Discussion article for the meetup : Cambridge, MA first-Sundays meetup

Discussion article for the meetup : Cambridge, MA first-Sundays meetup

I just read Antidepressants: Bad Drugs... Or Bad Patients, linked by wallowinmaya in a discussion post and based on the journal articles Antidepressant Clinical Trials and Subject Recruitment: Just Who Are Symptomatic Volunteers? and Failure Rate and "Professional Subjects" in Clinical Trials of Major Depressive Disorder (paywalled). The authors of the latter paper "were told anonymously by trial sponsors that duplicate subjects in some protocols have been as high as 5%", and write "we believe that failure rates are rising due to the increase in "professional subjects," who go from site to site, learning inclusion and exclusion criteria and collecting stipends."

Aha! No wonder so much antidepressant research is crap. How many people do you suppose there are, who sign up for lots of trials at once? They'd have to defraud the researchers, of course; no one would allow a patient like that into their study knowingly. What do you suppose that sort of person would do, and how would it be reflected in the data? What other types of studies are affected? And how would we find out? (Dietary studies look vulnerable, and their results have been conspicuously unreliable. On the other hand, lots of people want to lose weight, so legitimate subjects are probably plentiful and drive down the percentage).

I have posted an article Question Templates on my blog. This is the start of a sequence (of sorts), and it's close to the core of Less Wrong's subject matter.

For quite a while, I've felt that my mind contains important insights which are getting held up because I don't write enough. So to encourage myself to write more, I've started a blog: Concept Space Cartography. My most recent post there, Two Definitions for Critical Thinking, is likely to be of interest to Less Wrong.

Also, every page on my blog has an embedded copy of Textcelerator, a tool I created for speed-reading. (It's normally a browser plugin, which makes it appear on every web page. But you can use it on my blog without the plugin.)

Discussion article for the meetup : Cambridge (MA) Saturday meetup

Discussion article for the meetup : Cambridge (MA) Saturday meetup

The placebo effect (benefit in groups receiving fake pills) and nocebo effect (detriment in those same groups) have frequently been the bane of medical research. They are usually explained in terms of psychology: because people receiving placebos believe they have been treated, they get psychosomatic effects that cure symptoms and create side effects. This explanation is supported by the fact that the placebo effect is strongest when the effect being studied is subjective - eg, tests of painkillers and antidepressants. This explanation is neat, tidy, and in my opinion, altogether unsatisfying.

I have an alternative theory. Most people in medical studies take more than one medication; in addition to the drug being studied, they take unrelated drugs and supplements, usually including a multivitamin and often including other things they were prescribed. However, many people take their pills inconsistently; they miss or mistime some fraction of their doses. This is especially true of depressed people. Prescribing a placebo, however, fixes this; when they take their placebo pill in the morning, they are reminded to take everything else they should be taking. In addition to making pill-taking more salient, being prescribed a placebo may also cause some people to fix the organization and affordances they have for taking pills.

I suspect that many of the benefits attributed from placebos may in fact be due to increased compliance with unrelated prescriptions and correction of vitamin and mineral deficiencies. Arranging a study to test this should be fairly straightforward; simply measure the rate at which unrelated prescriptions are refilled in two groups, one of which receives sugar pills and one of which does not.

Discussion article for the meetup : Cambridge, MA Sunday meetup

Discussion article for the meetup : Cambridge, MA Sunday meetup

Discussion article for the meetup : Cambridge (MA) third-Sundays meetup

Discussion article for the meetup : Cambridge (MA) third-Sundays meetup

Less Wrong contains over four thousand posts. This is awesome. For newcomers, however, it's quite intimidating. Rather than leave newcomers to figure out which posts are worth reading themselves, we provide some guidance, in the form of suggested reading orders. Previously, this has mainly meant the sequences, which are a list of posts that fit neatly into topics, sorted by topic. Unfortunately, reading in topic-sorted order is less than ideal, and many of Less Wrong's best posts weren't part of any sequence. Therefore, I have put together a suggested reading order: the hundred best posts on Less Wrong, in my purely subjective and unofficial judgment, arranged in a sensible order. Thanks to Student_UK for pointing out the need to reconsider how Less Wrong's archived content is presented, to XiXiDu for creating a reading list and to Academian for another reading list; my reading list draws on (but is not a strict superset of) both these lists.

This is only a draft. Since the set of posts newcomers read has a significant impact on the community, I am soliciting feedback. After feedback has been collected, I will move (or clone) this list into the wiki, with feedback incorporated. Note that after my first pass, I had more than four hundred candidates for the top hundred; there were many excellent posts that I had to cut, and doubtless many more that I simply overlooked. I used karma as one consideration when deciding what to include, but this list is not karma based. Additional notes about what I did and didn't include at the bottom.

Discussion article for the meetup : Cambridge Massachusetts meetup

Discussion article for the meetup : Cambridge Massachusetts meetup