ReviewBMC medical research methodology2024
Contextual effects: how to, and how not to, quantify them.
Review in BMC medical research methodology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled 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.
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
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of exercise therapy for osteoarthritis: an overview of systematic reviews and randomised controlled trials.RMD open · 2026Pooled it
- Effects of Hidden Conditioning and Positive Expectations on Pain Intensity Following Spinal Manipulative Therapy: A Three-Arm Randomized Controlled Trial.European journal of pain (London, England) · 2026Trial
- Trial
- Clinical Efficacy of Electroacupuncture in the Treatment of Chronic Neck Pain: A Randomized Clinical Trial.Journal of pain research · 2025Trial
- Prediction, pain, and the power of context: toward a contemporary identity for the chiropractic profession.Chiropractic & manual therapies · 2026Review
- Observational
- Probiotic supplementation for anxiety symptoms in people with Parkinson's disease: a randomized, double-blind, placebo-controlled trial.NPJ Parkinson's disease · 2026Article
- Considerations for Issues of Regression to the Mean and Contextual Effects in Clinical Trials for Pain in Rheumatic Diseases.Arthritis care & research · 2026Review
- "The Dark Side of Musculoskeletal Care": Why Do Ineffective Techniques Seem to Work? A Comprehensive Review of Complementary and Alternative Therapies.Biomedicines · 2025Review
- Effects of Breathing Exercises on Neck Pain Management: A Systematic Review with Meta-Analysis.Journal of clinical medicine · 2025Review
- Contextual effects in musculoskeletal pain: are we overlooking essential factors?Frontiers in psychology · 2025Article
- "Trying to explain the unexplainable": why research on contextual factors in musculoskeletal pain is needed.Pain management · 2024Article
- Design of a Randomized Sham-Controlled Trial: Strengthening Positive Treatment Expectations Using a Communication Model for Maximized Antiemetic Effects of Acupuncture and Antiemetics During Emetogenic Neo-/Adjuvant Chemotherapy.Integrative cancer therapiesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The importance of contextual effects and their roles in clinical care controversial. A Cochrane review published in 2010 concluded that placebo interventions lack important clinical effects overall, but that placebo interventions can influence patient-reported outcomes such as pain and nausea. However, systematic reviews published after 2010 estimated greater contextual effects than the Cochrane review, which stems from the inappropriate methods employed to quantify contextual effects. The effects of medical interventions (i.e., the total treatment effect) can be divided into three components: specific, contextual, and non-specific. We propose that the most effective method for quantifying the magnitude of contextual effects is to calculate the difference in outcome measures between a group treated with placebo and a non-treated control group. Here, we show that other methods, such as solely using the placebo control arm or calculation of a 'proportional contextual effect,' are limited and should not be applied. The aim of this study is to provide clear guidance on best practices for estimating contextual effects in clinical research.
Indexed as
Identifiers
What OpenQuestion holds
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.