There's a reason the pills that Morpheus offered Neo in The Matrix were red and blue - randomised trials.

THE MATRIX HAS YOU, NEO

Ever wondered why the pills Morpheus offered to Neo in the Matrix were red and blue? It’s because randomised trials revealed that people are more likely to believe a blue pill is a sedative (something to put Neo back to sleep to remain in the Matrix), and a red pill is a stimulant (something to make Neo ‘wake up’ and realise the truth).

And such randomised trials didn’t just teach us about red and blue pills. Apparently, yellow pills are better at treating depression, white pills at reducing pain, and green pills at reducing anxiety. 

So I learned at a recent lecture by MP Andrew Leigh, who was promoting his new book Randomistas: How Radical Researchers Changed the World. Andrew spoke of the importance of randomised trials – of having a control group to determine the effectiveness of a policy or action.

SHAM SURGERY AND THE PLACEBO EFFECT

Another example was on the effectiveness of a type of knee surgery where the cartilage between the thigh and shin bone (the meniscus) has been torn. In 2013, a group of Finnish doctors conducted a study whereby patients were randomly chosen to either have the surgery, or just have their knee cut open and sewn up again without actually doing the surgery itself. Of course, the patients couldn’t be told which group they were in. 

The result – statistically, those that had the ‘sham’ surgery still recovered just as well as those with the real surgery. The real surgery had no discernible benefits. The ‘placebo’ effect of the ‘sham’ surgery was clearly a lot stronger than expected, with three quarters of patients saying they “feel better” after surgery, even though half were subject to the sham surgery. 

A lot of people were clearly upset with the findings, given that this particular surgery was the most common orthopedic surgery in the US and Australia.  

Of course the placebo effect isn’t limitless – a randomised trial of the polio vaccine in the 1950s proved it to be far superior to a placebo injection of salt water. So it was subsequently universally rolled out. 

But this does highlight the importance of such randomised trials in getting over problems where the placebo effect, or reverse-causality, does exist.

OTHER FUN FACTS FROM RANDOMISED TRIALS

·        Today, only one in 10 ‘promising’ drugs actually make it through the three stages of randomised trials and onto the market.

·        Placebo injections have a larger impact than placebo pills, possibly because it gives the illusion of something more drastic.

·        Multivitamins and fish oil supposedly actually reduce your longevity.

·        A 1970 California study suggested that cutting a prisoner’s sentence by 6 months had no effect on whether they would re-offend.

·        Google’s precise shade of blue they use on their homepage is estimated to add $200m to their bottom line as a result of extra ‘clicks’.

WAKE UP, NEO!

And all of these findings came about through the use of randomised trials – not just the statistical analysis of big data, but the use of real world experiments to control for things that data alone misses.