Editing 1526: Placebo Blocker
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==Explanation== | ==Explanation== | ||
− | + | {{Incomplete|Grammar correction and more references required.}} | |
+ | The {{w|placebo}} effect refers to the phenomenon in which patients given an inactive treatment (such as a sugar pill) can still show improvement relative to an untreated patient. The placebo effect is thus very important to consider when testing new drugs, since even ineffective drugs can have a positive effect on the patients due to the placebo effect. Modern drug experiments are hence conducted as {{w|Blind experiment#Double-blind trials|double-blind trials}}, where the patients are randomly given either the treatment or a placebo without either they or the administering doctors knowing who receives the new drug and who received the placebo pill. | ||
− | + | Generally the patients need to believe that they are receiving an active treatment (or at least could be in a blind trial), but one [http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015591 study] showed that the effect can occur even if the patients are told that they are receiving a placebo pill. The key factor seems to be that the patients most believe that a positive effect will occur. For example, (1) patients experience a greater effect if they believe that the treatment is expensive and (2) patients who know that they have not been given an active treatment will experience the effect if they are told that placebos can have a positive effect through the power of the mind. | |
− | + | Several reasons for the placebo effect have been proposed, from study artifacts - such as under-reporting of negative outcomes by patients who think they are being treated, to neurological explanations for how mental state can translate into physical outcomes. | |
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− | + | This comic specifically refers to a study published in May 2015, the same month in which the comic was released, about possible mechanisms for the placebo effect: | |
− | + | :Kathryn T. Hall, Joseph Loscalzo, and Ted J. Kaptchuk. (2015) ''[https://dx.doi.org/10.1016/J.MOLMED.2015.02.009 Genetics and the placebo effect: the placebome.]'' Trends in Mol Medicine. Volume 21, Issue 5, May 2015, Pages 285–294 | |
+ | <!--More links and references needed--> | ||
− | + | [[Cueball]] references the researchers from the above mentioned paper when he announces to [[Hair Bun Girl]] that his team have created a new drug designed to prevent the placebo effect from occurring: The '''Placebo Blocker'''. (This drug might be useful in studies of other drugs, to prevent the placebo effect from complicating those studies.) | |
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− | + | The joke centers around the difficulty in designing an experiment which would be able to test whether such a drug actually worked. Cueball begins to tell how to test this new drug with a trial. Following the typical experimental design, patients experiencing the placebo effect (i.e. who had just taken a placebo pill and been told it was a treatment for some ailment) would be split into two groups. The first group would then receive the ''Placebo Blocker'' drug, while the second would receive yet another placebo pill. | |
− | + | However, Cueball then trails off after realizing the problems with such a trial, such as the fact that one group receives placebos twice. It is also unclear how the patients could be told what the second drug was designed for without negating the effect of the original placebo. (The simplest solution would be to tell all the patients that both pills were part of a multipill treatment for the original ailment.) | |
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− | + | <!-- This seems like one person's opinion and I think it doesn't pass credibility. See comments section. | |
+ | Actually, it would be fairly simple if you can find a new drug that needed to be tested through a double-blind trial. But you require this to have a reason to give the patients the Placebo Blocker in the first place. Once this problem is solved the trial would run like this: Group 1 would receive the new drug and a placebo pill; group 2 would receive the new drug and a Placebo Blocker; group 3 would receive two identical placebo pills; and group 4 would receive one placebo pill and one Placebo Blocker. If the Placebo Blocker does not work, then it would produce a placebo effect, identical to what is experienced with the placebo pill, but if the Placebo Blocker gives different results than with the placebo pill, then it has an effect. If the effect is less than with the placebo pill, then the blocker actually works. If it is a larger effect then it would be a Placebo Booster instead (see title text). Of course there may be some problem with what to tell the patient about the second pill (which for sure has the sole purpose of reducing the effect of the treatment!) | ||
+ | --> | ||
+ | Cueball and Hair Bun Girl think about this trial until they both develop headache from trying to think of how to design this trial. Cueball then kindly offers Hair Bun Girl a sugar pill. While this might have helped cure the headache via the placebo effect had he told her it was a headache treatment, by revealing the pill as merely a sugar pill, it may suppress or reduce the effect (although as mentioned above, it might still have an effect. Also, if low blood sugar is contributing to her headache, then the sugar pill might be an effective treatment, and improve her condition, even without a placebo effect). | ||
− | + | It is possible that Cueball's sugar pills are, in fact, the Placebo Blockers themselves and that, seeing Hair Bun Girl has a headache, Cueball is inspired to somehow use the opportunity as an experiment to test the Blockers. On the other hand, in title text, Cueball mentions that his sugar pills against headache works even better together with the new experimental placebo ''boosters''. Incidentally, he indicates that he keeps those in the same bottle with his sugar pills. This may mean that the entire bottle is simply sugar pills which Cueball is passing off as other drugs (making them placebos themselves). It is also possible that somehow Cueball is suggesting Hair Bun Girl take a "placebo booster" which is really a "placebo blocker", thus testing the blocker he mentioned earlier in the comic. Or Cueball could be telling the truth and there could be "booster" pills in the bottle as well. The comic leaves the nature of Cueballs pills fairly ambiguous. | |
Placebo-blockers do actually already exist. A side-effect of the opiate antagonist {{w|Naloxone}} is that it [http://healthland.time.com/2009/08/26/a-neurological-explanation-for-the-placebo-effect/ blocks the placebo effect]. | Placebo-blockers do actually already exist. A side-effect of the opiate antagonist {{w|Naloxone}} is that it [http://healthland.time.com/2009/08/26/a-neurological-explanation-for-the-placebo-effect/ blocks the placebo effect]. | ||
− | + | Questionable neuroscience research is also discussed in [[1453: fMRI]]. | |
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==Transcript== | ==Transcript== | ||
− | :[ | + | :[Hair Bun Girl is standing in front of Cueball who does all the talking. Below them is a footnote.] |
:Cueball: Some researchers* are starting to figure out the mechanism behind the placebo effect. | :Cueball: Some researchers* are starting to figure out the mechanism behind the placebo effect. | ||
:Cueball: We've used their work to create a new drug: A ''placebo effect blocker''. | :Cueball: We've used their work to create a new drug: A ''placebo effect blocker''. | ||
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:Cueball: ...wait. | :Cueball: ...wait. | ||
− | :[ | + | :[Hair Bun Girl holds her chin, while Cueball just stand there for a beat panel.] |
− | :[ | + | :[Hair Bun looks again at Cueball who begins to take the lid off of a medicine bottle.] |
− | : | + | :Hair Bun Girl: ...My head hurts. |
:Cueball: Mine too. | :Cueball: Mine too. | ||
:Cueball: Here, want a sugar pill? | :Cueball: Here, want a sugar pill? | ||
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{{comic discussion}} | {{comic discussion}} | ||
[[Category:Comics featuring Cueball]] | [[Category:Comics featuring Cueball]] | ||
− | [[Category:Comics featuring | + | [[Category:Comics featuring Hair Bun Girl]] |
[[Category:Science]] | [[Category:Science]] | ||
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