Surgery: The ultimate placebo
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For many complaints and conditions, the benefits from surgery are lower, and the risks higher, than you or your surgeon think. In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. That these claims come from an experienced, practising orthopaedic surgeon who performs many of these operations himself, makes the unsettling argument particularly compelling.
Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?
PainSci notes
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.
~ Paul Ingraham, PainSci Publisher
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About this item:
- “Book extract: Surgery, The Ultimate Placebo by Ian Harris,” Ian Harris, www.smh.com.au.
Ian Harris presentation on YouTube.com.- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981174/
Closely related items:
- “A controlled trial of arthroscopic surgery for osteoarthritis of the knee,” Moseley et al, New England Journal of Medicine, 2002.
- “Sham Surgery in Orthopedics: A Systematic Review of the Literature,” Louw et al, Pain Med, 2016.
- “To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials,” Jonas et al, BMJ Open, 2015.
- “Use of placebo controls in the evaluation of surgery: systematic review,” Wartolowska et al, British Medical Journal, 2014.
- “Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline,” Siemieniuk et al, British Medical Journal, 2017.
- “Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence,” Blom et al, British Medical Journal, 2021.
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