“Placebos are the ghosts that haunt our house of biomedical objectivity, the creatures that rise up from the dark and expose the paradoxes and fissures in our own self-created definitions of the real and active factors in treatment”. (The Placebo Effect, Harrington A Ed, Harvard Univ Press 1997)

Well, I wouldn’t put it exactly like that, but at the end of my talk I hope the audience picks up enough knowledge about this fascinating subject to be able to argue about whether the following statements are true or false:

• The “Placebo Effect” (PE) is essentially equivalent to natural history.

• There is ample evidence based proof that the PE is short lived.

• A placebo never produces measureable objective changes.

• The “Placebo Effect” is affected by:

1. natural history
2. regression to the mean
3. whether the treatment is open or hidden
4. naloxone, when dealing with analgesics
5. demographic or socio-economic factors

• A placebo can affect:

1. only subjective parameters
2. autonomic responses
3. endocrine responses

• A placebo affects a continuous response to a greater extent than a binary response.
• Placebos can cause objective (structurally & functionally measurable) changes in physiological functioning.
• Placebo reactors are different from non-reactors.
• Many doctors are placebos in their own right.
• There are placebo effects that occur in animals.

What Alan Wein says about the ICS
The ICS, including its publications and meetings, is, for me, the collegial repository of all objective knowledge about Lower Urinary Tract Function and Dysfunction. The ICS vocabulary permits us to communicate with one another without confusion. The composite statements and presentative are without subjective bias and enable us to follow a rational plan for evaluation of any given LUT problem and to devise a fact or consensus based stepwise plan of management.

To read Alan Wein's full biography click here