Category: Uncategorized

That darn placebo effect

Wired.com recently reported on something that may be considered atypical fare by most of its readers: pharmaceutical companies running into problems outperforming the placebo effect. But technology geeks or not, this is a very interesting story for all of us.

The story starts with Merck and the story of MK-869, an experimental antidepressant (the same class of drug as Prozac, Zoloft, Paxil, Effexor, and Xanax, among others). Everything is going fine with the clinical trials, and Merck even goes as far as to start bragging about its holy grail of happy pills at shareholder meetings. But then:

Behind the scenes, however, MK-869 was starting to unravel. True, many test subjects treated with the medication felt their hopelessness and anxiety lift. But so did nearly the same number who took a placebo, a look-alike pill made of milk sugar or another inert substance given to groups of volunteers in clinical trials to gauge how much more effective the real drug is by comparison. The fact that taking a faux drug can powerfully improve some people’s health–the so-called placebo effect–has long been considered an embarrassment to the serious practice of pharmacology.

Ultimately, Merck’s foray into the antidepressant market failed. In subsequent tests, MK-869 turned out to be no more effective than a placebo. In the jargon of the industry, the trials crossed the futility boundary.

The history of the placebo effect and how it came to change the way that pharmaceutical trials were conducted can be traced back to World War II and a nurse that very shrewdly told a wounded soldier he was getting morphine when in fact, the morphine supply had been exhausted and in fact the soldier was getting a shot of mere salt water.

There are several ways of looking at this and what it means for the future of medicine. To see where this came from, the regulations about pharmaceutical advertising were loosened about a decade ago; I’m a bit fuzzy on the year, and a cursory Web search hasn’t turned it up, so it may have been a bit longer than that. My point is there was an age during which a drug company simply could not air ads for prescription drugs like Prozac or Viagra; unless it was available over-the-counter, advertising was restricted to at most print media, if that.

These days one can’t leave the television on for longer than about three hours of normal commercially funded programming aimed at adults without seeing at least one prescription commercial. So we, as a society, have been trained more and more that “there’s a pill for everything.” I attribute at least some of the rise in the effectiveness of the placebo in drug trials to this.

Incidentally, the article ends with a twist describing a new protocol for testing drugs, called “open/hidden,” where some subjects get the drug at random intervals through an IV line controlled by a hidden computer. This will be something to keep an eye on in the months and years to come.

A tale of two perjuries

I really haven’t been in the mood to blog much lately. I have at least a good five things to write about that I need to clear out of the queue, but various personal and health issues have made it really difficult to focus on blogging.

A page on americaswronglyconvicted.com details the rather upsetting tale of Robert McClendon, a victim of perjury. It’s a very long narrative and if you have any sense of fairness and justice it’s likely going to be a very upsetting read.

But it gets even better (worse?). Linked from the narrative, early on, is this report from KHOU-TV dating from 2008.

I’m horrified at the difference between the two cases. Perjure oneself for the prosecution, one gets away with it. Perjure oneself for the defense, get nailed to the wall, in this case for aggravated perjury. (For those who don’t have valid law nerd cards, in Texas, aggravated perjury is a third-degree felony; simple perjury, where the statement is not made during or in connection with a simple proceeding or is not material, is a class A misdemeanor.)

Where’s the fairness here? Isn’t perjury the same crime, no matter who is affected? It makes no sense to call what the system dispenses “justice” if it’s not just. Letting perjurers get away with their crime when the end result is innocent people take up prison, parole, and probation spaces needed to handle real criminals, is patently devoid of any sense of decency or scruples. It’s un-American. No, I’ll go farther than that, because this happens in countries besides the US. I think the word is “inhumane.”

Getting railroaded

A bit dated, but I didn’t come across it until now.

A law.com article details a very unusual settlement. Settlement of the case Klein v. Amtrak, during the appeal phase after a $24 million judgment in favor of the plaintiff was handed down, included a provision for the trial judge to vacate his published opinions. The vacation of his opinions also includes their removal from Lexis and Westlaw.

What may be most disturbing is that the defense lawyers were allowed to seal their motions. From the article:

Robert C. Clothier of Fox Rothschild, who has handled access cases for The Legal Intelligencer, said he was troubled by the court’s decision to allow the defense lawyers to file all of their motions under seal, including the motion that asked for permission to seal the other papers.

To justify sealing any document, Clothier said, the courts have consistently held that it is necessary to “articulate on the record” the extraordinary circumstances that justify secrecy. As a result, he said, the motion to seal itself cannot be under seal.

And I’m inclined to agree here. This is clearly improper. I don’t know what the judge could have been thinking here. Is it any wonder we have so much contempt for lawyers and the so-called “justice system” when such clearly improper decisions are made?

I’d like to know what was so damning about these vacated opinions Amtrak wants to disappear. Hopefully, someone out there kept a copy. Sunlight really is the best disinfectant, and I think it’s time the rest of us see what Amtrak is trying to keep in the dark.

The $2,520 question

I don’t have a separate blog for fundraising efforts yet. Maybe I should.

For those who haven’t seen it yet, check out my Extra Life fundraising page. The goal may seem a bit high, but yes, I’m for real. $2,520. That’s 105 people pledging $1/hour for the 24-hour event.

If you’re not familiar with Extra Life, it’s a fundraising effort started in 2008 by Sarcastic Gamer, benefiting pediatric cancer research at Texas Children’s Hospital. The event itself is a 24-hour video gaming marathon. Some of you may not know me that well, but I have been a rather avid video gamer over the years. I’ve sort of taken a break from video gaming, but I’ll just say I’ve been around video games long enough to know up-up-down-down-B-A-B-A-start. (Sadly, I never got enough time in playing Pac-Man to learn the patterns. My mom and grandparents had this strange notion that keeping my grades up in elementary school was more important than blowing my allowance on “those silly video games.”)

Anyway, enough of me waxing nostalgic. This year’s event takes place on 2009 October 17 (through the early morning hours of October 18).

There are two people close to me that are my inspiration to be a part of this fundraiser and other events like it. One is my best friend, the other is a younger cousin. Both were diagnosed with forms of cancer at rather young ages. The cause goes far beyond them, of course; way too many kids get cancer at young ages.

I have no ulterior motives here. This is only about me and my quest to help one great cause. I’m up for a 24-hour video gaming marathon. I hope enough of you out there are up for contributing to my chosen cause.

(Edit: added links to the respective Web sits for Extra Life and Sarcastic Gamer.)

The shell game played by ticketing service providers

Two recent posts I’ve read, this one from Jeff Balke and this one from TicketStumbler (Edit 2021-06-14: archived version), got me curious about the fees that Ticketmaster charges.

Very telling indeed are quotes like these from Jeff:

But, $8.60 PER TICKET for “convenience charges???” What the hell is convenient about that?

and this one from the TicketStumbler article:

But, this isn’t all Ticketmaster’s fault. Ticketmaster has tried switching to a pricing model where all or most of the convenience fees are built in to the face value ticket price. The end price would be the exact same, but the ticket buying experience would be significantly more transparent and mostly spared of backloaded fees. Unfortunately, this sort of pricing structure has been met with opposition from the artists and venues who don’t want to raise prices, or rather don’t want the appearance of raising prices. When the face value cost is lower, it’s much easier for the artists and venues to shift blame towards Ticketmaster for “excessive fees” even if the artists and venues are getting a cut.

I’m not sure where the blame really lies here. It seems like a huge finger-pointing game between Ticketmaster (or Live Nation, etc), the artists, and the venues. Ticketmaster tries transparency, and the artists and venues cry foul because it looks like the prices went up, even though it always cost in the neighborhood of $40-42 to buy what is labeled a $30 ticket.

It’s sad to say, but the only answer here may be truth-in-advertising legislation, to level the playing field for everyone. I can understand why people avoid some concerts; this is a shell game that ticketing agencies should not be allowed to play. I would deem one of two solutions to be more acceptable and fair (and I’m using a generic “Provider” to include Ticketmaster, Live Nation, and similar services for neutrality):

  1. Roll the fees everyone pays no matter what into the ticket’s face value, and allow Provider to show a separate line-item convenience fee specifically for their service. Ideally, this would be labeled “Provider’s convenience fee” (or whoever is doing the ticketing) with a full disclosure to include wording similar to “Provider charges a convenience fee for their service, and this is the only amount Provider keeps. The face value of the ticket goes to the artist and venue.” This fee would include what is today charged as part of the convenience fee and order-processing fee (if the graphic in the TicketStumbler post is taken as truth).

  2. Roll all fees into the ticket’s face value, and offer discounts off of this for multiple ticket orders or venue box office transactions. In this case a full disclosure would read along the lines of “The ticket price includes convenience and processing fees charged by Provider. Ticket prices may be lower through the venue’s box office or other services.”

Either way, fees like the TicketFast fee are outrageous and should be barred by law. This actually saves Ticketmaster and others that offer a similar option money by allowing one to print one’s own tickets at one’s own computer.

(I have heard of the convenience fee being charged even to those buying tickets at the venue, but was unable to locate a specific example. If anyone knows of one, please do comment or send me a message via the contact form.)