I was listening to “Science Friday” on NPR last week and heard about the work of Ted Kaptchuk, Director of Harvard University’s Program in Placebo Studies and the Therapeutic Encounter. I was particularly interested in one of his studies that investigated placebo effects on asthma. This study tested physical effects of real medication vs. placebos as well as patients’ perceptions of the effects. Over the course of 12 sessions, subjects were given the following three different treatments and a non-treatment session three times each: 1) an albuterol inhaler, 2) a placebo inhaler, 3) a fake acupuncture treatment, and 4) several minutes in the waiting room with no subsequent treatment. In each case physical effects were subsequently tested by measuring subjects’ lung capacity and subjective effects were tested by asking subjects to rate their perception of improvement on a 1 to 10 point scale. Based on actual lung function, the albuterol inhaler—the only real medical treatment—produced a 20% improvement while the two placebo treatments and waiting without treatment each produced a 7% improvement. Apparently the mere act of sitting for a while without activity produced some improvement. What’s interesting is that, even though neither placebo produced an effect greater than no treatment at all, indicating the absence of an objective placebo effect, subjective perceptions were quite different. Subjects reported the following perceived levels of improvement: 50% for the albuterol inhaler, 45% for the placebo inhaler, 46% for the fake acupuncture treatment, and 21% for merely waiting without treatment. Both placebo treatments provided subjective perceptions of improvement that were almost as great as the medical treatment.
In an article about this study in the Wall Street Journal’s Health Blog titled “The Placebo Effect, This Time in Asthma” Katherine Hobson wrote:
Isn’t it enough to feel better? In the case of some conditions, yes, says senior author Ted Kaptchuk…
He tells the Health Blog that when it comes to things like asthma or cholesterol or diabetes, while patient reports are important, it’s key to keep tabs on objective measures, too. I may feel great, but if my cholesterol level isn’t budging, the statin isn’t working and my risk for another heart attack isn’t going down.
But in conditions such as depression, pain and insomnia, the subjective response is the main thing being treated. If I’m depressed, take a pill and no longer feel depressed, by definition the medicine is working. There’s no blood or imaging test used to confirm whether my condition is being fixed.
I share Kaptchuk’s opinion. In a case such as insomnia, if a placebo allows someone to sleep, it does the job, and that’s enough. If a patient’s health is at risk, however, making her think she’s getting better when she isn’t is potentially harmful.
As I was listening to this story on NPR, I began to think of similar issues involving data visualization. If people enjoy your infographic, isn’t that enough? Or in the realm of information dashboards, if the CEO has fun looking at the flashy gauges, isn’t that enough? No, it isn’t. Both are meant to inform. To understand the story of an infographic or an organization’s performance on a dashboard requires real information. Enjoying a pretty picture and feeling like you’ve been informed is not the same as the actual understanding that’s needed to make better decisions.
I like to feel good as much as the next guy. Data visualizations often give me great pleasure. I do not think, however, that enjoyment is the goal. It is not essential. In fact, enjoyment that distracts from the information rather than drawing people into it in meaningful and useful ways impedes the goal. When it comes to the real health of people’s minds and decisions, placebos are definitely not enough.