|Poetry of reality|
|We must know. |
We will know.
|A view from the|
shoulders of giants.
A false placebo is a non-placebo factor that appears to cause an improvement of a disease. False placebos differ from actual placebos in that they occur regardless of whether the patient is treated or not. False placebos are the "other" things controlled for in the placebo arms of clinical trials.
Spontaneous remission (also known as spontaneous improvement or spontaneous regression) is a phenomenon in which an untreated disease or condition suddenly disappears for no apparent reason. This is one of the ways in which alternative medicine can seem to cure diseases such as cancer (along with misdiagnosis, in which case the person is "cured" of a disease they don't actually have).
The spontaneous remission rates for cancer depend on the type: according to studies done, basal cell carcinoma and breast cancer disappear in about 20% of cases, while the rates for melanoma haven't been studied, but have been estimated to be around 10%-20%. Autoimmune hepatitis goes into spontaneous remission in 13%-20% of cases. Untreated tuberculosis goes away in approximately 29% of cases. About 65%-75% of people with invasive group A streptococcal infections live.
Malaria misdiagnosis is a problem in Asia and Africa. In one study, out of 414 patients going to hospitals using clinical diagnosis, 412 were prescribed anti-malarial drugs, even though 413 tested negative for malaria.
Regression to the mean
Regression to the mean is just a fancy way of saying things tend to revert to normal given a set period of time. Many diseases are self-limiting. Time heals. So, most people will return to normal even if they have no treatment. Regression to the mean, however, can also mask actual efficacy of a treatment, and it's one of the many reasons anecdotes aren't reliable sources of information.
- Apparently Miraculous Cures: What Do They Tell Us?
- Spontaneous Regression of Melanoma May Offer Insight Into Cancer Immunology, Carrie Printz, JNCI J Natl Cancer Inst (2001) 93 (14): 1047-1048.
- Study reveals surprising cancer remission rate, Dartmouth Medicine Magazine.
- Hepatitis Chronic - Medical Disability Guidelines
- How to optimize tuberculosis case finding: explorations for Indonesia with a health system model, BMC Infectious Diseases 2009, 9:87 doi:10.1186/1471-2334-9-87.
- Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review, PLoS ONE 6(4): e17601. doi:10.1371/journal.pone.0017601.
- HPA - FAQs - Group A streptococcal infections
- Overdiagnosis and mistreatment of malaria among febrile patients at primary healthcare level in Afghanistan: observational study, Toby Leslie, Amy Mikhail, Ismail Mayan, Mohammed Anwar, Sayed Bakhtash, Mohammed Nader, Clare Chandler, Christopher J M Whitty, Mark Rowland, BMJ 2012;345:e4389.
- Symptom overlap for malaria and pneumonia--policy implications for home management strategies, Källander K, Nsungwa-Sabiiti J, Peterson S., Acta Trop. 2004 Apr;90(2):211-4.
- Malaria misdiagnosis: an interview with Dr Toby Leslie, July 26, 2012.