Evidence map›Paper›PMID 26656986›Full record

SynthesisBMJ open2015

To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials.

Wayne B Jonas, Cindy Crawford, Luana Colloca, Ted J Kaptchuk, Bruce Moseley, Franklin G Miller, Levente Kriston, Klaus Linde, Karin Meissner

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05003180 (SunBurst), which is not on this map. Cited by 74 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 10 pooled it
7.9field-weighted citation impact, top 2% 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.

NCT05003180 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

SunBurst (StUdy oN Burst Fractures) - a National, Multicenter, Register-based, Randomized Controlled Trial on Thoracolumbar Burst Fractures

TypeinterventionalSponsorUppsala UniversityRan2021 to 2036Enrolled202ConditionsThoracolumbar Burst FractureArmsSurgical stabilization
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 10 syntheses or guidelines pooled it, 179 citations in OpenAlex.

  1. Pooled it
  2. Surgical interventions for Ménière's disease.The Cochrane database of systematic reviews · 2023
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 8 institutions in 2 countries.

Wayne B JonasSamueli Institute, Alexandria, Virginia, USA.
Cindy CrawfordSamueli Institute, Alexandria, Virginia, USA.
Luana CollocaDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA Department of Anesthesiology, School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Ted J KaptchukProgram in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, Massachusetts, USA.
Bruce MoseleyThe Methodist Hospital, Houston, Texas, USA.
Franklin G MillerDepartment of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Levente KristonDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Hamburg, Germany.
Klaus LindeInstitute of General Practice, Technische Universitat Munchen, Munich, Germany.
Karin MeissnerInstitute of Medical Psychology, Ludwig-Maximilians-University Munich, Munich, Germany.
Samueli Institute · USBeth Israel Deaconess Medical Center · USLudwig-Maximilians-Universität München · DEMethodist Hospital · USNational Institutes of Health Clinical Center · USTechnical University of Munich · DEUniversität Hamburg · DEUniversity of Maryland, Baltimore · US

Funding

Chronic orofacial pain: genetics, cognitive-emotional factors, and endogenous modulatory systemsR01DE025946 · NIDCR · UNIVERSITY OF MARYLAND BALTIMORE · PI COLLOCA, LUANA · 2016 to 2019
$2.1M
6 · The paper itself

Abstract

objectivesTo assess the quantity and quality of randomised, sham-controlled studies of surgery and invasive procedures and estimate the treatment-specific and non-specific effects of those procedures.

designSystematic review and meta-analysis. DATA SOURCES: We searched PubMed, EMBASE, CINAHL, CENTRAL (Cochrane Library), PILOTS, PsycInfo, DoD Biomedical Research, clinicaltrials.gov, NLM catalog and NIH Grantee Publications Database from their inception through January 2015. STUDY SELECTION: We included randomised controlled trials of surgery and invasive procedures that penetrated the skin or an orifice and had a parallel sham procedure for comparison. DATA EXTRACTION AND ANALYSIS: Three authors independently extracted data and assessed risk of bias. Studies reporting continuous outcomes were pooled and the standardised mean difference (SMD) with 95% CIs was calculated using a random effects model for difference between true and sham groups.

results55 studies (3574 patients) were identified meeting inclusion criteria; 39 provided sufficient data for inclusion in the main analysis (2902 patients). The overall SMD of the continuous primary outcome between treatment/sham-control groups was 0.34 (95% CI 0.20 to 0.49; p<0.00001; I(2)=67%). The SMD for surgery versus sham surgery was non-significant for pain-related conditions (n=15, SMD=0.13, p=0.08), marginally significant for studies on weight loss (n=10, SMD=0.52, p=0.05) and significant for gastroesophageal reflux disorder (GERD) studies (n=5, SMD=0.65, p<0.001) and for other conditions (n=8, SMD=0.44, p=0.004). Mean improvement in sham groups relative to active treatment was larger in pain-related conditions (78%) and obesity (71%) than in GERD (57%) and other conditions (57%), and was smaller in classical-surgery trials (21%) than in endoscopic trials (73%) and those using percutaneous procedures (64%).

conclusionsThe non-specific effects of surgery and other invasive procedures are generally large. Particularly in the field of pain-related conditions, more evidence from randomised placebo-controlled trials is needed to avoid continuation of ineffective treatments.

Indexed as

Placebo EffectChronic PainGastroesophageal RefluxHumansRandomized Controlled Trials as TopicCOMPLEMENTARY MEDICINEINTERNAL MEDICINESURGERY

Identifiers

PMID26656986
PMCPMC4679929
OpenAlexW2265877516

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.