Yes I agree. if it is a really well designed large trial that shows no benefit – then that will often convince me – unless there happens to be an equally well designed large trial that does show benefit.

However if there is a really well designed large trial that does show clinically significant benefit then I would be encouraged but I would still want to see the study replicated by an independent team, before being convinced. I would remain sceptical until I saw the replicated evidence because we just seem so good at fooling ourselves that our treatments are effective when they turn out not to be the case.

So why do we keep trundling the US unit out despite the evidence of no effect. I think the reason why people won’t give up on US is that it is such a good placebo:

  • It is an impressive looking metal box with leads, buttons knobs and readouts that light up and flash.
  • There is the ritual of putting on the gel on the head and also on the painful part
  • Then gently rubbing the painful part while the machine knowingly keeps flashing lights at the patient and giving out readouts
  • And all the time the therapist is by the patient concentrating on the act of healing.


I am sure if it made a nice whooshing sound and they added some more flashing lights it would work even better.