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Hr Dr. Giarnella and other Super Trainers:

Interesting article and it fits right in with other research

conducted on food expectations.

In " Mindless Eating " by Wansink (GREAT BOOK), he describes a

research project they conducted where they served a wine they

described as " two-buck Chuck " with two different descriptions. One

was described the wine as a California red; the other had the SAME

wine was described as North Dakota red.

The people at the meal served the " California red " not only reported

the wine as better, but the entire meal as well; the " North Dakota

red " found the eaters with less enthusiasm for the meal. The capper

is that both groups were served the SAME food too!

Read " Mindless Eating " --it is an AWESOME book, from the group that

reported on the self-filling soup bowls early last year.

Merrick, M.A.

Bellevue, NE

>

> I found the following very interesting.

>

> Ralph Giarnella MD

> Southington Ct USA

>

> A Placebo Effect for Pricey Placebos in Placating Pain

>

> BOSTON, March 4 -- Irrational and extraordinary as it

> may seem, expensive placebos offer greater pain relief

> than cheap ones, found researchers here.

>

> Put another way, placebos that cost pennies may be no

> therapeutic bargain in a patient's eyes compared with

> placebos that cost dollars -- even though they are the

> very same placebo.

>

> One implication is that extra-clinical factors -- such

> as price or brand name -- may alter the perceived

> efficacy of a real medication, according to Dan

> Ariely, Ph.D., of Massachusetts Institute of

> Technology, and colleagues.

>

> The finding emerged from a randomized, blinded study,

> in which 82 healthy paid volunteers were given what

> they were told was a new opioid and asked to rate its

> effect on painful electric shocks, Dr. Ariely and

> colleagues reported in a research letter in the March

> 5 issue of the Journal of the American Medical

> Association.

>

>

> Carefully consider the placebo effect when explaining

> medications to patients and do not emphasize elements

> such as price discounts or brand names.

> In fact, the volunteers were all given the same

> placebo, but some were told its price was $2.50 a pill

> and others were told the cost was discounted to 10

> cents a pill, the researchers reported.

>

> Those who got the perceived expensive pill had

> significantly greater pain reduction (P=0.02) than

> those who thought they were getting the cheaper

> version, Dr. Ariely and colleagues found.

>

> Dr. Ariely, a behavioral economist at MIT's Media Lab,

> said the finding is part of a range of human responses

> to what are essentially marketing factors. He explores

> other aspects of the issue in his recently published

> book, Predictably Irrational.

>

> With pain, Dr. Ariely said, " if you expect it to be

> worse, it could be worse. So what can we do in the

> marketplace so people don't expect it to be worse? "

>

> For instance, he added, poor people are often offered

> medicines at a discount. " Maybe we don't want to

> advertise that it's discounted, " he said.

>

> More generally, he said, doctors might want to take

> the placebo effect into account when they explain the

> benefits of medications, avoiding terms that might

> cause a patient to think a drug is second-rate.

>

> Among other things, Dr. Ariely and colleagues said,

> the finding could explain why many patients prefer

> higher-priced drugs such as -2 inhibitors instead

> of old standbys like acetaminophen or acetylsalicylic

> acid.

>

> It might also offer an explanation as to why some

> patients report that generic drugs are less effective

> than brand-name products, they said.

>

> In the experiment, the researchers recruited the 82

> volunteers and told them they were part of a medical

> experiment using a new pain-killer called Velodone.

>

> Much of the information they were given was in a slick

> brochure for the " drug, " including its price. But in a

> random fashion volunteers got either a brochure in

> which the price was set at $2.50 or 10 cents per pill.

>

> Electrical shocks to the wrist were calibrated to each

> participant's pain tolerance and after calibration,

> they were given a series of test shocks, which the

> volunteers rated on a visual analog scale.

>

> They were given the pill -- which they were told would

> act rapidly -- and after 15 minutes the tests shocks

> were repeated. For each test voltage, the post-pill

> score was subtracted from the pre-pill score and the

> mean of the differences was calculated.

>

> The researchers found:

>

> In the regular-price group, 85.4% of participants

> experienced a mean pain reduction after taking the

> pill, compared with 61% in the low-price group

> (significant at P=0.02).

> When only the most painful shocks for each participant

> were considered, the results were similar: 80.5% of

> the full-price group had a mean pain reduction,

> compared with 56.1% of the low-price group. The

> difference was significant at P=0.03.

> Over all of the test voltages, pain reduction was

> significantly greater for the regular-price pill, at

> P0.001.

> In addition, for 26 of 29 voltage intensities, mean

> pain reduction was greater for the full-price pill.

> Dr. Ariely said placebos are known to have effects,

> which in clinical trials are usually considered a

> nuisance that must be discounted.

>

> " Do we really want to consider it a nuisance variable

> or do we want to think about how to use it, " he said.

>

> The study was supported by MIT. The researchers

> reported no conflicts.

>

> Primary source: Journal of the American Medical

> Association

> Source reference:

> Waber RL, et al. " Commercial features of placebo and

> therapeutic efficacy. " JAMA 2008; 299(9): 1016-17.

>

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