Discussion:
versus placebo
(too old to reply)
a***@gmail.com
2019-12-30 10:30:08 UTC
Permalink
1) In clinical tests versus placebo, this medication has been proven to
be effective.

2) This medication has been proven to be effective in clinical tests versus
placebo.

Are the above sentences grammatical?
Are they idiomatic?

Does 'versus placebo' modify 'clinical tests' in both of them?

Gratefully,
Navi
Peter Moylan
2019-12-30 10:43:42 UTC
Permalink
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.

I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
--
Peter Moylan http://www.pmoylan.org
Newcastle, NSW, Australia
Peter T. Daniels
2019-12-30 14:33:17 UTC
Permalink
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
A "control group," certainly, and one sort of control group would be
the one given placebos. The above sentences don't look natural at all.
Rich Ulrich
2019-12-30 19:04:33 UTC
Permalink
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
There are various sorts of clinical tests, and different levels
of control are identified and supported in the US by funding
agencies.

Initial testing for safety, and sometimes on possible
efficacy, will be on animals. Initial tests on humans
will be very small-N trials, also looking for safety and
efficacy.

Then there are informal trials, especially where a drug
is being using for some purpose not originally intended,
where someone may report "non-blind" data that, at
least, helps to justify a formal, "controlled trial". That's
the sort where one is apt to hope for "tests against
placebo."

If there is a "decent" treatment already available, it
could be unethical to use a placebo control when
looking for a better treatment. But that's a different
question.
--
Rich Ulrich
Peter Duncanson [BrE]
2019-12-30 20:07:59 UTC
Permalink
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
I am not a expert in this matter (understatement!). I think it possible
that some clinical trials might compare a new medication with an
existing one.

Anyway, in the sentences asked about, it is the "medication" that is
"versus a placebo".

The wording might be better as:

In clinical tests of this medication versus a placebo it has been
proven to be effective
--
Peter Duncanson, UK
(in alt.usage.english)
Katy Jennison
2019-12-30 23:39:54 UTC
Permalink
Post by Rich Ulrich
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
I am not a expert in this matter (understatement!). I think it possible
that some clinical trials might compare a new medication with an
existing one.
Anyway, in the sentences asked about, it is the "medication" that is
"versus a placebo".
In clinical tests of this medication versus a placebo it has been
proven to be effective
I think it would be more usual to see 'against a placebo' than 'versus'.
--
Katy Jennison
Peter Moylan
2019-12-31 00:33:21 UTC
Permalink
Post by Rich Ulrich
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
I am not a expert in this matter (understatement!). I think it possible
that some clinical trials might compare a new medication with an
existing one.
Anyway, in the sentences asked about, it is the "medication" that is
"versus a placebo".
In clinical tests of this medication versus a placebo it has been
proven to be effective
Yes, that's better wording. I'd be tempted to go even further:

In clinical tests this medication has been shown to be
more effective than a placebo.
--
Peter Moylan http://www.pmoylan.org
Newcastle, NSW, Australia
Peter Duncanson [BrE]
2019-12-31 12:08:11 UTC
Permalink
On Tue, 31 Dec 2019 11:33:21 +1100, Peter Moylan
Post by Peter Moylan
Post by Rich Ulrich
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
I am not a expert in this matter (understatement!). I think it possible
that some clinical trials might compare a new medication with an
existing one.
Anyway, in the sentences asked about, it is the "medication" that is
"versus a placebo".
In clinical tests of this medication versus a placebo it has been
proven to be effective
In clinical tests this medication has been shown to be
more effective than a placebo.
Agreed.

When answering this sort of question I find myself tending to suggest a
modified wording of the original rather than starting from scratch.
--
Peter Duncanson, UK
(in alt.usage.english)
J. J. Lodder
2020-01-01 13:26:34 UTC
Permalink
Post by Peter Moylan
Post by Rich Ulrich
On Mon, 30 Dec 2019 21:43:42 +1100, Peter Moylan
Post by Peter Moylan
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven
to be effective.
2) This medication has been proven to be effective in clinical tests
versus placebo.
Are the above sentences grammatical? Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
Yes, no, and yes. They look like unnatural English to me, but I can
well imagine them to be part of the jargon of the people who do clinical
trials.
I suspect a redundancy, though. In any clinical trial of a new
medication, wouldn't there be an automatic assumption that a placebo
would be included in the tests? It's hard to imagine a valid trial that
didn't include a null hypothesis. If I'm right, the words "versus
placebo" should be omitted.
I am not a expert in this matter (understatement!). I think it possible
that some clinical trials might compare a new medication with an
existing one.
Anyway, in the sentences asked about, it is the "medication" that is
"versus a placebo".
In clinical tests of this medication versus a placebo it has been
proven to be effective
In clinical tests this medication has been shown to be
more effective than a placebo.
A bit off, I think.
Placobos have no effect, by definition. (apart from a psychological one)
The placebo merely sets the baseline for detectability of an effect,

Jan
Rich Ulrich
2020-01-01 21:38:16 UTC
Permalink
Post by J. J. Lodder
Post by Peter Moylan
In clinical tests this medication has been shown to be
more effective than a placebo.
A bit off, I think.
Placobos have no effect, by definition. (apart from a psychological one)
The placebo merely sets the baseline for detectability of an effect,
umm - You too quickly dismiss "psychological" effect.

Clinical psychiatry regularly finds placebo effects when
testing medications, and they may be as much as
"improvement in 30% of patients." That can be, I
think, in comparison to 0% in a no-medication sample.
There can be a greater fraction improved if there
would be improvement in a no-drug group, too.


A confounding concern in psychiatric research is that
patients are often picked up at the /peak/ of a cycle,
or when they are otherwise at their worst (if not a
cycle), at the time when bad behavior gets them
arrested or has them brought to the emergency room of
a psychiatric hospital. Yesterday, they were better.
Tomorrow, they will /likely/ be better, given nothing
but time and sleep.

Where I worked, emergency room referrals were
typically put on minimal meds for a week to let them
"dry out" or cool off from their anger or come
down from whatever they were on, before they
were considered for admission to any clinical trial of
any sort. After a week or two, the best-guess for the
next couple of weeks is still going to be "regression
towards the (normal) mean" and continued improvement.
--
Rich Ulrich
Ken Blake
2020-01-01 17:31:51 UTC
Permalink
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven to
be effective.
2) This medication has been proven to be effective in clinical tests versus
placebo.
Are the above sentences grammatical?
Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
All of these sentences are very poor. It makes no sense to say "clinical
tests versus placebo." If a placebo is used, it is used as part of a
clinical test, not as something opposed to it.


You could say something like "This medication versus a placebo has been
proven to be effective in clinical tests."
--
Ken
Mark Brader
2020-01-02 06:23:47 UTC
Permalink
It makes no sense to say "clinical tests versus placebo."
Of course it does.
If a placebo is used, it is used as part of a clinical test, not
as something opposed to it.
You are misreading the "versus". What is being opposed to the placebo
is the treatment being tested. Therefore "versus placebo" is specifying
the kind of clinical test.
--
Mark Brader, Toronto, ***@vex.net
Irving Thalberg's advice on GONE WITH THE WIND:
"Forget it, Louis. No Civil War picture ever made a nickel."
J. J. Lodder
2020-01-02 12:27:56 UTC
Permalink
Post by Mark Brader
It makes no sense to say "clinical tests versus placebo."
Of course it does.
If a placebo is used, it is used as part of a clinical test, not
as something opposed to it.
You are misreading the "versus". What is being opposed to the placebo
is the treatment being tested. Therefore "versus placebo" is specifying
the kind of clinical test.
A clinical test without a placebo control isn't a clinical test.
It is at best junk, and at worst merely advertising,

Jan
Peter Duncanson [BrE]
2020-01-03 12:05:00 UTC
Permalink
Post by J. J. Lodder
Post by Mark Brader
It makes no sense to say "clinical tests versus placebo."
Of course it does.
If a placebo is used, it is used as part of a clinical test, not
as something opposed to it.
You are misreading the "versus". What is being opposed to the placebo
is the treatment being tested. Therefore "versus placebo" is specifying
the kind of clinical test.
A clinical test without a placebo control isn't a clinical test.
It is at best junk, and at worst merely advertising,
Jan
Don't some clinical tests use an existing treatment as the control?

If patients with a particular condition are routinely treated with
medication A it is not possible to perform trials of a new medication,
B, by putting some patients in the trial on a placebo rather than their
normal A. That would mean removing necessary medication from those
patients. Damaging and unethical, surely?
--
Peter Duncanson, UK
(in alt.usage.english)
Peter Moylan
2020-01-03 14:04:33 UTC
Permalink
Post by Peter Duncanson [BrE]
Post by Mark Brader
It makes no sense to say "clinical tests versus placebo."
Of course it does.
If a placebo is used, it is used as part of a clinical test,
not as something opposed to it.
You are misreading the "versus". What is being opposed to the
placebo is the treatment being tested. Therefore "versus
placebo" is specifying the kind of clinical test.
A clinical test without a placebo control isn't a clinical test. It
is at best junk, and at worst merely advertising,
Don't some clinical tests use an existing treatment as the control?
If patients with a particular condition are routinely treated with
medication A it is not possible to perform trials of a new
medication, B, by putting some patients in the trial on a placebo
rather than their normal A. That would mean removing necessary
medication from those patients. Damaging and unethical, surely?
Probably; but comparing B with the placebo will give more impressive
results than comparing B with A. After all, the latter test might well
show that B is not as good as A.

Are you accusing drug companies of ethical behaviour? The bigger ones
have moved beyond that.
--
Peter Moylan http://www.pmoylan.org
Newcastle, NSW, Australia
Peter T. Daniels
2020-01-03 18:08:50 UTC
Permalink
Post by Peter Moylan
Post by Peter Duncanson [BrE]
Post by Mark Brader
It makes no sense to say "clinical tests versus placebo."
Of course it does.
If a placebo is used, it is used as part of a clinical test,
not as something opposed to it.
You are misreading the "versus". What is being opposed to the
placebo is the treatment being tested. Therefore "versus
placebo" is specifying the kind of clinical test.
A clinical test without a placebo control isn't a clinical test. It
is at best junk, and at worst merely advertising,
Don't some clinical tests use an existing treatment as the control?
If patients with a particular condition are routinely treated with
medication A it is not possible to perform trials of a new
medication, B, by putting some patients in the trial on a placebo
rather than their normal A. That would mean removing necessary
medication from those patients. Damaging and unethical, surely?
Probably; but comparing B with the placebo will give more impressive
results than comparing B with A. After all, the latter test might well
show that B is not as good as A.
Are you accusing drug companies of ethical behaviour? The bigger ones
have moved beyond that.
Not just the bigger ones. I think that Grünenthal was a small company
when it precipitated the thalidomide disaster.
It didn't happen Over Here, because there were strict controls on using
drugs for things they weren't designed for, without the sort of rigorous
animal and clinical testing that had been used for its original purpose.

Thalidomide is still occasionally used here for its original purpose.
Anders D. Nygaard
2020-01-05 21:57:53 UTC
Permalink
Post by Peter T. Daniels
Thalidomide is still occasionally used here for its original purpose
"Initially thalidomide was promoted for anxiety, trouble sleeping,
"tension", and morning sickness"?

/Anders, Denmark.
Peter Young
2020-01-05 22:17:08 UTC
Permalink
Post by Anders D. Nygaard
Post by Peter T. Daniels
Thalidomide is still occasionally used here for its original purpose
"Initially thalidomide was promoted for anxiety, trouble sleeping,
"tension", and morning sickness"?
Now used for a last-ditch treatment for some cancers. Naturally in people
who have no danger of becoming pregnant.

Peter.
--
Peter Young, (BrE, RP), Consultant Anaesthetist, 1975-2004.
(US equivalent: Certified Anesthesiologist) (AUE Hg)
Cheltenham and Gloucester, UK. Now happily retired.
http://pnyoung.orpheusweb.co.uk
J. J. Lodder
2020-01-02 10:38:42 UTC
Permalink
Post by Ken Blake
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven to
be effective.
2) This medication has been proven to be effective in clinical tests versus
placebo.
Are the above sentences grammatical?
Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
All of these sentences are very poor. It makes no sense to say "clinical
tests versus placebo." If a placebo is used, it is used as part of a
clinical test, not as something opposed to it.
Exactly. A placebo is not some kind of medication.
Post by Ken Blake
You could say something like "This medication versus a placebo has been
proven to be effective in clinical tests."
Still poor. It is hopeless I guess,
you can't build a good sentence to express muddled thinking.
Something like: 'This medication has been proven to be effective in
controlled clinical tests' should be enough,

The fact that the controlled testing must have been double-blind
isn't mentioned either,

Jan
Peter Duncanson [BrE]
2020-01-03 20:24:04 UTC
Permalink
Post by J. J. Lodder
Post by Ken Blake
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven to
be effective.
2) This medication has been proven to be effective in clinical tests versus
placebo.
Are the above sentences grammatical?
Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
All of these sentences are very poor. It makes no sense to say "clinical
tests versus placebo." If a placebo is used, it is used as part of a
clinical test, not as something opposed to it.
Exactly. A placebo is not some kind of medication.
Post by Ken Blake
You could say something like "This medication versus a placebo has been
proven to be effective in clinical tests."
Still poor. It is hopeless I guess,
you can't build a good sentence to express muddled thinking.
Something like: 'This medication has been proven to be effective in
controlled clinical tests' should be enough,
The problem with that is that it doesn't distinguish between a clinical
trial using a placebo as the control and one using an existing
medication.
Post by J. J. Lodder
The fact that the controlled testing must have been double-blind
isn't mentioned either,
Jan
--
Peter Duncanson, UK
(in alt.usage.english)
Peter Duncanson [BrE]
2020-01-03 23:05:06 UTC
Permalink
On Fri, 03 Jan 2020 20:24:04 +0000, "Peter Duncanson [BrE]"
Post by Peter Duncanson [BrE]
Post by J. J. Lodder
Post by Ken Blake
Post by a***@gmail.com
1) In clinical tests versus placebo, this medication has been proven to
be effective.
2) This medication has been proven to be effective in clinical tests versus
placebo.
Are the above sentences grammatical?
Are they idiomatic?
Does 'versus placebo' modify 'clinical tests' in both of them?
All of these sentences are very poor. It makes no sense to say "clinical
tests versus placebo." If a placebo is used, it is used as part of a
clinical test, not as something opposed to it.
Exactly. A placebo is not some kind of medication.
Post by Ken Blake
You could say something like "This medication versus a placebo has been
proven to be effective in clinical tests."
Still poor. It is hopeless I guess,
you can't build a good sentence to express muddled thinking.
Something like: 'This medication has been proven to be effective in
controlled clinical tests' should be enough,
The problem with that is that it doesn't distinguish between a clinical
trial using a placebo as the control and one using an existing
medication.
The UK's National Health Service website has a description of clinical
trials. It is aimed at the public, in particular potential participants.

Part of this page says:
https://www.nhs.uk/conditions/clinical-trials/

Control groups, randomisation and blinding

If you take part in a clinical trial, you'll usually be randomly
assigned to either the:

* treatment group – where you'll be given the treatment being
assessed, or
* control group – where you'll be given an existing standard
treatment, or a placebo if no proven standard treatment exists

While the treatments are different in the 2 groups, researchers try
to keep as many of the other conditions the same as possible.

For example, both groups should have people of a similar age, with a
similar proportion of men and women, who are in similar overall
health.

In most trials, a computer will be used to randomly decide which
group each patient will be allocated to.

Many trials are set up so nobody knows who's been allocated to
receive which treatment.

This is known as blinding, and it helps reduce the effects of bias
when comparing the outcomes of the treatments.

The last section on that page starts:

Coverage in newspapers

You'll often see stories about research findings in mainstream
media.

But while news stories are easier to read than original research
papers, sometimes the findings are exaggerated or sensationalised.
....
Post by Peter Duncanson [BrE]
Post by J. J. Lodder
The fact that the controlled testing must have been double-blind
isn't mentioned either,
Jan
--
Peter Duncanson, UK
(in alt.usage.english)
Rich Ulrich
2020-01-04 00:32:49 UTC
Permalink
On Fri, 03 Jan 2020 23:05:06 +0000, "Peter Duncanson [BrE]"
Post by Peter Duncanson [BrE]
Many trials are set up so nobody knows who's been allocated to
receive which treatment.
This is known as blinding, and it helps reduce the effects of bias
when comparing the outcomes of the treatments.
For completeness: the patient is usually "blind"
to the medication, or blind to which other treatment
is expected to have better outcome.

The study is called "double-blind" when the clinicians
also are kept blind to who gets placebo. It is sometimes
feasible to have /raters/ who view specific interactions
or videos, and who are kept "blind", even when the treating
clinicians have to know what they are administering.

When the active med is too well-known to have
active effects, there is the temptation to use an "active
placebo" - like, a small dose of caffeine, for a study
where caffeine /should/ be irrelevant. That woud be
done more often, but experimenters worry that
whatever is at all active /might/ accidentally be
effective, if it hasn't already, thoroughly, been ruled
out.
--
Rich Ulrich
s***@gmail.com
2020-01-04 01:17:36 UTC
Permalink
Post by Rich Ulrich
When the active med is too well-known to have
active effects, there is the temptation to use an "active
placebo" -[...]
C.f. human trials of DMSO, no?

/dps "sulphured molasses would not be an active placebo for that"
RH Draney
2020-01-04 06:40:32 UTC
Permalink
Post by Peter Duncanson [BrE]
Post by J. J. Lodder
Post by Ken Blake
You could say something like "This medication versus a placebo has been
proven to be effective in clinical tests."
Still poor. It is hopeless I guess,
you can't build a good sentence to express muddled thinking.
Something like: 'This medication has been proven to be effective in
controlled clinical tests' should be enough,
The problem with that is that it doesn't distinguish between a clinical
trial using a placebo as the control and one using an existing
medication.
"Testing will be performed on our new anti-hypoglycemia treatment...one
test group will be given the drug, a concentrated glucose
supplement...the control group will be given an inert sugar pill"....r
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