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Medic. study—placebo tends to lack important effect—relevant to audio?, [was “Placebo effect does not exist”]
greynol
post Jun 10 2013, 18:25
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This issue at hand is that there is no mechanism in place to ensure that patients who are aware that they were given the placebo, or rather did not recognize any improvement in their condition, are honest in reporting it.

If you feel that a passed ABX is a valid way to demonstrating that any particular individual can distinguish a difference between two specific things at any particular time and that caution needs to be exercised when drawing conclusions from a negative result, the concerns raised about the study don't have any bearing.

To use it to claim that there is no such thing as placebo effect in hearing was more than just a bit of a stretch, however.

PS: I did not change the title of the discussion, though I will openly admit that it caused me to have a negative bias when entering it. Had the OP just added a question mark at the end ("Placebo effect does not exist?"), I imagine things would have gone a bit differently. Instead it was presented as a bold claim that is simply and patently false. Maybe the intention was to be controversial in order to attract attention. The problem is that it isn't controversial, at least not amongst the people who are knowledgeable on the subject, from what I can tell.

This post has been edited by greynol: Jun 10 2013, 22:35


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gnusmas997
post Jun 10 2013, 18:30
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Here's from the 2004 analysis by the same authors, Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment.:
QUOTE
We found no evidence of a generally large effect of placebo interventions. A possible small effect on patient-reported continuous outcomes, especially pain, could not be clearly distinguished from bias. (emphasis added)

The effect is "possible" and "small", but the important part is that it can't be distinguished from bias. So you have two explanations for the possible and small effect:
A) It really is just bias.
B) Faith and precoceptions can reduce subjectively reported symptoms BUT NOT objectively reported ones.

I find this study revolutionary when contrasted with the standard, widely accepted view on the subject.

This post has been edited by gnusmas997: Jun 10 2013, 18:32
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John_Siau
post Jun 10 2013, 18:32
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QUOTE (greynol @ Jun 10 2013, 13:25) *
If you feel that a passed ABX is a valid way to demonstrating that any particular individual can distinguish a difference between two specific things at any particular time and that caution needs to be exercised when drawing conclusions from a negative result, the concerns raised about the study don't have any bearing.


I agree.


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pdq
post Jun 10 2013, 18:39
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@gnusmas997: We all get the point of the study. You don't have to keep reinforcing it. The problem is that we don't see how it in any way applies to how we do ABX testing or what conclusions we draw from it. Nor are we likely to change our use of the term "placebo" because it can mean something somewhat different in a different application.

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greynol
post Jun 10 2013, 18:46
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I took issue with the way in which the term was used here long ago. After a few weeks I got over it.


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gnusmas997
post Jun 10 2013, 18:54
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QUOTE (pdq @ Jun 10 2013, 19:39) *
@gnusmas997: We all get the point of the study. You don't have to keep reinforcing it. The problem is that we don't see how it in any way applies to how we do ABX testing or what conclusions we draw from it. Nor are we likely to change our use of the term "placebo" because it can mean something somewhat different in a different application.

pdq,

Would you consider the following as an acceptable definition of placebo effect in audio?

PEA) The thesis that a listener's faith or preconceptions about audio gear or software could cause audible differences that could not be objectively verified.

If so, would you grant that PEA is at least prima facie comparable to B)?

B) Faith and precoceptions can reduce subjectively reported symptoms BUT NOT objectively reported ones.

This B is one of the possible explanations for the medical studies, an explanation that is somewhat implausible.

If the similarity is granted a re-examination of previous results in audio resarch would be justified. As I understod it, the concept placebo effect was introduced in audio precisely on the basis of this parallel with Medicine.
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greynol
post Jun 10 2013, 19:00
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I prefer to use the term expectation bias. I fear that your desire to equate the two has led you astray from reality.

This post has been edited by greynol: Jun 12 2013, 09:06


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gnusmas997
post Jun 10 2013, 19:17
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QUOTE (greynol @ Jun 10 2013, 20:00) *
We actually use the term expectation bias. I fear that your desire to equate the two has led you astray from reality.

Expectation bias as in, if I expect/hope that gold-plated connectors will sound better then they really will sound better? Maybe it's because I'm not a native speaker of english but I can't differentiate that from: if i expect/hope that homeopathy will cure me then I really will be cured.

Expectation, hope, faith, and other mental states are not like the visual cues in the McGurk effect. If homeopathy could really cure its believers there would be nothing wrong with it. If gold-plated connectors really sounded better to audiophiles, there would be nothing wrong with selling them either. What I want is to block the possibility of retreat into subjectivism - "maybe you can't hear, but I can - at least in the comfort of home, if I'm fully relaxed, have adjusted myself to the new equipment, haven't fought with the wife in the last month, etc."
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[JAZ]
post Jun 10 2013, 19:21
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Again, you are confusing what the report says.

I cannot relive a dead person, but I could convince you that he/she is talking to us. Do you now understand what objective and subjective is?


Addenum related to audio:
With audio, and especifically music, there are two clearly different parts: the sensory capacity to hear sounds, and the psychological effect that the sound provides to the listener. The expectation bias affects the phychological side.


Addenum to the addenum: (ehem...)
The problem with expectation bias/placebo effect in audio is that it is not constant. Contrary to the McGurk effect, one day you could believe it sounds great, while the next day it would supposedly sound bad, while objectively sounding the same. As such, not only it doesn't make an objective audible difference, but also the effects are wildly random.

This post has been edited by [JAZ]: Jun 10 2013, 19:38
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greynol
post Jun 10 2013, 19:26
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There will never be a silver bullet to refute faith-based claims. It's baked into the cake.


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greynol
post Jun 10 2013, 19:38
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QUOTE ([JAZ] @ Jun 10 2013, 11:21) *
With audio, and especifically music, there are two clearly different parts: the sensory capacity to hear sounds, and the psychological effect that the sound provides to the listener. The expectation bias affects the phychological side.

Allow me to tie this in with the McGurk Effect.

When what we hear doesn't go along with what see (i.e.: what we expect to hear), our brain will change what is heard (or our perception of what was processed by the cochlea) so that it agrees with what we expect to hear.

The McGurk Effect is a textbook example of the power (and reality) of expectation bias and the human auditory system.

This post has been edited by greynol: Jun 10 2013, 19:40


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gnusmas997
post Jun 10 2013, 19:56
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QUOTE (greynol @ Jun 10 2013, 20:38) *
The McGurk Effect is a textbook example of the power (and reality) of expectation bias and the human auditory system.

As repeatedly claimed, I'm not an expert, but this sounds like a textbook example of behavioral conditioning. A sound becomes associated in the brain with a visual cue. The visual cue is presented and the sound is heard automatically, even if a different sound had actually been played or spoken. If labial movement X is associated with the phoneme for m, then, in some circunstances, I'll hear that phoneme when I see labial movement X.

Contrast that with pure, unaided expectation: if I expect/hope that I'm singing in tune, then I will be hearing myself singing in tune.

If these two can't be dinstinguished then I'm forced to admit that Psychoacoustics is just absolutely beyond me.
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greynol
post Jun 10 2013, 20:01
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The source of expectation bias need not be limited to what is seen, though our sight probably has the strongest power of suggestion.

My guess is that you've never participated in a double-blind test where the difference in test subjects is beyond your ability to discern, but you've been told that others could successfully tell the difference; or worse: the test subjects were identical but you were told that they were different and how they differed.

This post has been edited by greynol: Jun 10 2013, 20:50


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Porcus
post Jun 10 2013, 22:10
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QUOTE (DVDdoug @ Jun 10 2013, 19:16) *
QUOTE
In general, placebo treatments produced no major health benefits, although on average they had a modest effect on outcomes reported by patients...
So, a placebo is an ineffective form of treatment, but some patients perceive an improvement! Is that surprising?

Exactly what we see in audio! Is that surprising?


I'd say the “modest” part is the surprise. And that for some diseases/treatments it is miniscule. Under their somewhat narrow definition, that is.


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Woodinville
post Jun 12 2013, 08:00
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Seems to me that the OP does not understand that when somebody says ".wav sounds better than .flac" in a sighted test, that is potentially a result of biased reporting, just like the publications says happens.

Since "I like that better" is reporting, in the parlance of the report, and without an ability to test veracity of reporting, one can not exclude biased reporting.

So, when a blind test shows no difference, the evidence is clear, it was biased reporting, brought about by something similar to the placebo effect.

If I may call attention to http://www.aes.org/sections/pnw/ppt/jj/heyser.pptx , slide 14, it is easy to see how visual cues (the same applies to all other cues like taste, touch, smell, proprioception, etc.) can affect what were thought to be auditory cues.

The paper is in agreement with the need for blind testing, and shows the placebo effect to be exactly what audio experts think it is, a bias in reporting subjective results brought on by how the brain works.

There is nothing here that calls into question double-blind tests, and furthermore, this paper makes it even clearer that such tests are absolutely necessary.

Consider, they say that biased reports of wellness happen, but measurements show that there is no change. That's very similar to the flac/wav controversy, where measurements show no chance, as do DBT's, while reporting from subjects is indeed biased by expectation.

Q.E.D.

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Porcus
post Jun 12 2013, 11:29
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QUOTE (Woodinville @ Jun 12 2013, 09:00) *
and shows the placebo effect to be exactly what audio experts think it is, a bias in reporting subjective results brought on by how the brain works.


A main point of the paper is to distinguish “placebo” (in a more narrow sense) from these other bias effects.


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Woodinville
post Jun 12 2013, 11:46
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QUOTE (Porcus @ Jun 12 2013, 03:29) *
QUOTE (Woodinville @ Jun 12 2013, 09:00) *
and shows the placebo effect to be exactly what audio experts think it is, a bias in reporting subjective results brought on by how the brain works.


A main point of the paper is to distinguish “placebo” (in a more narrow sense) from these other bias effects.



Your point?


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gnusmas997
post Jun 12 2013, 15:03
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Woodinville,

John_Siau, greynol, and others helped clarify many points so I’m going to borrow from them in what follows.

Suppose that an audiophile claims that wave sounds better than flac but fails to substantiate this claim after repeated ABX tests, done in varying conditions.

These tests allow us to conclude that there’s no difference between the way wave and flac sounds, but we still need to explain why the audiophile reported a difference.

One possibility is that the audiophile really heard a difference, that is, wave really sounded better because the audiophile wanted it to sound better. If true, this is expectation bias.

Another possibility is that the audiophile didn’t hear any difference but reported hearing it for varied reasons. The why is not really important, but some plausible examples are greed, peer pressure, or politeness. This does not presuppose complete dishonesty – for instance, other, non-aural factors (like elitism) could have ensured that listening to wave was more pleasant than listening to flac. The audiophile might have just misreported the experience – it really felt better, but not because it sounded better.

I thought that the analogy with the medical findings would strengthen the second possibility but everyone else disagrees. I just have a really hard time imagining what it would be like to have my aural experiences subtly manipulated by my hopes and desires. Would I really hear myself singing in tune if I hoped really hard that this was so?

One of the reasons why I think it’s important to clarify which of the two possibilities is true, is that if wave really sounds better to the audiophile because of his expectations, then he is fully justified in using it over flac. In fact, he is fully justified in preaching this usage, in the hopes that other people will also share his expectations and thus hear wave differently from the rest of us.

Coming back to the medical analogy: if faith healing really helped relieve pain in religious persons, doctors would be fully justified in making use of faith healing. But the paper indicates that placebos don’t really cause an improvement in the symptom, just a change in the way patients report their symptoms.
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greynol
post Jun 12 2013, 17:33
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QUOTE (gnusmas997 @ Jun 12 2013, 07:03) *
if wave really sounds better to the audiophile because of his expectations, then he is fully justified in using it over flac. In fact, he is fully justified in preaching this usage, in the hopes that other people will also share his expectations and thus hear wave differently from the rest of us.

...and another audiophile may preach compressed lossless over uncompressed PCM. I don't see how this changes the game any.

I'm sure there are people who consciously know they don't hear the difference who will say they do for whatever reason. I don't know how many of them will go through the trouble of conducting an ABX test and basing their answers on the toss of a coin instead of on what they hear, however.

What do you make of this very recent post?

There are others like it. There are also plenty of people who identify themselves as discerning audiophiles who zealously argue against ABX for various reasons on this forum. I do not think that they are doing so to fit in, rather they belong in the first category. Regardless, I hope you no longer hold the idea that the phenomenon we are calling expectation bias does not exist in audio.

As I already intimated, many people operate on faith to the point of irrationality. There is no logic or reasoning that will change this with people who are closed-minded and willfully ignorant.

...but justified? I guess one could make the argument that ignorance and the preaching of it are human rights, but in doing so might find yourself crossing the line into defining morality once you begin to weigh the consequences of ignorance and ignorant behavior.

This post has been edited by greynol: Jun 14 2013, 01:40


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db1989
post Jun 12 2013, 18:57
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QUOTE (gnusmas997 @ Jun 12 2013, 07:03) *
if wave really sounds better to the audiophile because of his expectations, then he is fully justified in using it over flac. In fact, he is fully justified in preaching this usage, in the hopes that other people will also share his expectations and thus hear wave differently from the rest of us.
Personally, I must disagree. If there are any valid candidates for valid measures of morality that could elevate it above pure subjectivism, truth has to be at or near the top of the list. Surely, as a scientifically/objectively based community, we can all apportion some degree of plausibility to that. Saying people can believe whatever they want is one thing: thinking it’s good for them to be able to coax others into others believing the same unverifiable claims and the untruths that generally underlie them is another. But I’m by no means a philosopher, as is probably evident, so I’ll stop here. :|
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Porcus
post Jun 12 2013, 19:12
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QUOTE (Woodinville @ Jun 12 2013, 12:46) *
QUOTE (Porcus @ Jun 12 2013, 03:29) *
QUOTE (Woodinville @ Jun 12 2013, 09:00) *
and shows the placebo effect to be exactly what audio experts think it is, a bias in reporting subjective results brought on by how the brain works.


A main point of the paper is to distinguish “placebo” (in a more narrow sense) from these other bias effects.



Your point?



Precisely what I wrote. I obviously read the article way different than you claimed to.


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krabapple
post Jun 12 2013, 19:21
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QUOTE (gnusmas997 @ Jun 12 2013, 10:03) *
I thought that the analogy with the medical findings would strengthen the second possibility but everyone else disagrees. I just have a really hard time imagining what it would be like to have my aural experiences subtly manipulated by my hopes and desires. Would I really hear myself singing in tune if I hoped really hard that this was so?


Your argument from incredulity is not convincing. Yes, we assume the listener is sincere in his/her claim that A sounded better than B. SO WHAT?

If I may quote from JJ's powerpoint, because he states the modern understanding of the psychology of audio so succinctly:

QUOTE
First, what you like to listen to is PREFERENCE, not “accuracy”. You listen to what you prefer to hear, not what is measurably more accurate, unless of course, you prefer a good measurement. Preference is inviolate!
Preference can amount from many, many things, in many, many ways.


And, regarding those many many things:

QUOTE
No, you can’t ignore them.
It’s not delusion, hallucination, or stupidity, it’s how your brain works.
If it’s not a DBT, you have no idea what you were responding to, beyond “something.”


If you aren't acknowledging all that, then your 'justification' for trying to convince others that A sounds better than B, is simply unwarranted faith in the perfection of your senses.

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TomasPin
post Jun 12 2013, 21:38
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QUOTE (greynol @ Jun 12 2013, 13:33) *
There are also plenty of people who identify themselves as discerning audiophiles who zealously argue against ABX for various reasons on this forum.

Are there? Well, they've come to they right place... There are many places on the net where they'll be quite well received, so why bother?

QUOTE (db1989 @ Jun 12 2013, 14:57) *
Saying people can believe whatever they want is one thing: thinking it’s good for them to be able to coax others into others believing the same unverifiable claims and the untruths that generally underlie them is another.

And there you have the modus operandi of most religious people. biggrin.gif Let me tell you, that behavior in audiophiles does not surprise me in the least. Quite faithful folks...

In all seriousness, ABX testing was quite a mind-opener for me when I first tried it a couple of years ago. I would have never encoded mp3 below constant or average 192kbps, as I was quite certain it sounded awful below that. So imagine my surprise when I found I couldn't discern V6 LAME-encoded songs I knew quite well... A massive re-encoding session was to take place. rolleyes.gif

So, I would say the community here is quite right in thinking the effect of placebo in audio does matter. The reasons for that are already explained throughout this topic, just wanted to give my two cents.

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gnusmas997
post Jun 12 2013, 23:03
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QUOTE (greynol @ Jun 12 2013, 18:33) *
I hope you no longer hold the idea that the phenomenon we are calling expectation bias does not exist in audio.

My SOP is to defer to the expertise of any community that pays allegiance to rationality and objective evidence. If I don't understand something, I presume that the problem lies with me. But in all honesty I still don't understand how expectation bias in audio would work. As you hinted earlier, I've never experienced this kind of illusion myself. Actually, the only time I heard a difference between audio gear that measurably should sound identical involved a problem with volume matching. After proper matching I could no longer detect any difference.

My greatest difficulty is on why expectation bias differs from other auditory illusions like the Shepard tone or the McGurk effect. These are real illusions, that remain after blind testing, even though they might not affect everyone equally. But in expectation bias it's not that a specific group of people (children, those who suffered specific brain injuries, the left-handed, etc) has greater propensity to experience the illusion. It's that each and every listener might be hearing something different, and they're the only ones who can tell.

QUOTE (greynol @ Jun 12 2013, 18:33) *
As I already intimated, many people operate on faith to the point of irrationality. There is no logic or reasoning that will change this with people who are closed-minded and willfully ignorant.

I think you are right. But still, many audiophiles are otherwise reasonable persons. They don't believe in conspiracy theories, secret UFO invasions or the more wacky elements of some religions. And yet they fail to see that some audio myths are equally ridiculous.

QUOTE (krabapple)
If you aren't acknowledging all that, then your 'justification' for trying to convince others that A sounds better than B, is simply unwarranted faith in the perfection of your senses.

I'm not sure I follow. This difference between preference and unwarranted faith seems to me more a matter of attitude than anything else. If I say that I have a personal preference for golden cables I'm embracing a live-and-let-live mentality, accepting that others might have different preferences. Whereas if I say that you can't hear the differences provided by golden cables because I've got golden ears and you haven't, then I'm being arrogant. But in both cases it seems that I'm claiming the same thing, namely, that I can hear something especial that you cannot.

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krabapple
post Jun 13 2013, 04:34
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QUOTE (gnusmas997 @ Jun 12 2013, 18:03) *
My SOP is to defer to the expertise of any community that pays allegiance to rationality and objective evidence. If I don't understand something, I presume that the problem lies with me. But in all honesty I still don't understand how expectation bias in audio would work. As you hinted earlier, I've never experienced this kind of illusion myself. Actually, the only time I heard a difference between audio gear that measurably should sound identical involved a problem with volume matching. After proper matching I could no longer detect any difference.


I'd be willing to be you have experienced expectation bias in audio at some point in your life. You surely haven't tested every instance where you thought something sounded different/better, have you?

If you are going to defer to expertise, perhaps now is the time: psychoacoustics researchers *always* use blind protocols when they are studying perception of audio difference/preference.

And btw, expectation bias is not the *only* kind of bias that confounds the accuracy of audio perception.

QUOTE
QUOTE (krabapple)
If you aren't acknowledging all that, then your 'justification' for trying to convince others that A sounds better than B, is simply unwarranted faith in the perfection of your senses.

I'm not sure I follow. This difference between preference and unwarranted faith seems to me more a matter of attitude than anything else. If I say that I have a personal preference for golden cables I'm embracing a live-and-let-live mentality, accepting that others might have different preferences. Whereas if I say that you can't hear the differences provided by golden cables because I've got golden ears and you haven't, then I'm being arrogant. But in both cases it seems that I'm claiming the same thing, namely, that I can hear something especial that you cannot.


The part you keep missing is that your preference is not necessarily due to sound...even if you believe it is only due to the sound.

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