clip your own toenails?". "No.", he replied, "not for many years."
It never occurred to me that someday I might lose the freedom of movement to cut my own toenails.  But there it is. I should live so long. Our bodies have physical freedoms.  Is it healthy to have 'more' physical freedoms? I'm not sure, but I know it's healthier to be able to clip your own toenails, even if you choose have someone else do it for you.
What types of freedoms does the body have? The body has freedom to move, freedom to stop moving, to rest, and even freedoms to change itself - to cut it's own toenails, if necessary. In summary, the body has freedom to change.
The mind has different freedoms. Don't think of the mind as the brain. The brain is part of the body.  The mind consists of the processes, conscious and unconscious, that happen in the brain components including sensory organs and nervous systems. The mind can make decisions. Not only that, the mind can make decisions, and stick to those decisions, or change them. It is free to remember what it decided, or to change what was decided. The mind can learn, but not only that. The mind can choose to teach itself, or to neglect what it has learned - consciously or unconsciously. Likes and dislikes are learned, and as a result, the mind has freedom to change what it likes, what it doesn't like; what it likes to do and what it doesn't like to do; what it wants to do, what it doesn't want to do.
A healthy mind has freedom to choose. Freedom to choose to change what has been chosen, to choose again - the same or differently.
Our spirits have other freedoms. Perhaps a moment to define what I mean by the spirits. Minds and spirits evolved together, so closely that it is almost impossible to state with certainty which came first.  There is no doubt that even the smallest animal has a mind, and also has spirits. Senses provide input from the outside world and also the internal states.  The mind remembers, forgets, and calculates. Working with the spirits, it decides. What do the spirits provide that the mind does not?  Fear.  Anticipation. Joy. These higher level emotions are not logical, cannot be calculated by the mind. They are not directly connected to our senses, they emerge from the complexity of sensory components. If they can be calculated, they are simple facts - part of the mind, and there is little need for emotion.  Why do we need emotions?  To make better use of the past to facilitate our future. To anticipate danger, to anticipate and enjoy success. To feel excited, or bored - so that we move towards excitement and opportunity.
What freedoms do our spirits have?  The freedom to change. If our spirits cannot change, then once we become depressed - we might stay depressed, even in the face of opportunity. Once we become happy, we might stay happy - even in the face of danger.  Healthy spirits are always changing, feeling what is happening, what might happen, analyzing what has happened in the past.  Unhealthy spirits are stuck. Healthy spirits have freedom to change.
When we normally think of freedoms - we might first think of community freedoms and constraints: parents, family, religion, the law, the government, corporations - are entities that restrict our freedoms. If we don't behave, as judged by a community, we get put in our room, in purgatory, jail, or worse. It is important to understand that communities also enable our freedoms. Communities provide opportunities for cooperation, which creates many things and opportunities an individual could never create by themselves.  Humans cannot live without the assistance and opportunities provided by communities. From paths to roadways to highways to jet flight paths. Created by communities, not by individuals.  It is possible for an individual to create a path, even a small road, but it's easier with a community - and with a community, it's much more useful. Sharing is an important aspect of freedom. Communities have freedoms too.  They have freedom to grow, to shrink, and freedom to change.  Over the long term, families, labour unions, companies and corporations, religions and governments grow and change.  Communities have freedom to change. When a community loses freedom to change, it becomes weaker, less healthy.
"The spirit is willing, but the flesh is weak", a common phrase about the differences between the freedoms of the spirit and those of the body.  Maybe the body is tired.  Maybe the mind is convinced that there is no time, or no logic to the action.  Sometimes, it's actually "the spirit is willing, but the mind is weak". In other situations, when the spirit is willing, the mind can overrule the body's complaints.  Freedoms, even individual freedoms are not simple, not trivial - are often in conflict. That's the way of health, the way of life.
When we look analyze in more detail at the relationships between body, mind, spirits and communities, we might see something like this. In this diagram we can see that mind/body (or body/mind) and spirit/mind, and community spirit are also important considerations. Body and mind compete and cooperate. Spirit and mind compete and cooperate with each other creating spirit-mind, or mind-spirit. Communities and individuals compete and cooperate.  This is how freedom works.  Not by absolute rights and absolute wrongs, not by complete freedom of individuals, not complete freedom of mind, nor of spirit, nor of communities.  The freedom to compete for attention, to compete with other layers, and also freedom to cooperate with other layers are essential to freedom. We need freedom to make better choices in complex situations.
Freedom is not about actions, not about thought. It is about choosing.
But for every individuals, choosing freely is not so simple. Choosing freely is simply not possible, unless we identify which layer is choosing, and I suspect, if we look closer, we will find more layers of wants, needs, goals, and objectives, of choices. Our bodies are, after all, communities of cells, which compete and cooperate freely to create communities of tissues, which compete and cooperate freely to create communities of organs and limbs, which compete and cooperate freely to create organ and limb systems, which compete and cooperate freely to create and maintain our body. Mind, spirits, and communities simply extend the cooperation, and the competition; the freedoms that bring life and health. Freedoms do not exist without constraints. Freedoms do not exist without the need to decide which freedom to choose, consciously or unconsciously.
Are our freedoms healthy?  Which freedoms are healthier? Which are less healthy? Freedoms that serve one area, be it body,  mind, spirits, or community, but detract from the other areas, are less healthy.  Freedoms that function in or assist more than one area are healthier.  Freedoms that limit freedoms, like community laws against individual or community actions -risk decreasing healthiness.  Freedoms that enable other freedoms are healthier.
Absolute freedoms are not true freedoms, not truly healthy, they are the freedoms that do not change, freedoms that are sickly, that lead to sickness in other areas.
The healthiest freedoms are freedoms that facilitate positive changes, that facilitate more freedoms.
to your health, tracy

Tuesday, January 3, 2017

A True Placebo has No Effects

Do clinical studies lie? A true placebo has no effect. Is the Gold Standard of medicine, the double blind placebo controlled trial, scientific nonsense, based on "fools gold"?

A placebo effect, is defined by Webster's dictionary as: "improvement in the condition of a patient that occurs in response to treatment but cannot be considered due to the specific treatment used".

In other words, a placebo is not caused by a placebo. If it is a true placebo, then it did not cause the placebo effect. Only false placebos can cause placebo effect.

How can this be? Aren't placebos a gold standard tool of modern medicine? Actually no. Placebos are scientific nonsense.

The best known, perhaps first, serious medical consideration of placebo effect, was written by Henry K. Beecher, M.D. with the title "The Powerful Placebo". Beecher documented many situations where a placebo, given to a patient in a clinical study, had a powerful effect. But the placebo given, by definition, could not cause the effect.

But Webster's says the effect "cannot be considered due to the specific treatment used". How can a placebo have a powerful effect, if placebo effects are not caused by the placebo?

The Oxford Dictionary attempts to provide an answer with their definition: “A beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment

This answer that has been used to support many medical research studies.

But, it's nonsense.

If placebo effect is "due to the patient's belief in the treatment",

then... if we treat the patient by modifying their belief and we successfully change the beliefs of the patient,

then...changing the patient's belief is a treatment. It's the that treatment caused "the beneficial effect" on the patient.

But, by definition, it's a real treatment, causing a real effect, not placebo treatment.

A placebo treatment cannot cause placebo effect. When a treatment causes an effect, it's not a placebo treatment. 

How can this paradox be resolved?  It's easy actually. We need to rewrite the definitions of placebo and placebo effect, with definitions that make sense.

Placebo Effect: a beneficial effect on a patient's illness, where we do not understand the cause. 

 - when we understand the cause, it is not a placebo effect.
 - when we don't understand the cause, it is placebo effect.
 - when we figure out the cause of a placebo effect, it becomes a real, known cause, and the placebo effect disappears. It's converted in to a real effect.

Placebo effects are like shadows, illusions, unknowns, caused by misunderstanding. As soon as we understand, they disappear.  They become real effects.

But... If a placebo effect is an effect where we do not understand the cause, then, what is a placebo?

Placebo: a treatment followed by a beneficial effect on the patients illness, where we do not understand the cause of the benefit.

We're not saying the placebo caused the effect.  Maybe it did.  Maybe it didn't. We don't understand.

What does this mean for the Gold Standard of medicine, the double blind, placebo controlled, clinical trial?

A double blind placebo controlled clinical trial pits a placebo against a new medicine or treatment. Sometimes, the medicine wins. Often, it's a statistical, technical draw. Once in a while, the placebo wins.

Let's look at all six cases.

Six cases? Aren't there only three possible results?  Actually no. There are six possible results for any treatment, depending on whether the treatment cures, or only makes the patient (or the doctor) feel better. When a treatment cures, the results have a different meaning.

When the Treatments cure:

1. If the cure is only produced in the medical treatment group, and never produced in the placebo treatment group, the medicine is clearly the best treatment.

2. If the cure is sometimes produced in the medical group, and sometimes in the placebo group, then - we really don't know what happened.

3. If the only the placebo treatment group produced cures, then we need to study the placebo treatment, and abandon the medical treatment.

NONE of the above situations occurs in today's clinical studies. Today's clinical studies don't cure. Almost never.  If the treatment cures, it is not necessary to test against a placebo.  Why not? There are two main reasons:

a. A cure is a cure. If we know how to cure, there is no need for a clinical study. We diagnose the disease - and prescribe the cure. The illness is cured.

b. Cured is not defined for most diseases. Cured is almost NEVER defined for clinical studies. There is no need to define 'cured' for a double blind placebo controlled clinical study. In the vast majority of clinical studies, if a cure is encountered, it is ignored. Cures are not defined for the purposes of the study, and it is assumed that any cure is not a result of the medicine being tested.

When the Treatments Don't Cure:

The clinical study might produce a beneficial effect on the patient's illness, or their symptoms of illness, (or not), but it cannot produce a cure for the illness. Most clinical studies have no intention to cure.

4. If the treatment group gained more benefit, than the placebo group, the treatment wins.

5. If a benefit results from the treatment group, and the placebo group also sees a benefit, then we really don't know what happened. This is the result of many, perhaps most, double blind, placebo controlled clinical studies.

6. If the placebo group benefits more than the treatment group - we should to pursue the placebo treatment, and discard the medical treatment.  But that never happens.  What actually happens? We dismiss the placebo treatment, and pursue a different medical treatment.

And the Winner is? 

Most, almost all placebo controlled double blind clinical studies today result in 5. The treatment group sees some benefits. The placebo group sees some benefits. We're not really sure what happened.

If the treatment group wins, the treatment heads to market.  If the placebo group wins, the results are discarded.

How can this happen? It happens because the goal of double blind placebo controlled study is to find a medicine that "does not cure" better than the placebo treatment "does not cure".

Double blind placebo controlled studies measure which treatment "does not cure better".  The result is predictably, nonsense, failure to understand.

We know that we don't know why the placebo treatment worked some of the time. But nobody cares, because they forget that a true placebo treatment has no effects.

The next time someone says "It's probably just placebo effect.", ask: 
"Was it caused by a real placebo, or a false placebo?"

to your health, tracy