Opinion Change – Judgement and Decision Making


Marketing the Placebo Effect: A Power Balance Example
November 7, 2010, 11:30 am
Filed under: Uncategorized

By Nicola J. Martin

Power Balance is an American company that has been highly successful in 2009/10 marketing a silicone wristband embedded with two holograms. The creators and distributors of Power Balance claim that by wearing the band, placing it within your “natural energy field”, the wearer would experience up to a 500% increase in strength, power and flexibility (Power Balance New Zealand, 2010). Averaging $60 cost for each band, at the end of September it was estimated that over 2.5 million bands had been sold worldwide (Dunning, 2010).

Rather than providing scientific data to convince consumers of the efficacy of their product, Power Balance relies on celebrity endorsements and anecdotal reports of the bands effects. Stakeholders in Power Balance have released no scientific evidence to support their claims nor to describe exactly how the band exerts a measurable effect. Further, they admit that to date there has been no peer-reviewed testing of Power Balance products (Lalor, 2010). Steve Hambleton from the Australian Medical Association has branded the company’s claims as “medically implausible” (Russell, 2010a) and a small double-blind study conducted by consumer watchdog CHOICE (2010) revealed the band to be an expensive placebo effect.

The placebo effect refers to an improvement in health or wellbeing based on an individual’s belief that the treatment given to them will be effective (Grivas, Down & Carter, 2004). Although scientists and sports psychologists suggest that Power Balance products provide no benefit above that of the placebo effect (Russel, 2010; Walshaw, 2010) it is not within the scope of the paper to rigorously test or explore the efficacy of these products. It is the purpose of this paper to discuss perhaps why people are so ready to believe a product which has no real evidential, scientific basis. It is too easy to say that people are gullible. A cold cognition approach, for which this paper will undertake, attempts to explain such instances in terms of the person’s cognitive heuristics and erroneous beliefs. It is these cognitive processes which we all utilise in order to make sense of a complex world, normal processes that when used indiscriminately lead us vulnerable to believing things that may be highly unlikely to be true or effective (Gilovich, 1991). This paper will first discuss what Power Balance claims to be, why it is believable and the evidence for why it shouldn’t be, what people really believe and finally why any of it matters anyway.

Perhaps the primary reason Power Balance has been so successful is that it sounds intuitively appealing and somewhat believable. This aura of plausibility is commonly utilised by alternative therapies as a way of convincing consumers of their benefit above more traditional therapies (Gilovich, 1991). This is combined in the Power Balance marketing material with a host of pseudoscientific claims aimed at convincing the consumer that their product has a scientific basis (Appendix A). Tom O’Dowd, owner of the Australian Power Balance brand, admits that he does not know of the science behind the product, that “There is no scientific proof at the moment that is 100% correct, but there is no scientific proof on a lot of things”. (Lalor, 2010). Dr Marc Cohen, a medical doctor and associate professor of complementary medicine at RMIT University, states “If you look into the science behind the band it is unstated, unclear and unpublished. I’m very dubious of anything that is based on anecdote and testimonials and absolutely no scientific evidence” (Phillips, 2010).

To compensate for this lack of scientific evidence, Power Balance heavily relies on celebrity endorsements to advertise their products (Figure 1). This use of high-profile figures strongly operates on the consumers’ use of the availability heuristic. The availability heuristic refers to the process by which we assess the frequency or probability of an event by the ease of which instances or occurrences can be brought to mind (Plous, 1993). By the use of vivid images and exceptional performances, consumers can easily bring to mind examples of the products’ purported success and thus may overestimate the chance of its effectiveness. This may explain why the anecdotal evidence for Power Balance is so powerful in the absence of scientific data.

Figure 1. Celebrity endorsement from Power Balance website (2010).

The best evidence Power Balance offers for their product, besides celebrity endorsements, are a series of balance and flexibility tests performed at demonstration stands and circulated online. For the most popular balance test a participant is asked to balance on one leg with arms outstretched while the demonstrator presses on one arm until the participant loses balance and steps down. The test is then repeated with the participant holding a Power Balance product (Figure 2). For the majority of participants, balance in the test is greatly improved when wearing the band. However, Richard Saunders from Australian Skeptics revealed that by the experimenter exerting pressure closer to the participants’ centre of gravity it gives the illusion of enhanced performance, when really it is little else but the experimenter’s own expectancy effect (Pangello, 2009). This manipulation is not necessarily a conscious process. When neither the experimenter nor the participant are aware of the band being present or absent, the effect disappears (Pangello).

Figure 2. Power Balance demonstration at Mind/Body/Spirit convention (Facebook Power Balance Group, 2010).

To assess the efficacy of claims made by the distributors of Power Balance, the researcher conducted a small study consisting of 36 double-blind trials. Participants were comprised of 12 athletes and coaches based at a metropolitan sports complex. A total of 8 males and 4 females participated in the study, with ages ranging from 18 to 43 years (M = 27.67, SD = 9.54). Each participant completed 3 trials of the Power Balance flexibility and balance tests (Power Balance Australia, 2010). During the trials an assistant placed either a Power Balance or “LiveStrong” band in the pocket of the participant while standing out of view of both the participant and experimenter. For the purposes of this study the LiveStrong band was the control condition, as it is a similar weight and shape to the Power Balance band however contains no hologram nor claims to be of any scientific benefit. For each trial the participant was asked to respond with whether they thought the Power Balance band was in their pocket while performing the balance and flexibility tests. The collated responses are presented below (Figure 3).

Figure 3. Contingency table of reported effect (yes/no) of band present.

Responses of the participants reveal that they were no more likely to correctly report the presence of the Power Balance band than what would be expected by chance. In fact, there were slightly more responses reporting an effect when the band was absent (false positive) then there were reports of an effect when the band was present (hit). Participants were further more likely to report no effect when the band was in fact present (miss) than in the control condition (correct rejection). By eyeballing the data in Figure 2 it is clear that over the 36 trials there was no effect greater than sheer guessing.

In a study with correct controls and presentation of data, it is easy to see the absence of any real effect of the Power Balance band. However, in reality people rarely consider all 4 cells of the contingency table. People have a tendency to focus on confirmatory evidence, or the ++ cell shown above. The cold cog explanation for this excessive reliance on confirmatory information is that instances which confirm our belief are easier to process cognitively. This is particularly relevant for asymmetric variables, where one level of the variable is simply the absence of the other (Gilovich, 1991). It is in this category where Power Balance may exert its influence. That is, a person may wear the Power Balance band during a good performance and attribute that extra bit of improvement to the presence of the band. They may fail to recognize that they have worn the band at training all week with no noticeable improvement in performance, nor think about previous improvements in performance in which they were not wearing the band.

The above mentioned reliance on the ++ cell is particularly important to understand when evaluating claims of a scientific nature. For example, in one online discussion a “researcher” reported testing Power Balance on over 100 athletes (Hall, 2010). Not surprisingly, they all reported an improvement in performance. Is this evidence of the products effectiveness? No. This study conveys no real information as no control groups were included in the design. If an experiment of the same scale was conducted with appropriate controls, what would the other 3 cells look like?

This focus on confirmatory evidence further contributes to a phenomena known as Post Hoc Ergo Propter Hoc, or “after it therefore because of it” (Gilovich, 1991, p. 128). Because a person may perform better whilst wearing the band, they attribute the increase in performance to the product. They may fail to recognize that this improvement may be better accounted for by a more typical event, such as a better quality of sleep or diet. We are all vulnerable to this cognitive error. For the purposes of this paper, the researcher wore a Power Balance band two weeks prior to commencing any research into the products. Even when educated about the placebo effect and confirmation biases, the researcher was convinced that she was sleeping and concentrating better while wearing the band. This belief was further strengthened after hearing other consumers report a similar effect. However, when closely evaluating the two weeks in which the product was worn it became apparent that the researcher was simply concentrating better because she was sleeping better and vice versa. Both continued after the researcher ceased to wear the band. Without being aware of these confirmation biases one may have continued to falsely believe in the product’s effectiveness.

So, what do people really believe about Power Balance? And why do they hold that belief? These questions were posed by the researcher to a large number of athletes, coaches and the general public over a period of two months. Those who believe in the products’ efficacy cite anecdotal evidence to support their belief. In contrast, those who are skeptical cite the complete lack of scientific evidence in addition to the implausible explanations the distributors offer. When asking these polarized groups whether the other perspective really contradicts their current belief, and what it would take to change it, the researcher received mixed responses. Those who already believe in the product can relate to the skepticism of the opponent perspective. They understand the absence of scientific evidence. However, they justify their current position with responses such as “hey, it works for me” and “they can’t all be faking”. Instances were provided of other phenomena for which science can’t account for and parallels were drawn between practices of eastern medicine such as acupuncture.

Skeptics report that the belief in Power Balance strongly contradict their current position and that the only data that would lead them to believe in the claims would be double-blind, peer reviewed studies that had been replicated by independent sources. The majority of those who believe in the product either questioned the point of scientific enquiry or state that even if the findings discover Power Balance to have no effect, personally they believe it works for them. A responder on one online forum asserts that “the placebo effect has been scientifically demonstrated. Saying PB is nothing else but a placebo does not mean it doesn’t work” (Fjeldstad, Walsh & Riccio, 2010). This passive but unconvinced response is echoed in the media statements from those within Australia’s sporting community. For example, SANAFL coach Scott Borlace states that “the bottom line is I’m not convinced. But even if it does give you an edge, even if it’s mental, I think it’s worth it” (Fjeldstad, Walsh & Ricco).

In a recent submission to the Therapeutic Goods Administration (TGA) Dr Ken Harvey, a public health researcher at LaTrobe University, stated that Power Balance was breaking the Therapeutic Goods Act by making unsubstantiated claims of a medical nature (Phillips, 2010). If proven correct, this could be very costly to Power Balance stakeholders. In 2006 the American company that marketed Q-Ray Ionization Bracelets was ordered by the courts to refund consumers up to US$87 million in “ill-gotten gains” (Barrett, 2008). During the trial the distributor confessed that he could not describe the term “ionization” but picked it up because it was simple and easy to remember. The courts found that there was “…no testing or studies to support his theory” and that the terminology was created “with the intent to defraud consumers…by preying on their desire to find a simple solution” (Federal Trade Commission, 2008). In hindsight it is seemingly apparent that these products were flawed, however if it was clear from the beginning then the products would not have initially been so successful. With clinical trials due to commence in coming weeks (Lalor, 2010) it will be interesting to see what hindsight bias might effect our perception of the Power Balance phenomena. In a few months time, will the 2.5 million consumers of Power Balance testify that they knew all along it was only a placebo?

If Power Balance is found to provide nothing above a placebo effect, does it matter? To address this question we must consider the payoffs. How much are we, as the consumer, willing to risk accepting that the Power Balance claims are a false alarm (saying there is an effect when there isn’t) in the chance that there really is a physiological effect of the band (hit)? One of the dangers of anything that claims to increase performance or treat medical conditions is that it may delay an appropriate diagnosis (Lalor, 2010) and commencement of appropriate treatment. With the Australian promoters of Power Balance claiming that wearing the band may lead to a reduction in pain and relief from neurological disorders (Ham, 2010), this delay may have severe implications indeed. A further complication of using the band for a placebo effect is that, what may happen when the athlete no longer wears the band? Should we expect a decline in confidence and thus performance? And although the $60 may not be a severe penalty for the individual consumer, when totaled over the millions sold worldwide it is certainly enough to warrant investigation into the product’s claims.

References

Barrett, S. (2008). Q-Ray bracelet marketed with preposterous claims. Retrieved September 28, 2010 from http://www.quackwatch.com/01QuackeryRelatedTopics/PhonyAds/qray.html.

Dunning, B. (2010). Power Balance: Magical energy bracelets, or nonsense? Retrieved September 24, 2010 from http://skepticblog.org/2010/09/23/power-balance-magical-energy-bracelets-or-nonsense.

Facebook Power Balance Group (2010). Retrieved October 1, 2010 from http://www.facebook.com/powerbalance?v=wall.

Federal Trade Commission (2008). Appeals court affirms ruling in FTC’s favor in Q-Ray bracelet case. Retrieved September 28, 2010 from http://www.ftc.gov/opa/2008/01/qray.shtm.

Fjeldstad, J., Walsh, S., & Riccio, D. (2010, April 04). Power of holograms or just a big scam? Adelaide Now, http://www.adelaidenow.com.au/sport/power-of-holograms-or-just-a-big-scam/story-e6frecj3-1225849554095.

Gilovich, T. (1991). How we know what isn’t so: The fallibility of human reasoning in everyday life. New York: The Free Press.

Grivas, J., Down, R., & Carter, L. (2004). Psychology: VCE Units 3&4. (3rd. ed.). Australia: Macmillan.

Hall, H. (2010). Power Balance products: A skeptical look. Retrieved September 26, 2010 from http://www.devicewatch.org/reports/power_balance.

Ham, L. (2010, September 8). A question of balance. The Age, Retrieved October 1, 2010 from http://www.theage.com.au/small-business/entrepreneur/a-question-of-balance-20100907-14ysj.html.

Lalor, P. (2010, September 18). Science takes up challenge of wrist band. The Australian, p. 1.

Pangello, F. (Reporter). (2009, December 22). Bracelet claims put to the test [Television broadcast]. Pyrmont, NSW: Today Tonight.

Phillips, N. (2010, June 24). The power of one – band claims to be tackled by health regulator. The Sydney Morning Herald, Retrieved September 26, 2010 from http://www.smh.com.au/national/the-power-of-one–band-claims-to-be-tackled-by-health-regulator-20100623-yz9c.html.

Plous, S. (1993). The psychology of judgment and decision making. United States of America: McGraw-Hill Inc.

Power Balance Australia (2010). Retrieved October 6, 2010 from http://www.powerbalance.com/australia/test-video

Power Balance New Zealand (2010). Retrieved September 30, 2010 from http://www.powerbalance.co.nz/technology.php

Power Balance quick review with Choice.com.au. Retrieved September 28, 2010 from http://www.choice.com.au/Reviews-and-Tests/Food-and-Health/Diet-and-exercise/Exercise-equipment/Power%20Balance%20quick%20review/page.aspx

Russell, M. (2010a, June 20). ‘Power’ wristbands might be the biggest scam. The Age, http://www.theage.com.au/sport/power-wristbands-might-be-the-biggest-scam-20100619-yo11.html.

Walshaw, N. (2010). Power Balance wristband and NSW blues. Retrieved September 26, 2010 from http://www.rlcm.isntweb.net/latest-news/6127-rugby-league.

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7 Comments so far
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Very well put forward. Can you tell me more about this? “With clinical trials due to commence in coming weeks (Lalor, 2010) it will be interesting to see what hindsight bias might effect our perception of the Power Balance phenomena. In a few months time, will the 2.5 million consumers of Power Balance testify that they knew all along it was only a placebo?”

Thanks

Philip Muir

Comment by Philip Muir

Hi Philip

The hindsight bias is often referred to as the “I knew it all along” effect, or the tendency for people to exaggerate the predictability of an event after it has occurred (http://www.wisegeek.com/what-is-hindsight-bias.htm).

In this context, I would suggest that after clinical trials on Power Balance have been conducted those who currently believe in the bands effects will report that they “knew all along” that it was only a placebo effect. When reading media reports after the Q-Ray court proceedings people often referred to the pseudoscientific promotional claims as being clearly flawed and transparent. However, the product would not have been so successful if their claims were so obviously questionable to consumers from the beginning. I am interested in whether the same will hold true in the Power Balance instance.

According to media reports (http://www.theaustralian.com.au/news/nation/science-takes-up-challenge-of-wrist-band/story-e6frg6nf-1225925607304), trials are due to commence before the end of the year. At this stage I do not have much information on the details or methodology of these proposed studies. I do believe more research is likely to occur given the attention these bands have recently received from CHOICE and the Therapeutic Goods Administration. I will keep updating http://www.facebook.com/group.php?gid=159711944044453 as new information becomes available.

Thanks for your comment and I hope helps with your question. I welcome any further questions/comments you might have as well.

Nikki

Comment by Nikki Martin

Do you mind if I put a link to this on the Sidewiki for http://www.powerbalance.com.au/australia ?

Comment by @chippy70

@chippy70

Sure, not a problem. Although I don’t think the link you provided is working.

Matt Thompson

Comment by fingerprintresearch

If this is a scam I gladly donate my few (SA rands) to the genius who came up with the idea! PB also somehow makes you feel part of the global community (gullibles V sceptics?)
Jessica S (SOUTH AFRICA)

Comment by Jessica S

what do people really believe about Power Balance? And why do they hold that belief? These questions were posed by the researcher to a large number of athletes, coaches and the general public over a period of two months.

Comment by Power Balance




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