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Surgery: The ultimate placebo

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What if a fake surgery had the same effect as a real one, because the “active ingredient” in surgery is just the dramatic ritual? What if surgery delivers a huge placebo effect?

This often appears to be case, as shown in a few well-known examples. Most surgeries have still never been subjected to the gold standard of evidence-based medicine, the randomized controlled trial. Instead, they are based mainly on tradition, authority, and the “common sense” of surgeons, who have been slow to embrace the need to subject their methods to trials, citing a list of typical reasons — none of which stand up to scrutiny, and sound more like turf-defending excuses every year.

In this superb book, orthopedic surgeon Dr. Ian Harris explores the shameful history of untested surgeries in detail. It’s fascinating, and mostly easy enough reading even for patients. There’s a free excerpt from the book that you can read to get started.

Many scientific papers before and since publication of the book have supported Harris’ position.

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a book
Ian Harris
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NewSouth Publishing

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About this item:

“Book extract: Surgery, The Ultimate Placebo by Ian Harris,” Ian Harris,

Closely related items:

  1. “A controlled trial of arthroscopic surgery for osteoarthritis of the knee,” JB Moseley, K O’Malley, NJ Petersen, and others, New England Journal of Medicine, 2002.
  2. “Sham Surgery in Orthopedics: A Systematic Review of the Literature,” Adriaan Louw, Ina Diener, César Fernández-de-Las-Peñas, and Emilio J Puentedura, Pain Med, 2016.
  3. “To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials,” Wayne B Jonas, Cindy Crawford, Luana Colloca, Ted J Kaptchuk, Bruce Moseley, Franklin G Miller, Levente Kriston, Klaus Linde, and Karin Meissner, BMJ Open, 2015.
  4. “Use of placebo controls in the evaluation of surgery: systematic review,” Karolina Wartolowska, Andrew Judge, Sally Hopewell, Gary S Collins, Benjamin J F Dean, Ines Rombach, David Brindley, Julian Savulescu, David J Beard, and Andrew J Carr, British Medical Journal, 2014.
  5. “Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline,” Reed A C Siemieniuk, Ian A Harris, Thomas Agoritsas, Rudolf W Poolman, Romina Brignardello-Petersen, Stijn Van de Velde, Rachelle Buchbinder, Martin Englund, Lyubov Lytvyn, Casey Quinlan, Lise Helsingen, Gunnar Knutsen, Nina Rydland Olsen, Helen Macdonald, Louise Hailey, Hazel M Wilson, Anne Lydiatt, and Annette Kristiansen, British Medical Journal, 2017.
  6. “Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence,” Ashley W Blom, Richard L Donovan, Andrew D Beswick, Michael R Whitehouse, and Setor K Kunutsor, British Medical Journal, 2021.

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