Evidence map›Paper›PMID 33075796›Full record

ArticlePsychotherapy and psychosomatics2021

What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus.

Andrea W M Evers, Luana Colloca, Charlotte Blease, Jens Gaab, Karin B Jensen, Lauren Y Atlas, Chris J Beedie, Fabrizio Benedetti, Ulrike Bingel, Christian Büchel and 19 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Psychotherapy and psychosomatics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

45 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  20. How the magnitude and precision of pain predictions shape pain experiences.European journal of pain (London, England) · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors.

Andrea W M EversHealth, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands, a.evers@fsw.leidenuniv.nl.
Luana CollocaDepartments of Pain Translational Symptoms Science and Anesthesiology, School of Nursing and Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA.
Charlotte BleaseGeneral Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Jens GaabFaculty of Psychology, University of Basel, Basel, Switzerland.
Karin B JensenDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Lauren Y AtlasNational Center for Complementary and Integrative Health, National Institute of Mental Health, and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA.
Chris J BeedieSchool of Psychology, University of Kent, Canterbury, United Kingdom.
Fabrizio BenedettiPhysiology and Neuroscience, University of Turin Medical School, Turin, Italy.
Ulrike BingelDepartment of Neurology, University Hospital Essen, Essen, Germany.
Christian BüchelDepartment of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jet BussemakerPublic Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Ben ColagiuriSchool of Psychology, University of Sydney, Sydney, New South Wales, Australia.
Alia J CrumDepartment of Psychology, Stanford University, Stanford, California, USA.
Damien G FinnissRoyal North Shore Hospital, Sydney, New South Wales, Australia.
Andrew L GeersDepartment of Psychology, University of Toledo, Toledo, Ohio, USA.
Jeremy HowickNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Regine KlingerCenter for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Stefanie H MeeuwisHealth, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.
Karin MeissnerDivision of Health Promotion, University of Applied Sciences, Coburg, Germany.
Vitaly NapadowAthinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, USA.
Keith J PetrieDepartment of Psychological Medicine, University of Auckland, Auckland, New Zealand.
Winfried RiefDepartment of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany.
Ionica SmeetsScience Communication and Society, Institute of Biology, Leiden University, Leiden, The Netherlands.
Tor D WagerDepartment of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA.
Vishvarani WanigasekeraNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Lene VaseDepartment of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
John M KelleyBeth Israel Deaconess Medical Center, Harvard Medical School, Program in Placebo Studies, Boston, Massachusetts, USA.
Irving KirschBeth Israel Deaconess Medical Center, Harvard Medical School, Program in Placebo Studies, Boston, Massachusetts, USA.
Consortium of Placebo Experts

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after the administration of both inert and active treatments.

objectiveThere is an increasing need for up-to-date recommendations on how to inform patients about placebo and nocebo effects in clinical practice and train clinicians how to disclose this information.

methodsBased on previous clinical recommendations concerning placebo and nocebo effects, a 3-step, invitation-only Delphi study was conducted among an interdisciplinary group of internationally recognized experts. The study consisted of open- and closed-ended survey questions followed by a final expert meeting. The surveys were subdivided into 3 parts: (1) informing patients about placebo effects, (2) informing patients about nocebo effects, and (3) training clinicians how to communicate this information to the patients.

resultsThere was consensus that communicating general information about placebo and nocebo effects to patients (e.g., explaining their role in treatment) could be beneficial, but that such information needs to be adjusted to match the specific clinical context (e.g., condition and treatment). Experts also agreed that training clinicians to communicate about placebo and nocebo effects should be a regular and integrated part of medical education that makes use of multiple formats, including face-to-face and online modalities.

conclusionsThe current 3-step Delphi study provides consensus-based recommendations and practical considerations for disclosures about placebo and nocebo effects in clinical practice. Future research is needed on how to optimally tailor information to specific clinical conditions and patients' needs, and on developing standardized disclosure training modules for clinicians.

Indexed as

Nocebo EffectPlacebo EffectConsensusHumansSurveys and QuestionnairesDisclosureExpert consensusNocebo effectsPatient-clinician communicationPlacebo effects

Identifiers

PMID33075796

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.