Editing 1526: Placebo Blocker
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==Explanation== | ==Explanation== | ||
− | + | {{Incomplete|Grammer}} | |
+ | 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 knows 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. | |
− | + | 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. | |
− | + | 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 | |
− | + | [[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'''. | |
− | + | 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. | |
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− | + | 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. | |
− | + | 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 needed 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 do not work, then it would produce a placebo effect, identical to what is experienced with the placebo pill, but if the Placebo Blocker gives a different results than with the placebo pill, then it has an effect. If the effect is less that 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!) | |
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− | + | Cueball and Hair Bun Girl thinks about this trial, without getting to the solution mentioned here above, at least not until they both develop headache from trying to think of how to design this trial. Cueball then kindly offers her a sugar pill from a pill bottle he has on him. 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 even effective, and improve her condition, without a placebo effect.) | |
− | + | It seems likely that the pill bottle with sugar pills is in fact his bottle with the Placebo Blockers, why would he else carry them around at this moment? This would thus mean that his Placebo Blockers are simple placebo sugar pills themselves. | |
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]. | ||
− | + | In title text, Cueball mentions that his sugar pills against headache works even better together with the new experimental placebo boosters. Incidentally he keeps those in the same bottle with his placebo sugar pills. This makes the above suggestion that all his pills are just plain sugar even more likely, as he is now suggesting that also the ''placebo boosters'' are just sugar pills. | |
− | + | It's unclear whether it would be ''called'' a placebo booster in front of the patients, which would possibly have the effect of ''diminishing'' the effect of the first placebo. | |
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− | + | Alternatively, what if the placebo booster was actually effective. However since it's kept in the same bottle as the placebo [[Hair Bun Girl]] won't know if she got the placebo (sugar pill) or the real booster, which might then reactivate the placebo effect in her brain since she doesn't actually know which one she got. But if she got the booster but didn't get the placebo, would the booster boost the placebo effect from her not knowing if she got the placebo or not, or would she also need to have received the placebo (sugar pill) itself? She should probably take two, as the title text suggests. But then would she get two placebos, two boosters, or one of each? My head hurts... | |
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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? | ||
{{comic discussion}} | {{comic discussion}} | ||
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[[Category:Comics featuring Cueball]] | [[Category:Comics featuring Cueball]] | ||
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[[Category:Science]] | [[Category:Science]] | ||
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