(see more about placebo – nocebo at http://biopsychosocialmedicine.com/projects/rd-international-projects-2/placebo-rd/)
Here will placebo and noncebo be discussed
- First some thought about speed and observable changes.
When we discuss placebo effects we do focus on quite fast changes which we do not have any good explanation for, which can depend on a number of reasons where one is that we understand too little about complex systems interactions.
Spontaneous recovery is said to occur when we have not good explanation for not very fast, but sufficient fast processes where changes are subjected to observations.
When long termed changes – in for the individual negative or positive direction – occurs we do not know very well why they occurs but we assume that a particular treatment have effect on focused dysfunction. The problem is that we often observe symptoms (behaviors) but not the corresponding dysfunction(s) and their interactions with dependent systems.
Confounding factors is a problem which relates to understanding of complex systems interactions. We believe we can have some control over confounders using different kind of methodological approaches. The problem is that statistic is only statistics and this tell not much about functions and processes. Furthermore we often measure what can be measured which is not the same as what we need – which in it selves is complex to know when we know very little about complex systems interactions where nested synergy effects probably is the most important “thing” – think about H and O which during certain conditions “became” water.
At present lack of important knowledge we need to be careful in our communications with patients at the same time we need to “do something”. A scientist far from patient and reality can elaborate but a clinician must act although on very limited knowledge – in most cases (which clearly is not a part of examination questions).
3. Changes of different speeds in a particular observed system
We need to try to develop approaches to study individuals in certain conditions and measure changes of flow in crucial system (in terms of operational predicted parameters behaviors – will come up with a better expression here)
One way to do it is to measure continuous changes in autonomic nervous system behaviors in (assumed) stress related diseases/problems. As hormonal interactions are extremely complex it might be easier to study biofeedback induced changes in hormonal dependent measures.
Another ways is …
… more text soon …
Appreciated is suggestions to bo.vonscheele(at)stressmedicin.se marked “placebo”