Placebo effects in the extreme

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esldude

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http://www.statnews.com/2016/02/19/6-phony-surgeries-placebo/

I have read of such medical studies before, but a recent short summary in the link above.

I think they are extreme examples of how powerful, far reaching, and the high level of influence placebo and nocebo effects have upon the human organism. So many wish to trust their ears and ignore how powerful such effects are that it has created a schism like having this one forum among dozens here in order to cut down on the deeply felt disagreements inherent in the high end of the hobby as it is. Having been one of those people for years I get it, been there, done that whatever.

Commonly, those who don't see the need or benefit in scrupulously protecting yourself from fooling yourself or simply being fooled imagine those on the other side to have some deficiency in our hearing, our gear etc. What I find is rather these are people who have had experience where clearly their golden ears betrayed them. They have personal experience of how wrong that can be due to expectation bias, and placebo. It quickly becomes apparent how rampant that is in the high end audio business. In my own experience it was a very uncomfortable feeling for quite some time. But dammit I wanted to really know the truth.

Yet sticking with simple facts, appropriate use of measurements, and studying psycho-physical effects upon our hobby of music reproduction, I find it exceptionally difficult to find forums where you can simply do that. Facts aren't, touchy feely emotional connections trump it all, and we aren't supposed to comment if we haven't heard whatever is under discussion, even when there isn't anything to hear. I like no doubt plenty of others, have been banned a few times for very innocuous factual comments that simply didn't go down well with those wishing to believe in magic. Just recently I was 'chided' by Steve Williams for suggesting a couple of ways to find out what is inside of a sealed box you aren't allowed to open. Claiming I was being insincere, inflammatory and sarcastic when nothing of the sort was true.

So I guess this is something of a rant. And a question in approaches that others have found useful to get the points across. No matter how factually correct one might be, if you can't convince anyone else, can't communicate that to others, then your knowledge has limited usefulness.

I have the experience more than once, of convincing people much of what they thought was different was only bias and placebo. We are talking hands on, comfortable events to show what was going on. Those people recognized the truth of it, and yet, they were so uncomfortable it makes only marginal difference in their approach to music reproduction. In particular situations they acknowledge the rightness of how things work, yet want the magic, the mystery and the self developed acolyte role in this hobby so much they can't really let go of it.

So, comments and thoughts????
 
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Rodney Gold

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I have "fooled" myself many times , but I still trust my ears/brain interface...after all its what you perceive is really your reality
 

bonzo75

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Apples and oranges - there is no way for a patient to know what's a real surgery/pill or what isn't. Only the doctor is qualified to know that, and the patient takes whatever he says at face value. On the other hand, I am qualified to hear the difference between Mozart and Metallica, and to me they are distinguishable unlike a real pill and a fake one, and I don't need to be dependent on a qualified person to tell me which one is Mozart and which one is Metallica. Also, unlike with a surgery or a pill, which are usually one-offs, my A/B experiences can be repeated multiple times over a short and a long timeframe and in different systems

All that you proved with your article is that placebo in medicine exists. You are the one who is making the jump that you can use it to imply that hence the same principle applies to audio and people risk getting fooled due to it
 
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Gregadd

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I find it ironic that doctors believe in the placebo effect, but have no belief in homeopathic medicine. That is to say, you can be treated with a sugar pill or sham surgery but not with homeopathic medicine or therapy.

The right to speak is not the same s the right to not be criticized.

When I criticized blind testing Amir invited me to "move on." The thread was closed. I have been repeatedly invited to leave the measurement forum.
http://www.whatsbestforum.com/showthread.php?12209-Tips-for-ABX-Tests/page8 Post#79.
 
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Speedskater

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I find it ironic that doctors believe in the placebo effect, but have no belief in homeopathic medicine. That is to say, you can be treated with a sugar pill or sham surgery but not with homeopathic medicine or therapy.
I think that 'belief' is the wrong word. The doctors are looking for real solutions of real problems. For the most part doctors are not trying to change how the patient feels about a real problem. The patient must be fully aware of the placebo or homeopathic medicine for it to have any effect. In fact placebo medicine and homeopathic medicine are the same product just with different labels.
 

Gregadd

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I think that 'belief' is the wrong word. The doctors are looking for real solutions of real problems. For the most part doctors are not trying to change how the patient feels about a real problem. The patient must be fully aware of the placebo or homeopathic medicine for it to have any effect. In fact placebo medicine and homeopathic medicine are the same product just with different labels.
i walked into that one. I am curious that you coined a term"placebo medicine." Homepathic medicine is about stimulating the auto immune system ussing natural substances to counter disease and maintainingg health in general.
 
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BlueFox

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Apples and oranges - there is no way for a patient to know what's a real surgery/pill or what isn't. Only the doctor is qualified to know that, and the patient takes whatever he says at face value. On the other hand, I am qualified to hear the difference between Mozart and Metallica, and to me they are distinguishable unlike a real pill and a fake one, and I don't need to be dependent on a qualified person to tell me which one is Mozart and which one is Metallica. Also, unlike with a surgery or a pill, which are usually one-offs, my A/B experiences can be repeated multiple times over a short and a long timeframe and in different systems

All that you proved with your article is that placebo in medicine exists. You are the one who is making the jump that you can use it to imply that hence the same principle applies to audio and people risk getting fooled due to it

+100%. There is no such thing as 'placebo' in listening to music. It is purely a medical term. Unfortunately, it has been adopted by some as a way to justify their hearing deficiency.
 

amirm

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So, comments and thoughts????
Sure :). The recipe I have for anyone who thinks they can trust their ears is to get a job where being right there determines their job and compensation. A story in that regard :).

Again this is at Microsoft and we are duking it out with our competitor to see who has the better codec in the days of dial up modems and slow and low-speed adoption of broadband Internet access. So getting the bandwidth down while keeping fidelity up was a big deal. My team worked and worked to optimize our encoder with me as their feedback loop. I would keep doing competitive testing and eventually we got to the point where I thought we had two to one advantage. That is, we could produce the same fidelity as our competitor but at half the bit rate.

I tell that to my marketing team and they get all excited. They knew that if we announced it, it would have little value. So the results had to come from an outside lab. We hire one at a cost of $20,000. They go and recruit 100+ listeners and create a blind test after a couple of weeks of prep. The testing starts and I get this early morning panic call from our marketing guy saying the testing is not going well and I better call the testing company. I call them and they say that they have had only a few people through the test but the outcome is clear: they are picking the competitor as sounding better by far. That is, by lowering the bit rate we also lowered the fidelity so there was nothing new and good there.

I was outraged. I had the same files they were using and I had tested them myself and "knew" that we had matched the competitor at half the bit rate. I was convinced they were doing something wrong. Asked them to send the files to me that they were using and they were identical to what I had. By then my wife is up and I recruit her for testing. Horrors of horrors, she agrees with the results of the testing agency!

I take a moment to calm down and consider that outcome potentially valid. I then did my listening tests again this time allowing for that possibility as much as the outcome I wanted. Well, I started to hear the problems in our fidelity and conceded that I was wrong. We were better at the same bit rate as them but not a 2:1 advantage.

I called our marketing guys and said I was wrong and apologized for costing them $20,000. And we cancelled the rest of the testing.

I have told this and many stories like this before. It cannot be more convincing if you were sitting in my shoes to hold the stance people hold with listening tests. Our brain has this incredible ability to synthesize positive outcomes. As creatures we are optimistic ones. We want happiness. We want success. So we read those emotions into what we think we heard, but not what enters our ear canal.

Of course I am not alone. The entire scientific and engineering field in audio believes in exactly the same. How it is that we have made it fashionable to disagree with that, especially coming from professionals where in their daily lives they act opposite, belies any logic to me. But here we are.
 

Steve Williams

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well it only goes to show once again that there will always be those who trust their ears and those who don't

When I listen I make no comparisons other than something sounds better or not. I never quantitate it as a 2:1 advantage

Something is either better or something different.

If it is something better, I always ask myself, "how so". I never quantitate. It's either better or not
 

bonzo75

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Amir - the only thing I can conclude form your anecdote is that we shouldn't trust your ears :)
 

Speedskater

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i walked into that one. I am curious that you coined a term"placebo medicine." Homepathic medicine is about stimulating the auto immune system ussing natural substances to counter disease and maintainingg health in general.
If there is 'homeopathic medicine' then surely there is 'placebo medicine'. But 'placebo medicine' is much less dangerous.
 

amirm

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Amir - the only thing I can conclude form your anecdote is that we shouldn't trust your ears :)
The ears? No. You should trust your ears 1000%. It is the brain that incorporates other senses and imagination is the thing you don't want to trust.
 

amirm

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well it only goes to show once again that there will always be those who trust their ears and those who don't
No, it shows once again denial of how our perceptions work, sadly coming from a doctor who should know this cold. What is the saying in high-end restaurants? That we eat with our eyes and hence the reason they make the plate pretty?

When I listen I make no comparisons other than something sounds better or not. I never quantitate it as a 2:1 advantage
If I gave you an amp that was half the price as another, and you compare their sounds to see if they are equal, that is exactly what you are doing. In the story I told that was precisely the case. One file was half the size/bit rate of the other and the goal was to see if they still sounded the same. Much like those two amps.

Something is either better or something different.

If it is something better, I always ask myself, "how so". I never quantitate. It's either better or not
And that is the sure way to fall in the ditch....
 

amirm

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Apples and oranges - there is no way for a patient to know what's a real surgery/pill or what isn't. Only the doctor is qualified to know that, and the patient takes whatever he says at face value. On the other hand, I am qualified to hear the difference between Mozart and Metallica, and to me they are distinguishable unlike a real pill and a fake one, and I don't need to be dependent on a qualified person to tell me which one is Mozart and which one is Metallica. Also, unlike with a surgery or a pill, which are usually one-offs, my A/B experiences can be repeated multiple times over a short and a long timeframe and in different systems

All that you proved with your article is that placebo in medicine exists. You are the one who is making the jump that you can use it to imply that hence the same principle applies to audio and people risk getting fooled due to it
Unfortunately the preamble in your post defeats your conclusion. It is absolutely true that in a medical experiment somebody knows the answer (in double blind tests the doctor administrating the treatment does not know either). It is that ultimate truth and answer to the puzzle that allows that system to work. We "know" we gave placebo to someone and hence if they got better, we know it was not due to medication.


In audio we walk blind and deaf. We put in something in our system and declare it either effective or not. Yet there is no envelop we can then open that tells us if we were correct or not. Lacking that, we build up experiences completely on false basis. In reality the change may have made no difference, or made things worse, or better. You don't know the ultimate truth. You took a test and graded your own exam with an A+. "Oh I trust my ears." No, you trust false experiences.

Have yourself tested by a loved one and a dose of reality sets in. Have them put in and remove the change without looking once in awhile at least. Know the truth and see if you can determine it with your senses. I am confident you will not in any form or fashion trust these outcomes where audio science and engineering say they are different than what you think.

Speaking of science/engineering, that is what you should use when you lack the time/discipline to perform the above tests. Don't go against the grain of what is known by the experts in the field. Don't think you are so good that you are creating your own science. I know I am not that smart. Hopefully you don't think either.
 

RayDunzl

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The ears? No. You should trust your ears 1000%. It is the brain that incorporates other senses and imagination is the thing you don't want to trust.

Is the brain responsible (not counting its prior choices of acoustic environment, if applicable) for hearing loss?
 

amirm

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Is the brain responsible (not counting its prior choices of acoustic environment, if applicable) for hearing loss?
Are you asking that independent of the point I made? Because if you have a hearing loss, your conclusions are still valid for you if you only rely on your hearing and not eyes, preconceptions regarding brand, cost, looks, color, etc. With or without hearing loss, a fair comparison of these two speakers cannot be made with eyes open:





Your conclusions of course would not apply to someone without hearing loss if that part of your hearing deficiency is exercised in the evaluation.
 

bonzo75

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Unfortunately the preamble in your post defeats your conclusion. It is absolutely true that in a medical experiment somebody knows the answer (in double blind tests the doctor administrating the treatment does not know either). It is that ultimate truth and answer to the puzzle that allows that system to work. We "know" we gave placebo to someone and hence if they got better, we know it was not due to medication.


In audio we walk blind and deaf. We put in something in our system and declare it either effective or not. Yet there is no envelop we can then open that tells us if we were correct or not. Lacking that, we build up experiences completely on false basis. In reality the change may have made no difference, or made things worse, or better. You don't know the ultimate truth. You took a test and graded your own exam with an A+. "Oh I trust my ears." No, you trust false experiences.

Have yourself tested by a loved one and a dose of reality sets in. Have them put in and remove the change without looking once in awhile at least. Know the truth and see if you can determine it with your senses. I am confident you will not in any form or fashion trust these outcomes where audio science and engineering say they are different than what you think.

Speaking of science/engineering, that is what you should use when you lack the time/discipline to perform the above tests. Don't go against the grain of what is known by the experts in the field. Don't think you are so good that you are creating your own science. I know I am not that smart. Hopefully you don't think either.

I have blind tested myself on shun mooks, stillpoints, such tweaks and and cables multiple times. You assume I haven't. And I have blind tested many on the mooks too.

Now, you again miss the point. It is possible a placebo can cure a medical condition. The analogy has nothing to do with audio, however. In audio, the patient can distinguish between Mozart and Metallica
 

amirm

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I have blind tested myself on shun mooks, stillpoints, such tweaks and and cables multiple times. You assume I haven't. And I have blind tested many on the mooks too.
Well, this is the place to outline such. How did you test them?

Now, you again miss the point. It is possible a placebo can cure a medical condition. The analogy has nothing to do with audio, however. In audio, the patient can distinguish between Mozart and Metallica
No, it is exactly the same. I can make your system better by giving you an empty box that does absolutely nothing and have you and others rave and swear that it made your system sound better. More so, you would pay thousands of dollars for the same.
 

JackD201

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No, it shows once again denial of how our perceptions work, sadly coming from a doctor who should know this cold. What is the saying in high-end restaurants? That we eat with our eyes and hence the reason they make the plate pretty?


If I gave you an amp that was half the price as another, and you compare their sounds to see if they are equal, that is exactly what you are doing. In the story I told that was precisely the case. One file was half the size/bit rate of the other and the goal was to see if they still sounded the same. Much like those two amps.


And that is the sure way to fall in the ditch....

You make no sense. The ears are only part of the entire auditory system. It's like saying you can trust your tires, well not really if your suspension is off. You're going sideways even with the best tires in the world. Besides, not fully understanding how the brain works doesn't mean it doesn't work. Have you ever thought just maybe you are expecting to find ultimate truth when our senses have evolved simply to keep us alive, pleasure being the ol' reward for good job done with a bit of serotonin release? Well, we're all entitled to our approaches to this hobby. If you guys want to bust out mics and laptops for fun, knock yourselves out. Just respect that that is not fun to many people.
 

bonzo75

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Well, this is the place to outline such. How did you test them?


No, it is exactly the same. I can make your system better by giving you an empty box that does absolutely nothing and have you and others rave and swear that it made your system sound better. More so, you would pay thousands of dollars for the same.

Not really - if you gave a medical pill, there would be no way for us to tell - so our brain fooling us doesn't even come into the picture, we are incapable of making the distinction. We are quite capable of making the distinction between Mozart and Metallica. We trust doctors, we naturally don't trust dealers are skeptical of them. There are zero similarities here. A pill gets tested once - your empty box will go through multiple iterations of testing, with friends and in different systems.

You are actually implying that "a guy who trusts his ears and compares things multiple times with friends in different settings where the goods are bought from a dealer he is skeptical about" is comparable to "a guy who doesn't trust his medical knowledge and buys something from a person he is totally dependent on in that regard and does not test it except once"
 
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