Placebo effect for babies and animals

[Trinoc]

Following on a bit from the "Altmed for pets" thread ...

Last time I got into the inevitable argument with my homeopathy-believing friends, they brought up the usual canard about homeopathy working on patients who couldn't possibly know they are being treated, such as babies and animals, and so (they said) couldn't possibly be responding to the placebo effect.

I suspect that most, if not all, such claims are bogus, but I didn't have the evidence to back this up. Even if I had evidence against, they could simply say that there are cases where it works, but that I hadn't found them.

Assuming for the moment that these cases are not completely made up, it occurred to me later, given that homeopathy can't rationally be anything but a placebo, that the question we should be asking is not whether homeopathy can work on patients who (supposedly) don't know they are being treated, but whether a placebo can work in these cases.

At least this makes it part of an existing mystery for which there is good evidence (unlike homeopathy). The placebo effect exists - no possible doubt - but does it work by a mechanism that rules out being effective on patients who are at best dimly aware that they are being treated, and can't be expected to have any detailed understanding of what's going on.

So, the questions are ...

First, is there any credible evidence for homeopathy or any other sort of placebo working on babies or animals (or, I suppose, older humans mentally unable to understand)?

Second, if so, is there any plausible mechanism by which the placebo effect could work on such patients?

[Mongrel]

I briefly answered in the other thread

Doing a search of the JREF forum for Rolfe* (probably the Science and Medicine section) should net you some stories of Alt-med vets and their patients.




*Sorry, I have to be up at stupid O'Clock tomorrow

[Matt]

Simply ask why trials are double blinded rather than just the patients being blinded.

[Trinoc]

Simply ask why trials are double blinded rather than just the patients being blinded.

Ask who? My creduloid friends? I'm not sure they would understand the question. In fact I'm not sure I understand it myself.

[Trinoc]

I briefly answered in the other thread

OK, saw that.

Doing a search of the JREF forum for Rolfe* (probably the Science and Medicine section) should net you some stories of Alt-med vets and their patients.

I will look in JREF, but I suspect I will find mostly stuff confirming my own anti-homeopathy preconceptions there. I suppose what I want is evidence from sources with neither an alt med nor an anti-alt med agenda, but I don't hold out much hope of finding it.

Edit: Nope, no references to Rolfe on JREF.

Edit edit: I take it back - I thought you meant a researcher, not a forum member. Found him/her now.

[FarSideOfTheMoon]

I'm not a baby expert by any means, but experience has taught me that they can be feverish and tetchy one day, happy and content the next. It must be quite difficult to run properly controlled trials on young persons who have such developing immune systems and bodies.

[Trinoc]

I'm not a baby expert by any means, but experience has taught me that they can be feverish and tetchy one day, happy and content the next. It must be quite difficult to run properly controlled trials on young persons who have such developing immune systems and bodies.

This is what I suspect. Likewise for animals. They will generally get better anyway (as will most of us), but if someone is treating them - particularly if they believe the treatment has some mystical mechanism - they will almost certainly take credit for the improvement.

I'd like to be able to point my credulous friends at some genuine research on the matter though - more for my own satisfaction, since I don't think it would change their views one bit.

[Mongrel]

This is what I suspect. Likewise for animals. They will generally get better anyway (as will most of us), but if someone is treating them - particularly if they believe the treatment has some mystical mechanism - they will almost certainly take credit for the improvement.

I'd like to be able to point my credulous friends at some genuine research on the matter though - more for my own satisfaction, since I don't think it would change their views one bit.

Sorry about the Rolfe thing, should have mentioned that bit

Anyway, here's a piece (with references) from Science Based Medicine regarding the placebo effect in animals.

If your friend has pets ask them how they're treated when ill. They generally get better food (poached chicken and rice was our dogs 'sick food'), clean blankets, mini mars bars (with tablets) and lots more cuddles. When asked how the pet's doing you'll often hear "Well there still seems to be pain but he seems much happier..."

[skbuncks]

Simply ask why trials are double blinded rather than just the patients being blinded.

Ask who? My creduloid friends? I'm not sure they would understand the question. In fact I'm not sure I understand it myself.

Think Matt was hinting at experimenter/observer bias, see the oft cited Jacques Benveniste for an example of this in action

skb

ETA: some stuff comparing single to blinding in rats http://www.ncbi.nlm.nih.gov/pubmed/17233886

[Mojo]

First, is there any credible evidence for homeopathy or any other sort of placebo working on babies or animals (or, I suppose, older humans mentally unable to understand)?

As far as animals are concerned, there are no more than a handful of adequately blinded trials of homoeopathy, none of which gave a convincing positive result. Rolfe has certainly posted references/critique over on JREF.

Second, if so, is there any plausible mechanism by which the placebo effect could work on such patients?

Certainly: remember, it isn't going to be the animal reporting an improvement.

[Mojo]

Rolfe has posted a list of published controlled trials of veterinary homoeopathy on the JREF forum, but I can't find it at the moment. I think there were only about half a dozen or so, and none of them positive. Some of them are discussed on this page of the British Veterinary Voodoo Society's website (the site is currently being updated - there may be some other more recent studies not yet mentioned there).

[Trinoc]

As far as animals are concerned, there are no more than a handful of adequately blinded trials of homoeopathy, none of which gave a convincing positive result. Rolfe has certainly posted references/critique over on JREF.

We can deduce that homeopathy is no better than placebo. That's barely surprising since homeopathy is placebo. The issue is: what is placebo?

Certainly: remember, it isn't going to be the animal reporting an improvement.

Ah, so you are suggesting that the placebo effect is a bias in reporting beneficial effects rather than actual effects? A hypothesis worth pursuing, but aren't there reports of placebos causing actual, measurable effects such as reduced blood pressure, not just the patient reporting feeling better?

Maybe there are two types of placebo at work here (and possibly a continuum in between, just to avoid a false dichotomy) ... in all cases the patient feels better, but in the case of symptoms such as blood pressure which are known to be related to mental stress then physical symptoms can be improved as well.

[Mongrel]

Maybe there are two types of placebo at work here (and possibly a continuum in between, just to avoid a false dichotomy) ... in all cases the patient feels better, but in the case of symptoms such as blood pressure which are known to be related to mental stress then physical symptoms can be improved as well.

Or because they're feeling better their blood pressure goes down?

Placebo is a 'messy', but interesting, area of research. Have you looked at the entry for it on Wiki?

[Croydon Bob]

I don't know much about this area but isn't the usual phrase used: 'placebo by proxy'? An identified effect where adults report that children or animals are responding positively because they think that they should be. Not as sinister as 'munchausen's by proxy' but can still result in death if real medicine isn't given to the child/pet.

[Trinoc]

Or because they're feeling better their blood pressure goes down?

That's what I meant.

Placebo is a 'messy', but interesting, area of research. Have you looked at the entry for it on Wiki?

Long article ... will read later.

If the belief that one is receiving treatment can cause the brain to activate the body's own recovery processes (whatever they may be) then it opens up some interesting possibilities. For instance, if one believes that the placebo effect works, presumably it would be possible to self-administer placebo pills and they would work just as well as placebos "dishonestly" prescribed by a doctor. In fact, why bother with the pills at all ... maybe all that is needed is a belief that the body will heal itself of anything not serious enough to do permanent damage. Could this be how I managed nearly 30 years without ever needing a doctor, until something mechanical went wrong that needed surgery?