Saturday, October 01, 2005

So, just wash your hands, I guess...

Just in time for cold and flu season--this just in:

Echinacea trials*

Vitamin C trials**

But I'll probably still use my Emergen-C packets, which product I claim accounts for my never getting colds (though I didn't really get them before, either) and my staying awake during most of grad school. And I'll probably still use echinacea as part of my multifarious UTI treatment. (I know that's a misuse. I just like saying multifarious, and rarely get a chance to do so.)

*(Mirror article)
**(Mirror article)

13 comments:

argotnaut said...

I still have Emergen-C once in a while just because it's tasty. I wish I could find fizzy vitamin tablets like the ones I had in Germany. Found something close, but they're chewables, not drinkables. I have to stop myself from eating the whole bottle (as I did when I was little).

Why would you still use echinacea when it's been proven ineffective in clinical trials?

liz said...

It hasn't been proven *harmful*...

liz said...

Oh yeah: also because in my research training, we have had the difference between "effectiveness" and "efficacy" beaten into us pretty throughly.

argotnaut said...

What's the difference?

liz said...

(Wy can't I just finish a comment in one go?)

...And not being proven effective is much different than being proven ineffective.

...And even if it's about as useful as eating sand, but I think there's the teeniest bit of efficacy, why then the placebo effect might work anyway.

(Although the last time I was worried about a UTI I didn't have any on hand, so used mainly unsweetened berry juices and Cystex anyway. Which do work.)

liz said...

Effectiveness = shown to make a statistically significant difference in observations of a group/population

Efficacy = usefulness for an individual client, wherever their particular freak flag may fall on the normal curve. (Maybe at the tips!)

argotnaut said...

>not being proven effective is much >different than being proven >ineffective.

That I knew, but I was too lazy to fix my comment.

Once something has been _not_ effective in trials, then I can't use it. I don't believe in it anymore, thus eliminating any possible placebo effect.

liz said...

I think it works that way if you think of yourself as "normal".

argotnaut said...

Okay...maybe I'm thinking about this the wrong way:

If something is about as effective as placebo, then isn't it likely that its effect _is_ placebo?

Let's say 20% of people feel better with placebo. Then I'd assume that 20% of people receiving real treatment would _also_ feel better due to placebo, so you'd have to have _more_ than 20% feeling better for it to be anything other than placebo.

Or are you just saying that it _is_ placebo, but that doesn't matter as long as it works for an individual?

argotnaut said...

Or am I just completely unedjoomacated and ignernt of how it all works?

liz said...

Yes, I would also guess if they have about the same effectiveness in a controlled investigation, it could likely be placebo.

But there is usually no good way to sort out the "real" underlying mechanism for an individual client who is responding to even an established treatment, unless you do single-subject design research with them, which would be time-consuming and in most cases unethical anyway.

As far as efficacy goes, in some ways the "why" really doesn't matter.

There are so many weird things about the way we work, why aren't we trying to get a placebo effect for _more_ things? I mean, how the heck does placebo work, anyway?! For "real" things, too, not just "oh, you're imagining it" things. (Which can kill people, too.)

From this aspect, credulousness might be akin to hypnotizability in its usefulness for treatment.

argotnaut said...

I think it would be interesting to study people who respond to some placebo or another. Find out how many still respond after they've been informed that it's a placebo! Although you might have some angry dropouts...

liz said...

If that isn't a band name, I don't know what is.