Evidence map›Paper›PMID 22833756›Full record

ReviewDeutsches Arzteblatt international2012

Nocebo phenomena in medicine: their relevance in everyday clinical practice.

Winfried Häuser, Ernil Hansen, Paul Enck

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Deutsches Arzteblatt international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
106citing papers in PubMed, 8 pooled it
9.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

106 citing papers in PubMed, 8 syntheses or guidelines pooled it, 226 citations in OpenAlex.

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  7. The Efficacy, Safety and Applications of Medical Hypnosis.Deutsches Arzteblatt international · 2016
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  9. Expectation shapes hunger and craving: placebo effects of verbal suggestion on food-related experiences.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2026
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  10. Impact of Verbal Suggestions on Finger Flexor Activation and Strength in Healthy Individuals.Medical science monitor : international medical journal of experimental and clinical research · 2023
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46 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Winfried HäuserDepartment of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de
Ernil Hansen
Paul Enck
Klinikum Saarbrücken · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNocebo phenomena are common in clinical practice and have recently become a popular topic of research and discussion among basic scientists, clinicians, and ethicists.

methodsWe selectively searched the PubMed database for articles published up to December 2011 that contained the key words "nocebo" or "nocebo effect."

resultsBy definition, a nocebo effect is the induction of a symptom perceived as negative by sham treatment and/or by the suggestion of negative expectations. A nocebo response is a negative symptom induced by the patient's own negative expectations and/or by negative suggestions from clinical staff in the absence of any treatment. The underlying mechanisms include learning by Pavlovian conditioning and reaction to expectations induced by verbal information or suggestion. Nocebo responses may come about through unintentional negative suggestion on the part of physicians and nurses. Information about possible complications and negative expectations on the patient's part increases the likelihood of adverse effects. Adverse events under treatment with medications sometimes come about by a nocebo effect.

conclusionPhysicians face an ethical dilemma, as they are required not just to inform patients of the potential complications of treatment, but also to minimize the likelihood of these complications, i.e., to avoid inducing them through the potential nocebo effect of thorough patient information. Possible ways out of the dilemma include emphasizing the fact that the proposed treatment is usually well tolerated, or else getting the patient's permission to inform less than fully about its possible side effects. Communication training in medical school, residency training, and continuing medical education would be desirable so that physicians can better exploit the power of words to patients' benefit, rather than their detriment.

Indexed as

Anticipation, PsychologicalPlacebo EffectDrug-Related Side Effects and Adverse ReactionsHumansInformed ConsentPhysician-Patient RelationsPrevalence

Identifiers

PMID22833756
PMCPMC3401955
OpenAlexW113059859

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.