Archive for the ‘Efficacy’ Category

Intelligent Design, Spontaneous Remission and the Placebo

Friday, September 14th, 2007

This is not going to be an article on Intelligent Design. But Intelligent Design is a member of a class of concepts that appear in scientific dialogue without ever having earned their way in the usual fashion of combining theory with evidence. Now Intelligent Design just happens to be a concept that scientists would like to banish from the discourse. But other concepts that similarly lack the particulars of a scientific theory have overcome the immune reaction and reside happily among us. Examples are the placebo effect, the idea of spontaneous remission, and the Anthropic Principle. These concepts were never intended to become true science. They serve a useful function as placeholders, even as overt “untheories.”

Just as the idea of Intelligent Design makes a place–at least in principle–for a “God of the gaps,” the placebo model and spontaneous remission serve in the role of filling gaps in our scientific models. Matters are least ambiguous with regard to the concept of spontaneous remission. No scientist who is uncomfortable with the idea of Intelligent Design is any more comfortable with the idea of spontaneous remission. The term is not meant literally. One assumes that the spontaneous remission of cancer will ultimately yield to mechanistic understanding. But we have not been prepared to deal with that issue up to now. So everyone understands that spontaneous remission is just a placeholder that allows the conversation to proceed on issues that we can handle. (more…)

Antidepressants may not offer relief in Bipolar Disorder

Tuesday, May 1st, 2007

PillsAn article in a recent issue of the New England Journal of Medicine finds that anti-depressants don’t contribute significantly to the recovery of bipolar patients. It is estimated that some 70% of bipolars are also being prescribed one or another anti-depressant. Since these are not fast-acting medications, it is often difficult to tell which of the medications being prescribed are actually doing the work.The surprise in the paper, however, was something else. It turns out that the placebo group did better than the medication group! Not only did the addition of anti-depressants fail to improve outcome, but the outcome was actually somewhat worse overall than among those who did not have anti-depressants added to their regimen. The difference was not statistically significant, according to the researchers. Some 23.5% of the treatment arm made “durable recoveries,” whereas some 27.3% of the placebo group did so. (more…)

Another Inconvenient Truth

Tuesday, May 1st, 2007

Plant Truth ComicJonathan Chait, a senior editor at the New Republic, reports that when the National Journal asked Republican senators and members of the House last year “…whether it’s been proven beyond a reasonable doubt that the earth is warming because of man-made problems,” only some 23% said yes. Since that time there has been a further strengthening of the scientific evidence, and the UN Intergovernmental Panel on Climate Change (IPCC) released a study signed by 2000 scientists to the effect that the likelihood of man-induced global warming now lay at the 90% level. When a similar question was asked of the Congressmen this year, the percentage assenting had surprisingly dropped to only 13%.

This depressing development should be a cautionary tale for those who believe that the acceptance of neurofeedback is just going to be a matter of putting forward better and larger scientific studies. This might just possibly be true in an environment where entrenched interests are not involved. But when real economic interests or basic belief systems are threatened, the skills of scientists in making evidence disappear or look unconvincing are brought into play. Moreover, even if the scientists are of one mind, as they are on the matter of global warming, yet other interests can still manage to confuse the picture. (more…)

A Simple Proposition

Wednesday, June 7th, 2006

One issue in particular has been weighing on a number of people with regard to our work. It is the question of why a single protocol should be so effective for such a variety of conditions, and why a particular virtue seems to attach to the use of bipolar training, a tactic that has been abandoned by many in the field who have made the transition to QEEG-based training. This issue has come up again recently, so this is not a bad time to discuss it. A secondary issue is why inter-hemispheric training should hold such special virtues for us, but that issue can await its own individual treatment.

First of all, it needs to be recalled that all of the early work of Barry Sterman and Joel Lubar was done with bipolar placement, which is characterized by the fact that both active leads are placed on the scalp over cortex, as distinguished from referential placement in which one active lead is placed on a “quasi-neutral” site such as the ear. (more…)

A Critique of NIMH’s Major Study of Anti-Depressant Effectiveness

Wednesday, April 26th, 2006

On March 23rd the Washington Post reported in a front-page article on the findings just released from NIMH’s 35-million dollar “Sequenced Treatment Alternatives to Relieve Depression” study. The study results were met with mixed reviews. The url:
The results from this study were published in three articles and discussed in an editorial in the New England Journal of Medicine (NEJM):

  1. The 1st article appeared in the January 2006 American Journal of Psychiatry (AJP) and focused on the initial response to citalopram (an SSRI) by 2,876 patients presenting with major depression in either a psychiatric clinic or primary care setting.
  2. The 2nd article appeared in last week’s NEJM and focused on the effectiveness of bupropion, sertraline, or venlaffaxine for patients who failed to respond to citalopram.
  3. The 3rd article appeared in last week’s NEJM and focused on medication “augmentation” by adding either bupropion or buspirone to citalopram for those patients who failed to respond to citalopram alone.


The Efficacy Document: A Celebration and a Critique

Wednesday, June 23rd, 2004

The AAPB has just published the document “Evidence-Based Practice in Biofeedback and Neurofeedback,” by Carolyn Yucha and Christopher Gilbert. It has been more than ten years since the AAPB has issued an official statement of conditions where efficacy of biofeedback is recognized by the organization. Since that earlier document, we have witnessed the continuing thrust toward evidence-based medicine. As a professional community, there was no choice but to respond in a fashion such as this.

So let’s look at the good news: First of all, the document puts together under the same covers the case for neurofeedback and for peripheral, somatic neurofeedback. The document makes the case for “self-regulation” as the active ingredient (page 2), irrespective of how it may be achieved with biofeedback. The document acknowledges that evidence-based practice must take into account not only efficacy in controlled studies but effectiveness in actual clinical practice. It forthrightly acknowledges the methodological problems confronting biofeedback when it is placed in random controlled studies under blinded conditions. (more…)


Subscribe to Email Newsletter

The EEG Info Newsletter circulates via email at least once a month. A variety of topics related to the Neurofeedback / EEG Biofeedback field are covered in over 200 articles.
* Email
First Name
Last Name
* = Required Field
I hereby allow EEG Info permission to send messages to me via email as means of communication as indicated by my signing up for this email newsletter.