On LENR Forum, maryyugo bloviated:
When James Randi’s foundation exposed Sniffex as a fraud, he was sued. The suit was similarly dropped before independent technical experts could perform tests on the device. Strange how that works. You may recall that Sniffex was sold as an explosive detector but was really a dowsing rod which when tested by many different agencies, detected nothing. It and similar devices did and probably still do maim and kill many people who rely on them to detect explosives and IED’s, especially in S. E. Asia and the Middle East and IIRC Africa where they can still be promoted and sold. Amusingly, Lomax the abdominable snow man, still thinks these things have merit. I propose giving him one and turning him loose with it in a minefield so he can prove it if he thinks we are slandering the makers.
I know the Sniffex case and have researched it fairly deeply. Much of what Mary Yugo has claimed is not verifiable, but some is. It does appear that the Sniffex was a very expensive dowsing rod (about $6,000, though there are sources saying as high as $60,000).
However, dowsing rods can detect something, this is where Mary goes too far. What they detect is entirely another issue, I call it “psychic.” Meaning “of the mind,” not meaning woo. A “psychic amplifier” or “sensor” will fail a double-blind test, the kind that Mary considers golden. However, in real life, there are often what are called “sensory leakages,” in parapsychological research. Information that comes through in ways that are not necessarily expected.
In medicine, there is the placebo effect, but, then, are there approaches which amplify the placebo effect? Clinical manner certainly would. Anything else?
I never claimed that the Sniffex “had merit.” This is Mary’s corrupt interpretation, radically misleading, like much of what Mary writes.
And I never claimed that Yugo was “slandering the makers.” Mary made all that up.
Mary does not understand what is in front of “her”, the actual conversation with a real person, but imagines that “she” can understand far more difficult issues.
There is one circumstance where the Sniffex might work better than an obvious dowsing rod: where someone hiding a bomb worries that the Sniffex will work, looking high-tech and all that. The mechanism then would be the same as with any border security: the border guards become very skilled at detecting nervousness or other signs of something being concealed. Someone practiced in this might even move the Sniffex accordingly, just like subconscious motor activity can move a Ouija Board.
To a pseudoskeptic, it is all pure bogosity, but to a genuine skeptic — which Mary is not –, there is curiosity and interest in how something works or might seem to work.
Sniffex does not kill people as Mary claims. Bombs would, and naive guards who rely on something outside themselves for what really would be, to work at all, their own knowledge and intuition, might fail to prevent those deaths. In our time, anyone who relies on something like a Sniffex as anything other than some kind of support for intuition is not smart, and stupid guards cost lives.
Was the company a scam? Did the Sniffex people know it “didn’t work”? I found a story on one guilty plea, but it was in connection with securities fraud, it was not about the device itself being a fraud. There was also an SEC settlement.
Having said that, I would not walk a mile to see a Sniffex demonstration, unless I needed the exercise, then I might for the lulz. Or not. Remarkably, though, for a device that sold for thousands of dollars, I have been unable to find any for sale used. Does that mean that the owners don’t want to let go of their precious Sniffex?
Sniffex detectors are still being sold, apparently. Total BS.
24 thoughts on “Mary Yugo, Sniffex and the Blindness of Reactive Certainty”
Abd I enjoyed your articles regaling us with the fraudulent clown with snakes Rossi and you made some very valid points about the ITER project but you are defending a group thats killing people with dowsing rods , that abhorrent, why would you do that.
Do you know what a double blind test is? You doubt the veracity of its results?
I really like the whole LENR subject area and we probably agree that almost all are crooks and charlatans with sone idd ball cranks but I’m sure that there are a few groups somewhere that are legitimate. For instance, the university if Missouri,if they reported something interest, that would be noteworthy, but if you know of a group anywhere that has gotten useful energy out these various LENR or cold fusion devises , please let us all know because I’ve never read anything from you that would indicate anything of the smallest passing interest and I read everything from you that I see.
Actually it doesn’t even have to pretend to be real, I’m fascinated by why people would have faith in things that are so obviously fake. But I would not be surprised if you wrote me of some interesting efforts, I’m all ears. I love going to Eat world and marveling at the faithful worshiping at Rossi;s altar when you wrote so well about his tricks. Are you banned fromECW I don’t see you on there anymore
Whom did I defend who is killing people?
As to double-blind tests, there are aspects of life that are difficult to test that way. I very much appreciate such testing, I simply understand that there are limitations.
There are genuine LENR researchers, there have been since 1989, and few have been “crooks and charlatans,” it’s rare. The science is called Condensed Matter Nuclear Science, and it is irrelevant whether or not anyone has yet found out how to make “useful energy.” The existence of an effect does not depend on the ease of replication or control. The scientific question is whether or not there are measureable nuclear effects without high applied energy, and the preponderance of the evidence is, yes, there are. So far, what has been found is difficult to control, but nevertheless, the evidence is, I found, convincing.
Sorry, I know of no true “useful energy” projects, Brillouin might be the closest, maybe, but I don’t consider that well-confirmed.
What is confirmed, and currently the subject of new confirmation with increased precision, is the production of helium correlated with anomalous heat in Fleischmann-Pons class experiments. These results do not indicate how to make the reaction more reliable; the ratio appears reliable, though. But that is the research under way. I will report on it when I have more information and permission. These are real scientists and don’t jump into the media.
I am not banned from ECW, probably because I’ve been respectful in my writing there, and they also appreciated my reporting from Miami (and cited it). I also do not hate Rossi. I had no trouble greeting him and wishing him well, and he was certainly polite with me as well.
If it ain’t broke, don’t fix it
I do not think the placebo effect exists. See:
The modern placebo effect hypothesis was introduced in 1955. I think it was a statistical error. The authors did not compare the effect of a placebo to the effects of no treatment at all. That is, not even seeing a doctor. The rate of recovery is the same in both cases.
I think the authors overlooked the rate at which sick people get better on their own, naturally. They ascribed this recovery rate to the placebo.
I am aware that this view of placebos is not widely held, but I think the clinical evidence for it is strong. Furthermore, addressing the broader issues, I think it is extremely unlikely that attitude or mental processes can affect the prognosis of a disease. If that could happen, it would have a profound effect on evolution and population. Pessimistic people would have gone extinct eons ago, or they would be extremely rare.
I think that notions of attitude affecting disease are illusions caused by fear of illness and death. We want to believe that we have a measure of control over a prognosis. But, we do not. Along these lines, there is no indication that cancer is more likely to cured or that survival rates increase because the patient has a positive attitude, faith in modern medicine, or a sunny or optimistic disposition.
Obviously, a person who is so depressed she does not take her meds or go to the doctor is less likely to recover from many diseases. A depressed person who continues to drink or smoke is less likely to recover. But without a direct physical cause such as that, there is no reason to think that attitude plays a role.
Regarding dowsing rods, there is some positive experimental evidence. I suppose that if this is real, it is probably connected to the natural ability of any animal to locate water by visual and olfactory clues, and by people’s natural inclination to use their hands as a means of expression or to assist thought processes. There is no reason to think it would have a supernatural or extrasensory cause.
Jed – it seems the placebo can cause the brain to release dopamine (see http://www.bbc.com/news/health-26191713 ) or endorphins (see http://news.bbc.co.uk/2/hi/health/4176078.stm ). There was also a Harvard study in the last couple of years (sorry, can’t find a link) where the doctors checked for different outcomes based on “bedside manner”. Either the doctor was warm and empathic (better results) or not engaged (worse results). I think if medicine was given was not placebos in either case.
I’m also aware that people often get better whether or not medicine is given, and that this can be ascribed to placebos if they are given, thus that the placebo effect may also be overstated in some cases. I’ve also seen where people improve even when they know it’s a placebo they are receiving.
Maybe the best we can say is that it’s complex, and since no two cases are the same then it’s always going to be difficult to be certain. Placebos may work in some cases but not in others. For some people, spells or faith-healing may work, too.
I am aware of the studies you mention, and claims about dopamine and the doctor’s bedside manner. But the study I cited in the NEJM, along with other studies, indicate that these effects are negligible or nonexistent. I have long suspected the placebo effect is a mistake, for the reasons I gave above. To reiterate:
1. It did not take into account the body’s natural ability to recover. Researchers have compared the placebo to an active treatment; comparing, for example, a sugar pill to a medicine pill. They neglected to compare the placebo to nothing at all — no doctor visit. It turns out the latter has the same effect as the placebo, which means the placebo hypothesis is wrong. The doctor’s bedside manner is no more effective than no doctor at all.
2. If this mechanism existed it would show up prominently in many other ways in biology and evolution.
That was my hunch all along. I did not study the effect carefully or learn much about it. I would not want to claim that I thought of this before the NEJM authors. Many people have suggested the placebo effect might not exist for these and other reasons.
There is no evidence that spells, faith-healing or prayer have any effect on the prognosis of disease. In some cases they may make the patient feel better, or feel less anxious, but as far as I know studies to measure the clinical outcome show no effect at all. You either recover or you die in a happier frame of mind, but the outcome is not changed.
I suppose there is something to be said for dying happy.
I have not studied this in detail so I may well have overlooked a positive study. However, there are some well known large scale studies conducted by people who expected to find an effect from prayer, yet they found nothing.
This does not mean that ancient physicians, shamans and others were useless. On the contrary, they often used valid medical techniques, and effective medicines. There are records of ancient medical techniques. Some of them were quite similar to modern techniques. If your time machine broke and marooned you in the year 4000 BC with a broken leg or in labor, you would be more likely to survive with the help of a doctor than without.
Jed – there’s also homoeopathy, which is as close as you can get to a placebo. Obviously perceived to have some value by some people – see https://www.integrativepractitioner.com/whats-new/all-news/harvard-study-has-good-news-for-homeopathic-medicine/ . IIRC Quinine was originally used against Malaria because Quinine gave the same symptoms (a homoeopathic reasoning) but does in fact work clinically.
On the efficacy of faith-healing, I can offer an individual story. Nearly 30 years ago my dad was dying slowly from Motor Neurone Disease (ALD in the USA, as Hawking has), and my mum had heard of a local faith-healer and thought “what have we got to lose?” so called him in. Mr. Waite called himself a healer, and not a faith-healer, since no faith was required of the clients he treated. He looked at my dad and said there was nothing he could do, but that he could help my mum. She’d had a long history of neck problems, and had been told the bones were worn and thus there was no cure, so she could no longer do knitting or sewing as she used to. He put his hands on her neck, and she said it felt warm. She regained the ability to knit without the pain, and that pain never came back. This is a one-off story, and I’m not that certain the original doctors were correct about bone-wear, and of course my mum didn’t go get X-rays afterwards since it no longer hurt, so this isn’t good scientific evidence. However, Mr. Waite did help a lot of people in the Forest area and had a good reputation. For my mum, it was worth the money.
As you say, something to be said for dying happy. I wouldn’t discount the value of placebos or auto-suggestion in reducing pain or stimulating the brain to produce the chemicals it needs to function well. Where we can see something has infected the body or something is damaged, then I wouldn’t expect placebos to be useful, but where we can’t see any reason for the dis-ease it may be psychosomatic and may thus be “cured” using a placebo or homoeopathy. It seems that diabetes may often be cured by a sustained fast, which re-sets the system. People are complex systems. We may have more control over them (for better or worse) than we currently think.
Yes. As well, being “right” is not all it is cracked up to be. It can be completely useless.
“there is something to be said for dying happy.”
Since we are all going to die, the question is not dying happy or not dying, it is dying happy or dying otherwise. Your choice is?
Jed, what is it that you think does not exist? Are you denying that the brain can treat the body?
The placebo effect is a complex psychic (“of the mind”) and social effect.
Simon talked about what I knew about as “applied kinesiology,” or “muscle testing,” perhaps. The theory is utterly BS. But it might actually provide some benefits, through “psychic effects.” And it might also be used by quacks to extract money from gullible people. The whole concept of “quackery” I don’t particularly trust. I don’t think it ever made anyone happy.
You wrote: “Jed, what is it that you think does not exist? Are you denying that the brain can treat the body?”
Yes, I think that is unlikely. I have not studied this carefully, but in my opinion the evidence for it is a misinterpretation of the data, as described in the NEJM article on placebos. The mind can affect the outcome of the disease only when it causes people to take physical actions on their own behalf, such as taking medicine or losing weight. There can be no direct mind-to-body effect. If there were, and if positive thinking could produce even a tiny improvement, gloomy people would have gone extinct eons ago. Even a small advantage will play a large role in evolution.
I think there are mainly three misinterpretations of the data:
1. Invalid null cases as described in the NEJM article I cited. They did not compare outcomes to a complete blank where there is not only no effective treatment but no visit to the doctor at all. When you make this comparison you find no advantage to placebos.
2. There is correlation and causality but it is reverse causality. That is, an optimistic attitude does not cure disease but rather disease gets better on its own, and this causes optimism.
3. Something similar to what you often call the file drawer effect. Consider a serious disease with four groups of patients:
1. Optimistic survivors
2. Pessimistic survivors
3. Optimistic people who die
4. Pessimistic people who die.
Suppose you are surveying the attitudes of these people a year after treatment. You will hear nothing from groups 3 and 4 because they are dead. You have no idea what their attitude was. It seems likely to me that the number of people in group 4 is larger than 3 because dying from a disease makes people pessimistic.
I think you are also more likely to hear from group 1 than group 2 because optimistic people tend to be more outgoing and willing to discuss their experience. Some of them may feel that their attitude contributed to their recovery so they might want to tell you about that. People in group 2 would not have think their attitude contributed anything. Since they are gloomy they may not want to talk about the experience. You end up with people in group 1 overrepresented.
Regarding reverse causality, imagine a study of these four groups while they are ill, before groups 3 and 4 die. As I said, it seems likely to me you will find many former optimists becoming gloomy people and moving to group 4. Because they are dying. That is a very depressing experience.
Jed, you are considering this in a very narrow way, focused only on “placebos,” and you have not understood what I meant with “the brain [treating] the body.” The human organism is highly integrated, the brain is not some separated thing. Neural activity is neurochemistry and much of our life is chemical messaging. The endocrine system is fully connected with the brain. We do not ordinarily have any consciousness of this, though we can certainly see indirect signs of it. “No mind to body effect,” as you think, imagines a mind that is separate from the body. I visualize myself raising my hand, or simply intend it, or it is even automatic, and my hand raises. That’s psychokinesis, isn’t it? Ah, but there is a connection! Okay, the mind and body are thoroughly and intimately connected, cannot be separated.
In what universe is there no “mind to body effect”? You think narrowly about “positive thinking,” which is totally naive. What does that mean? Jed, what is routine to me appears to be completely invisible to you. The brain is programmable, and “the power of positive thinking,” though often naively understood, is about how to program it to create desired results.
It seems that by the NEJM article, you are looking at an old publication from 2001. Yes, I see you linked it. You might look at something more recent, in that journal, from 2015: http://www.nejm.org/doi/full/10.1056/NEJMp1504023#t=article .
As to the 2001 article, I agree with the conclusion: Outside the setting of clinical trials, there is no justification for the use of placebos.
Howwever, in that context, a “placebo” is a substance known to have no clinical effect, but used with a pretense of treatment. That is, my view, unethical. But why, then, would placebos be used in clinical trials. It’s obvious, Jed. Because of the “placebo effect.” If there is no “placebo effect,” it would be useless to use placebos in clinical trials. Rather, because “treatment” may have an effect, one uses a placebo so that there is “treatment.”
However, there are many treatment interventions that may not be known to be effective, in the sense of proof in double-blind trials. Further, how we think about life affects our lives. Or do you believe that it doesn’t?
I do understand what you mean by the mind treating the body. I do know a fair amount about biology. Mostly evolutionary biology, and as I said, on that basis I think it is extremely unlikely that any conscious thought or attitude can affect the prognosis of disease. If that could happen it would a tremendous advantage, and over millions of years we and other animals would evolve to do it, leaving almost no pessimistic people who do not instinctively try cure themselves with a positive attitude. Pessimists would be as rare as hemophiliacs.
Obviously, brain tissue and brain function has an effect on the body, including healing. But attitude does not.
I do not think the power of positive thinking exists. Believing in it is wishful thinking. It is a myth — and a dangerous myth at that. See B. Ehrenreich, “Bright-Sided.” It is modern idea, seldom seen before the 19th century as far as I know.
“If there is no ‘placebo effect,’ it would be useless to use placebos in clinical trials.”
That is correct. It is useless. However, placebos have to be administered because it is customary, and because it would be considered unethical to do a true blank by refusing to treat the patient at all. I mean turning him away from the doctor without consultation. Since I do not think placebos have any effect, this seems no worse to me than administering a placebo. If I were the patient, I would prefer it, because it be more convenient. But, since many people including doctors think placebos are real, and placebos might help after all, refusing all consultation and treatment would probably be considered a step too far, or even unethical.
There was a study in the U.K. on the effect of placebos in which they did turn away patients untreated, with no explanation. Their recovery rate was the same as the patients who got consultation and placebos.
You wrote: “However, in that context, a “placebo” is a substance known to have no clinical effect, but used with a pretense of treatment. That is, my view, unethical. But why, then, would placebos be used in clinical trials. It’s obvious, Jed. Because of the ‘placebo effect.'”
Yes, that is obvious, but it is a mistake. There is no placebo effect, so the technique is useless. They might as well skip it and send the patient home. Of course the people doing this think there is a placebo effect, but they are wrong. There are many mistakes, many useless treatments, and a great deal of harm in medicine, such as the recent recommendation that systolic blood pressure be reduced to 130. See:
“Further, how we think about life affects our lives. Or do you believe that it doesn’t?”
Only when it leads to physical actions. Not necessarily dramatic actions. It could just be feeding the cat or taking a walk.
Jed, your concept of “disease” is limited. “Attitude” is a complex interpretation of brain activity. First of all, there is no “placebo” technique in ethical medicine. The “attitude” — brain activity — of the physician is also important. (That’s why double-blind testing!) What you might call a “positive attitude” is often a concealed pessimism. There are techniques for managing the brain and how the world occurs to us, but they generally take training (though some aspects are natural for some people). When a physician administers a “placebo,” knowingly, they expect it is useless, by definition, and then there are many other considerations.
Jed, you often write in ways that resemble the attitude of pseudoskeptics. You are radically naive about what you criticize, like pseudoskeptics. You are cherry-picking studies that seem to show what you are claiming.
Your argument from evolution is blatantly in error. Human thinking evolved, including our entire emotional machinery, and, while it is true that the “positive thinking” movement is modern, the roots go far, far back. I actually discussed this issue with Andy Weil many years ago, considering how homeopathy might function. Suppose we can create reality by thinking. Remember Forbidden Planet! Maybe this isn’t such a great idea! Maybe there would need to be safeguards, restrictions! From my experience, there is a truth to creation through word. But it isn’t like you might think. The argument you give is that we would be using this all the time. I will say that we are using it all the time, but that does not make it “all-powerful.” Your argument is essentially that if it existed, it would be all-powerful, it does not appear to be all-powerful, and therefore it does not exist.
The ancient reality underlying creation through word is not an ego-facility, it does not serve individual identity, and if that sounds like psychobabble, it is because you have never actually studied or practiced this.
To actually practice what may be called “positive thinking” requires far more than repeating stupid affirmations that one doesn’t believe. I would not suggest “believing in the power of positive thinking,” which is what you seem to be reacting to. I would suggest, however, learning, through practice and, if possible, training, how the brain works, how our reactive mechanisms seem to be automatic and not controllable, but, in fact, can readily be influenced. And this then has effects on the body, especially through the endocrine system, but in many other ways. For example, I nearly died a year ago. I defined this as a transformative moment, good news, not bad news. My recovery — that may be taking me to levels of health I had not experienced for a long time — required regular exercise. But exercise is boring, right? I redefined it, using techniques that I was trained in and that, to make a long story short, work.
So from what you might call “attitude,” I transformed my daily life in a way that all cardiologists will agree is far more likely to be effective than what they wanted to do: statins and an angiogram and probable stent placement. I am creating the natural equivalent of a bypass operation, collateral circulation. I defined exercise as fun, and continually reinforce this, deliberately. That, Jed, is attitude!
Simply saying “it’s good for me” never worked, I knew that all along. It had to be fun or I simply would not keep it up. And then I network, I make commitments, again and again, involving other people. This is basic human transformational technology.
Attitude governs behavior. If we do not have what might be called a “positive attitude,” we are quite likely to be noncompliant with dietary or other health recommendations. We may not take prescribed medicine. Gradually, our life will become more and more constricted, it is a practical certainty, extremely common.
You acknowledge that “how we think about life” may affect our life, when it leads to physical actions. Indeed, it could be just feeding the cat or taking a walk. Attitude does lead to physical actions (or it is only superficial, shallow, and will often be ineffective, mere lip service.) If you read the journal articles on the placebo effect, they mostly acknowledge that the effect works with pain and other “subjective” conditions. Thinking of pain as “subjective” and therefore not as real as “objective” symptoms, is a medical attitude that I first confronted in my twenties, with the birth of my first child.
My daughter developed Complex Regional Pain Syndrome, which, if not successfully treated, can lead to lifelong disability. Pain. With no apparent “organic cause.” (In fact, another name for CRPS is Reflex Sympathetic Dystrophy, and it is possible that the syndrome arises from a reflect created to protect an injured area. That reflex would exist in the spinal column or in the back-brain. It’s physical! But is system “programming.”) All treatments were failing, until a very skilled orthopedist said the magic words: “I know what you have. You are going to be fine. You have Complex Regional Pain Syndrome. Here, meet Maureen! She has worked with this many times. Start now, I want you here every day.” Maureen was confident, but cautioned Daughter, “this is going to hurt, a lot. But this is what will work.”
Couldn’t they have given Daughter pain medication? My guess: it would not have worked. What Maureen did was to straighten the leg that had not been straightened, by that time, for about two months. She did it a millimeter at a time, moving the foot out. Daughter managed to avoid biting her tongue off, but it was obviously excruciating. But at each point, Maureen would stop and wait. Until the pain went away. Then she went another millimeter. Took maybe forty minutes, and then she said, “Take a photo of this, or you won’t believe it when you get home!”
In order for this treatment to be possible, Daughter had to trust the orthopedist and Maureen, even though Maureen was hurting her. When we went home that first day, the leg froze up again. The second day, Muareen straightened the leg and then had Daughter putting weight on it. And, by the end of that session, daughter was walking again. Limping, yes, but walking. She returned her beloved wheelchair (that another orthopedist had told her to get rid of, but it had been making it possible for her to have a life, in spite of the disorder. When the new orthopedist said, “you are going to be fine,” she asked him, “should I return the wheelchair?” In fact, it was Friday and the rental was due to renew on Monday.
Daughter had been doing physical therapy for about six weeks with no improvement. What it took was some words: a diagnosis and a prognosis. With that, Daughter was willing to go through the pain. And that is what healed her: skilled words and skilled action. Both. No medicine.
CRPS is often not diagnosed, and doctors saying “it’s all in your head” — which Daughter had certainly heard — was useless. What made a difference was the *manner* of the orthopedist and his knowledge. I read about CRPS and think, “my God, they don’t know what it is!” The primary diagnostic symptom was allodynia. Once he pointed it out, it was obvious. I had been important to rule out “organic cause,” i.e., say, some condition in the knee, but once the X-rays and MRIs were done, with no visible condition remaining (the suspicion was a subluxated kneecap, which resolved, leaving the reflect activity in place), and with allodynia, it really should have been diagnosed sooner.
This is programming of the nervous system at a low level. Higher level programming can also have major physical effects. When the nervous system experiences pain, physical changes take place. Treatment of pain is a major component of medicine, but pain is “all in your head.” That is, it is an experience, and as a Lamaze parent (with my first child), I learned that pain can be reinterpreted and handled so that it is not disabling.
The “placebo effect” is badly named, because the clinical effect is from treatment and demonstrated care. You confidently assert that there is no “placebo effect,” but that is not what the research you cite shows, any more than a negative cold fusion experiment shows that there is no such thing as cold fusion. That confident assertion is pseudoskepticism.
If we want to overcome pseudoskeptical rejection of cold fusion, we need to recognize pseudskepticism in ourselves. Good luck.
You wrote: “You confidently assert that there is no “placebo effect,” but that is not what the research you cite . . .”
I think the research does show that. Perhaps the research is wrong, but I think that by the definition in the research — which is the definition I use — the placebo effect as described by researchers starting in 1955 does not exist. It was a mistake.
Let me summarize the 1955 hypothesis in a narrow definition. It is that a drug or treatment with no therapeutic value will sometimes have a positive effect on the prognosis.
That hypothesis does not say what causes the positive effect. A positive attitude? The doctor having more confidence? The cause is not stated, and it need not be stated for this to be a valid hypothesis. It does not have be stated to test the hypothesis, either. You only need to compare the the placebo to a null. The problem is, they chose the wrong null. They should have compared the placebo to doing nothing at all. No doctor visit or consultation, or treatment of any kind. Simply letting nature take its course. That comparison shows that the placebo is the same as the full null, so it has no positive effect on the prognosis.
That does not rule out the possibility that positive thinking has an effect on the prognosis. Positive thinking is not the same as a placebo. That is a different hypothesis. However, I doubt that one for other reasons. As I said, mainly because I suspect optimists are over-represented in patient study samples. To get a representative sample you would have to interview dead people.
Jed, I read the research you first referred to. It does not state what you took from it. I cited a more recent paper in the same journal. You have ignored it. Now you refer to a “1955 hypothesis,” which, as stated, is self-contradictory or dumb. You are apparently considering Beecher (1955). http://jgh.ca/uploads/Psychiatry/Links/beecher.pdf
You are full of opinion about what Beecher — if that is your source — “should have” done. The “hypothesis” you state is similar to his definition of placebo, but not the same. His paper is more of a review of other work than a primary research paper. What was described was controlled experiment. There were “non-treatment” options included in some studies. Basically, Jed, you are pooh-poohing ideas you do not understand and oversimplify. When other pseudoskeptics do this with LENR research, you recognize it. How about when you do it? You have often been ineffective in educating skeptics. Could this have anything to do with it?
The “placebo effect” generally refers to a “treatment effect,” or belief on the part of the patient that he or she is being treated. It’s not about the sugar pill or whatever is actually used. My general sense is that the “placebo effect” is therapeutically useful (Beecher is considering this issue) if the physician is using the “best effort” to investigate the patient’s condition and treat it, with a goal of not just the resolution of “organic disease” but also with regard to so-called “subjective” issues, such as pain or satisfaction or full life function. Beecher notes that placebo administration appears to have more success in handling “patient satisfaction” or other more subjective measures, than with “objective measures,” which are obtained without patient report, i.e., by measurements. But there was still a strong effect in some studies with objective measures. Beecher points to the use of placebos to enhance the effect of other medications.
For ethical reasons, I don’t like a doctor prescribing a “pure placebo.” There are many other similar interventions possible that are likely to have various life-enhancing effects, such as meditation or exercise, prescribed as a “treatment.”
I went to my doctor, mentioning that, recently, I’ve been getting a vastly increased occurrence of scintillating scotomas, i.e., the visual symptoms of a migraine. He prescribed 400 mg/day of vitamin B-2 (riboflavin) and 500 mg/day of magnesium. Placebo? I think he had the idea it might actually help. (I have long used B-3 (niacin) to prevent migraine, but this was breaking through. It seems to have had a substantial effect. Proving nothing, of course, this is an anecdote. However, it does appear there is supporting research. And then I need to consider the possible effect on cataracts…
You wrote: “The “placebo effect” generally refers to a “treatment effect,” or belief on the part of the patient that he or she is being treated. It’s not about the sugar pill or whatever is actually used. My general sense is that the “placebo effect” is therapeutically useful . . .”
Yes, I know. It cannot be about the sugar pill or whatever is used, because that has to something known to have no therapeutic value. Some people agree with you that the effect is a “treatment effect.” Many agree with you that it is therapeutically useful.
However, I disagree. I think there is no such thing as a “treatment effect” and nothing therapeutically useful. I think doctors and researchers mistakenly concluded these things exist because they did not understand the data, and they did not use a proper blank test, with no treatment.
That is what I am saying. I did not miss the definition or overlook what you just told me. I disagreed. You are not telling me anything I did not know. You fail to grasp that I know that stuff, and I disagree.
Jed, you are incautious about how you write. Perhaps you don’t mean to say what you say, but you say it. You think that “treatment” has no effect?
I.e., the practice of medicine is an entire mistake, totally bogus?
Medical practicee includes the usage of many tools. Are you saying that directly effective drugs and surgery, say, are the only tools? I’ve been reading many papers on nutrition and health for years, and there are many confounding factors in studies, i.e., social conditions that affect outcomes, where the behavior (“attitude”) of the patient may make a difference, explaining alleged differences in outcomes. You would just dismiss all that. Why?
“There is no such thing as a treatment effect,” you quite confidently state, but you have not presented evidence to justify that confidence — which would have to be quite strong, to claim the utter absence of such an effect, whereas the study you cited in NEJM had very different conclusions.
I would have difficulty accepting that “no such thing” claim if you were an expert, but you are not.
You also seem to think that “no treatment” hasn’t been tested, which contradicts what’s in the papers. A full “no treatment,” which would satisfy you, would be defined how?
You also seem to think that scientists, sophisticated ones, very aware of study problems, were mistaken, but you have not been specific. In *this* study — preferably one we can read — what alleged mistake was made? You are very aware of the problem when pseudoskeptics dismiss cold fusion, but your response is often vague there as well. What mistake, specifically, and what specific evidence exists?
In a controlled study, a placebo is a control, allowing distinguishing drug action, per se, from a treatment effect (and the strongest studies are double-blind. How would you manage “no treatment” for a double-blind study?)
Studies are possible to compare forms of treatment. so a patient presents with some disorder, which is normally causing them at least some discomfort or concern. What would be done with “no treatment”? Randomly, the patient is rejected when they register? Go away, you are in the “no treatment group!” Does the receptionist say anything? That is a kind of treatment. Will the patient cooperate? Will they go home and do nothing?
Maybe patients would be held in a locked facility so that it could be verified that there was “no treatment.” But that, of course, is treatment. The simplest and most ethical idea I can come up with is “Most people with your condition get better simply from waiting. When you signed up for free treatment, you agreed to being randomly assigned to the “no treatment group,” and that’s what has happened. You have a number to call if any serious issues come up.”
But assuring the patient that they will probably get better with no treatment is treatment. I go to doctors to hear that, because I want to rule out that something more serious is happening. And, yes, so far, I have almost always gotten better.
I can imagine that with some studies and some conditions, a “no treatment” option might be practical. But some “treatment” would still be involved, some interaction. Would the nature of that interaction cause effects on outcomes? How would we know?
“Perhaps you don’t mean to say what you say, but you say it. You think that ‘treatment’ has no effect?
I.e., the practice of medicine is an entire mistake, totally bogus?”
I said the placebo treatment effect does not exist. I am surprised you misunderstood. Obviously, many other treatments are effective. Most medications work. Setting bones, helping with delivery, and many other therapies are effective.
However, the placebo effect from taking drugs or getting placebo treatment (such as sham surgery) has no effect on the prognosis. I believe that is what the data shows. It is contrary to what is widely believed.
You wrote: “I can imagine that with some studies and some conditions, a “no treatment” option might be practical. But some “treatment” would still be involved, some interaction. Would the nature of that interaction cause effects on outcomes? How would we know?”
In principle it is easy to know that. In practice it would be difficult and unethical. You take a large group of patients. Give some of them interaction with placebos, while others are sent home with no interaction or treatment. When you do that, you find the prognosis is the same in both cases. Interaction and seeing the doctor does nothing to help cure disease.
A large scale test would be unethical, but easy in principle. As it happens, however, millions of people in the U.S. and millions more in the Third World cannot afford to see a doctor. So you have a large group of people in the “no treatment” group already. However, we do not have a large group of people we know are getting placebos, except in cases where we find out a treatment does not work. We could compare this group to the uninsured people. That might produce useful data.
For example, it has recently been determined that stents probably do nothing to prevent chest pain from heart attacks. They are probably an inadvertent placebo. You might confirm this by comparing chest pain in people who get only stents to people who cannot afford any medical care. The comparison would be difficult because the latter group suffers from many other problems that would be cured if they could see a doctor.
I have a cardiac blockage, diagnosed by a nuclear stress test. A year ago, it was recommended I have an angiogram and possible stent. I declined because I wanted to become more informed. I’d be sedated and impaired when they might tell me I need a stent, in the middle of a procedure that makes it easy to put one in. My cardiologist said, “If it were me, I’d have this done, but I know too much,” and he approved of my intention to research it. I asked him for risk numbers. (Doctors don’t like to do this, but when I assure them I am not asking them to play God, I just want their sense from knowledge and experience, they tell me.) The risk of waiting, with other measures being taken (such as exercise, starting with “cardiac rehab”), was low.
Then I did some reading. New York Times? Are you kidding, Jed?
The study: Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial
I have not read the full paper. Maybe I will, but the results are not surprising to me. Your usage of this paper is iffy, your comment actually assumes that the “placebo effect” works (for relief of pain).
I have “stable angina.” That indicates that angina is transient and disappears when exercise stops. I would not have a stent placed “for relief from angina.” There is a far more effective treatment, far less expensive, with fewer complications if done with care: exercise. The measure of “pain relief” in the study was increased exercise time. That is, when I exercise, if I get severe angina, I stop. If I’m getting angina at all, even barely detectable, I don’t increase the time or intensity.
What has happened over the year is that angina is rare, and exercise duration or intensity is gradually raised. That’s the normal course with exercise, and all cardiologists appear to agree that the best treatment for coronary artery disease (primary symptom, stable angina) is exercise, which builds collateral circulation. The benefit of angiograms and stents, more reasonably, would be reduction of fatalities, and it appears that this benefit is low; but stents can save lives with an acute obstruction (this is not “stable angina”).
The subtext of this report is that benefit of stents was probably considered due to patient reports of pain relief, ascribed to the stent. That could be a placebo or treatment affect, or it could be a result of other measures associated with treatment, such as dietary advice, exercise, and medications. I am taking metaprolol, a beta blocker. The effect of that drug is strong (and I have seen no side effects). If I do my weight routine without the drug, (I.e., I forgot to take it) my heart rate goes up to around 140 (which is not dangerous, but getting closer to dangerous). With the drug, it stays below 120. In neither case do I get angina.
“Treatment” includes a wide variety of interactions that many affect health and the prognosis of conditions. I’m pretty sure that the participants in that study were given all the best additional treatments. So, then, there is evidence, from an allgedly double-blind controlled randomized study, that a very common and very expensive procedure, with stable angina, is not helping at that level; if this is confirmed and sustained, we can expect far fewer stent placements, and my guess is fewer angiograms as well.
My continued avoidance of the angiogram was based on lack of evidence that it would extend my life. Basic treatment of angina is trivial: nitroglycerin is highly effective, but I’ve never gotten to the point that I’d have taken it.
They created angina in my nuclear stress test, with me being carefully monitored. That was very, very useful to me, because recognizing angina can be difficult. Later, in cardiac rehab, they took me up to exercise levels where angina symptoms appeared, but only occasionally, and only just “barely detectable.” One time the symptoms were strong enough that I wanted to sit down, so I did. Symptoms quickly disappeared.
“No treatement” would have meant “no exercise.” I did decline the statin that was offered and I am not following standard dietary advice.
Note added: heh! I did go back and read the whole New York Times article (since I could not read the original paper, what I wrote above was based on the abstract.) Yes. None of this is a surprise to me. I’m going to have a fun conversation with my cardiologist when I next see him! In any case, thanks for the link.
Adding this as well: The NYT discussion brings out the extensive lack of solid science behind much “standard of practice.” Taubes has documented this extensively in the area of dietary fat and obesity and heart disease, and is working to facilitate genuine research, controlled studies. In the discussion, the role of exercise was not even mentioned, and that seems to be endemmic. My insurance did not want to pay for cardiac rehab (which, it turns out, was very expensive; something very similar could be done self-monitored, far less expensively and almost as safe), and their reason was that I had not had a heart attack or “procedure.” Somehow, the idea of a monitored exercise program to prevent heart attacks has not penetrated the “standard of practice,” it was almost an off-hand comment from my cardiologist, “And I’d want to get you into cardiac rehab.” Later, I found out about “collateral circulation” as an exercise effect, that is similar to a bypass operation. It takes time to build collaterals. With the blockage, I became tired more easily, but this developed over a very long time; I was, then, exercising less, and this was snowballing. Had I not decided to fully address my situation, to begin an exercise program with the intention to maintain it (and to keep increasing levels, very slowly, as long as I can) for the rest of my life, “religiously,” I expect that my life expectancy — and the quality of remaining life — would have been much lower. So the “wake-up call” I got last year was life-saving.
(I also found out that if my cardiologist had added the magic word to my documentation, “angina,” they would have approved it, because when he did, they did. But this all caused a two month delay. Meanwhile I started my own program at the local senior center. $10 per month. Way cool.)
And it was fun! Jed, that is *declared*. It’s just words, but those words have effects. The hospital food was great! (You know I’m crazy when I say that the hospital food was fantastic! — however, I created that through expectation and … it then occurred to me that way! Of course, there were options on the menu, and when I did not want the main offerings, they had other standard offerings that were fine. In order to maintain an exercise program, it must be fun as well. So I say so! And so it is. “Attitude” has an effect on my prognosis. It isn’t magic, though it can seem so. It’s just how the brain works, and how life works.)
(I do not exercise to the point of significant pain. In the weight training, I repeat a weight until it just starts to burn, a point where the burning starts to spread and create a sense of “enough.” I do not attempt to push through pain — which runners do, and that can be why runners die from heart attacks, too often! If that pain is angina, it means the heart muscle is oxygen-starved, and if that continues for too long, some of it dies, that’s part of what is happening in a heart attack.)
And again: the NYT article mentioned this study, which showed that a stent and “optimal medical therapy,” vs the same medical therapy alone showed no benefit in reduction in rate of “primary outcome,” i.e., deaths or severe cardiac events. I had seen that before, but this time I noticed that optimal therapy included exercise. The stent group actually had slightly more deaths and rate of strokes was slightly higher as well. These differences were not of high significance. However, I notice this possibility. This wasn’t a blind study, the stent group knew they had a stent and the no-stent group knew that they didn’t have one. Compliance with an exercise program might be affected by this knowledge. The stent group, I could imagine, might be more complacent: “The stent will take care of it, and I already feel better. I’ll exercise next week.”
The lack of clear understanding — based on the best science — is killing people (i.e., causing avoidably premature deaths. According to that NYT article, there are 500,000 stent operations per year, worldwide, for treatment of angina, when it is ineffective, compared to other decent treatment, at far lower cost. At $10,000 to $40,000 per operation, using the figure of $30,000 (which I had heard before), that would be $15 billion per year. If the necessary research to justify this expenditure cost more than $100 million, I’d be astonished. But who is going to fund that research? This has to be done with public money (or private charity). The best known treatment is exercise, which costs me $10 per month for a membership. There isn’t enough money in this to fund the activity. If we want good research, we must pay for it, and not depend on drug companies or other conflicted interest groups.
All roads lead to Rome. How do we make collective decisions? This is underneath the cold fusion fiasco. Mostly, we just sit with the status quo, it is too much trouble to do anything different. In the hearings in the 1970s that led to the disastrous dietary recommendations that became Conventional Wisdom, it was realized that the research basis for those recommendations was poor, but it was considered too expensive to do better research. Penny-wise and obesity pounds foolish. So both U.S. DoE panels recommended more research. All right, who would fund that? Doesn’t matter! Someone else. Not us. Go away!
And our response was to complain that those panels were wrong. They made mistakes! (And, of course, they did, but instead of agreeing with the conclusions, those that were sound, and then lobbying for structure to implement it, we were left squabbling and divided and outside in the cold.)
We shouldn’t dismiss all strange stories as old wives’ tales. Some odd things come to mind here and I’ll put them forward without attribution or links but as talking-points, since they’ve been collected over a long time and searching out the backing-data would take a while.
Oil-companies employ dowsers, which implies that the success-rate for a good dowser is not pure chance.
Humans have magnetic sensors in the nose area, which some people may be able to actually use. Birds also have such sensors (and can use them), which helps in migration.
Acupuncture points on the human body may be found using a resistance meter – they show as lower resistance.
Sharks (specifically hammerhead but also others) can sense electric fields so they can find their prey when it is hidden. Moving water underground is likely to produce a difference in electric field.
Most people can’t read micro-expressions on other people, but some can. For example Derren Brown, who makes a good living reading people in ways that appear to be magical.
Tests for allergies (as used on my daughter) measure skin-resistance when certain encapsulated materials are put into a box in the machine. It shouldn’t work (the stuff doesn’t get near the skin and is encapsulated anyway), but the results seem to be consistent and repeatable. Accepted medical tests involve scratching the skin and putting the actual materials on the scratched bit, and looking for a skin response (swelling and redness) which seems more reasonable.
It’s thus possible that the Sniffex can aid in unearthing problems, providing there’s a belief that it works (or at least not a total disbelief) – the bad guys get more anxious and this can be sensed by the operator. Some people may therefore achieve success using the Sniffex providing someone there knows where the bomb is located. A bent wire coat-hanger in a broken ballpen case would “work” just as well except that the necessary belief may not be as strong.
Blind tests on dowsing for “lost objects”, where one person buries a gold ring in a certain gridded area and then the dowsers try to find, it have come up as negative. Maybe not that surprising, since such items will not have a large signature. Ground resistance plots can however find watercourses, so it’s not beyond belief that vestigial human senses (magnetic and electric fields) may provide small clues that can then show as small involuntary muscle-tension changes that are amplified and made visible by the dowsing-rods. It doesn’t however work for me, and when you see someone else do it (or hear stories) there’s always the feeling that there may be some trick happening.
As far as I can tell the Sniffex device is a total rip-off, and is oversold and overpriced. They are however in use. I haven’t seen any data on how many attacks have been stopped because the Sniffex “found” the explosives. It’s possible that lives have been saved because the Sniffex was in use, but no data that I’ve found. However, to stop all attacks the system has to be 100% reliable, and it only takes one successful attack to kill people. Even universal stop-and-search isn’t 100% successful.
The Placebo and Nocebo effects certainly seem to work well, and of course there’s quite a widespread belief in the power of prayer and the power of a curse. Any investigation into the paranormal has to go to great lengths to avoid any effects from belief and disbelief, and thus likely removes the reason why it might have worked in more normal circumstances. Rather than come down one side of the fence or another, it’s probably better to sit on it until better data comes in. In these days when a computer can decode brain-waves well-enough to decide on what picture you’re thinking about, it’s a bit early to discount all the stories of telepathy.
Something becomes science once we can measure it and put a number on the effect and a reason why it works. Some of the paranormal stories may be just stories, but others may be science we don’t know about yet. Hard to tell until we get a way of measuring it. Used to be we just knew that dogs and other animals could follow the trail of someone, but now we know that people leave a trail of their skin particles (and thus DNA) behind them everywhere so there’s a reason why one person can be tracked by their individual DNA.
What happens with pseudoskeptics is that they have an idea how the thing would work if it worked, and then they reject that idea as impossible. But what they are rejecting is their own idea. To be sure, Sniffex was sold with a hefty pile of bullshit. They claimed, by the way, 90% detection rate. Okay, how does that compare with having some “expert” who just uses, with appropriate fanfare, his or her own intuition? If Sniffex works better in real situations than other available approaches, maybe it is an improvement. But my guess is that one could develop training for personnel that would be even more effective, and I don’t really know that Sniffex works at all, that is, that it makes any improvement — improvement over what? But Mary Yugo is completely certain that it does not work at all.
I thought the proposal was hilarious that I be placed in a mine field with a Sniffex — as if somehow I was responsible for these things, which I consider a con and a scam, and don’t think I have said anything else about them, other than the ruminations about what possible positive effect they might have under some circumstances. There are various government officials in, say, Iraq, that swear by them. Dumb? Maybe. Maybe not.
If I ended up in the middle of that mine field, would I use a Sniffex? Probably not, I would consider it distracting. Life, in fact, is this minefield, and I already navigate it, and I trust the guides I have already. And someday I’m going to die and I don’t know how. It doesn’t matter to me.