Monday, May 11, 2020

Placebos

I have been reading Lissa Rankin, MD's book "Mind Over Medicine".  It is more about the same sort of thing that Marchant's "Cure" and Harrington's "The Cure Within" are about: the contribution or lack of it that the mind and emotions make to health and healing.  I am somewhat shocked to learn that many drug trials include a pre-trial "washout", in which all subjects get a "pill" and all those that do very well with that "medicine" are excluded from the real trial.  


One of my favorite statistics books is "How to Lie with Statistics" by Darrell Huff (1950) - yes, 70 years ago and still excellent.  One of the tricks Huff examines is an example using toothpaste.  Let's say I am selling Bill toothpaste.  Huff points out that I should find 10 dentists that try Bill's paste.  I give them a sample and later ask how many would recommend Bill's to their patients.  Gosh, 4 say they would. Huff says to thank them and say good-bye. Then assemble another panel of 10 more dentists.  Repeat and repeat and repeat until I stumble onto some group of 10 in which 8 or more say they would recommend Bill's paste.  Now, I create an ad that says 8 of 10 dentists recommend Bill's!  


That twisted procedure reminds me of the washout pre-trial.  To tell you the truth, I am not sure just what, if any, set of rules would guarantee the truth, the whole truth and nothing but the truth.  I suspect that the hardest part of that standard is "the whole truth."  The whole truth may be beyond us.

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