SynthesisBMJ open2022
Prevalence of medically unexplained symptoms in adults who are high users of healthcare services and magnitude of associated costs: a systematic review.
Synthesis in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- A transdisciplinary framework for chronic illness and chronic pain: a sequential qualitative meta-synthesis.Frontiers in public health · 2026Pooled it
- Breathing therapy for patients with medically unexplained physical symptoms and dysfunctional breathing: A pilot and feasibility trial.PloS one · 2025Trial
- Make diagnostic doubt visible in healthcare.Future healthcare journal · 2026Article
- Higher steps per day and better diet quality associated with lower symptom burden in adults with HIV: results from the PROSPER-HIV study.Research connections · 2026Article
- Feasibility of Videoconference-Based Cognitive Behavioral Therapy for Somatic Symptom Disorder: Single-Arm Pilot Trial.JMIR formative research · 2026Article
- Somatization and experience of physical, psychological, and sexual violence among women consulting gynecological clinics: a waiting room survey.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Identifying past-year self-reported suicidality in outpatients with somatic symptom disorder using an interpretable machine-learning model: a multicenter study with an online calculator.BMC psychiatry · 2026Observational
- The Prevalence of Medically Unexplained Symptoms in Emergency Neurology Service.Medicina (Kaunas, Lithuania) · 2026Article
- Non-visible disability in the medical curriculum: what medicine overlooks, patients inherit.Frontiers in medicine · 2026Article
- A patient perspective on enduring symptoms - the unmet need.Future healthcare journal · 2025Article
- The challenge of persistent physical symptoms.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Thirty Minutes to Transform Care: A Mixed-Methods Study on Brief Psychosomatic Education for Unexplained Symptoms.Cureus · 2025Article
- Review article: Somatization Disorders in emergency department: A critical overview of current challenges and future directions.Emergency medicine Australasia : EMA · 2025Review
- Article
- Optimism, Resilience, and General Self-Efficacy Predict Lower Somatic Burden during the COVID-19 Pandemic.Healthcare (Basel, Switzerland) · 2024Article
- The Association of Central Sensitisation with Depression, Anxiety, and Somatic Symptoms: A Cross-Sectional Study of a Mental Health Outpatient Clinic in Japan.Life (Basel, Switzerland) · 2024Article
- Medically unexplained pain and suicidal ideation among US adults.Journal of affective disorders · 2024Article
- The effects of a structured communication tool in patients with medically unexplained physical symptoms: a cluster randomized trial.EClinicalMedicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMedically unexplained symptoms (MUS) is a common clinical syndrome in primary and secondary healthcare service. Outcomes for patients with persistent MUS include increased disability, poorer quality of life and higher healthcare costs. The aim of this systematic review was to determine the prevalence of MUS in patients who are high users of healthcare or high-cost patients in comparison with routine users and the magnitude of associated costs.
designA systematic review of the available literature. DATA SOURCES AND ELIGIBILITY CRITERIA: The following electronic databases were systematically searched without language restriction from inception to June 2018 and updated on 22 October 2021: MEDLINE, PsycINFO, EMBASE, CINAHL and PROSPERO. Inclusion criteria included studies investigating adults aged ≥18 years, who were high healthcare users or accrued high healthcare costs, in which the prevalence and/or associated costs of MUS was quantified. Two reviewers independently extracted information on study characteristics, exposure and outcomes.
resultsFrom 5622 identified publications, 25 studies from 9 countries involving 31 650 patients were selected for inclusion. Due to high risk of bias in many studies and heterogeneity between studies, results are described narratively. There were wide variations in prevalence estimates for MUS in high users of healthcare (2.9%-76%), but MUS was more prevalent in high use groups compared with low use groups in all but one of the 12 studies that included a comparator group. Only three studies investigated healthcare costs associated with MUS, and all three reported greater healthcare costs associated with MUS.
conclusionMUS has been found to be more prevalent in high use healthcare populations than comparator groups, but the magnitude of difference is difficult to estimate due to considerable heterogeneity between studies and potential for bias. Future studies should prioritise a standardised approach to this research area, with agreed definitions of MUS and high healthcare use. PROSPERO REGISTRATION NUMBER: CRD42018100388.
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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.