What does “it works” mean?

Response to my rants about the hologram bracelets and articles like this one about magical thinking on SciAm have forced me to re-evaluate my language. I would like to say that the hologram bracelets “don’t work” because they have no physical effect on the phenomena that they claim to affect. However, people who use the bracelet will probably have a measurable improvement in their performance as per the SciAm article. So what to do?

Ever since reading Ben Goldacre‘s Bad Science, I’ve been fascinated by the term “no better than placebo”. The placebo effect is one of the reasons for using blind testing and shows what kind of rigour needs to be employed to avoid being fooled. Now, the idea is that a medicine is only really effective if it works better than placebo. Is there a corollary that says that if a medicine will not be particularly effective, it is better to attempt placebo treatment? I suppose this makes a kind of sense if the medical solution has physical side effects but the placebo doesn’t. I just can’t bring myself to think that I should start believing in crystals and holograms so that I can have cheap placebo improvements to my performance. Is this why superstition persists? I suppose it should be no surprise that it would have been selected away unless it conferred some advantage.

Unfortunately this brings us to an uncomfortable point. If the superstitions really do confer advantages (even if only mental) what is the sceptic’s method of achieving similar benefits for similar (low) cost? It costs nothing to wear gold thongs to important interviews – what should you do if you honestly don’t believe the thong will work? In fact, what does “work” even mean in this context? I hate semantics.