Why I don't believe in the placebo effect
Have you heard this before? In clinical trials, medicines have to be compared to a placebo to separate the effect of the medicine from the psychological effect of taking the drug. The patient's belief in the power of the medicine has a strong effect on its own. In fact, for some drugs such as antidepressants, the psychological effect of taking a pill is larger than the effect of the drug. It may even be worth it to give a patient an ineffective medicine just to benefit from the placebo effect. This is the conventional wisdom that I took for granted until recently. I no longer believe any of it, and the short answer as to why is that big meta-analysis on the placebo effect. That meta-analysis collected all the studies they could find that did "direct" measurements of the placebo effect. In addition to a placebo group that could, for all they know, be getting the real treatment, these studies also included a group of patients that didn't receive a placebo. But even after looking at the meta-analysis I still found the situation confusing. The only reason I ever believed in the placebo effect was because I understood it to be a scientific finding. This may put me in a different position than people who believe in it from personal experience. But personally, I thought it was just a well-known scientific fact that was important to the design of clinical trials. How did it come to be conventional wisdom, if direct measurement doesn't back it up? And what do the studies collected in that meta-analysis actually look like? I did a lot of reading to answer these questions, and that's what I want to share with you. I'm only going to discuss a handful of studies. I can't match the force of evidence of the meta-analysis, which aggregated over two hundred studies. But this is how I came to understand what kind of evidence created the impression of a strong placebo effect, and what kind of evidence indicates that it's actually small. Examples: Depression The observation that c
Interesting. Have they shared the GPT chatlog? I don't see it anywhere.