关于期望值在安慰剂镇痛研究中的作用的结论可能取决于我们如何调查它:荟萃分析、系统综述和方法论讨论建议。

IF 2.9 3区 医学 Q2 PSYCHIATRY
Psychosomatic Medicine Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI:10.1097/PSY.0000000000001333
Sigrid Juhl Lunde, Sophie Rosenkjær, Susan Tomczak Matthiesen, Irving Kirsch, Lene Vase
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引用次数: 0

摘要

目的:人们强调期望是安慰剂效应的一个关键因素。然而,对于安慰剂研究是否应考虑期望以及如何考虑期望,存在着不同的方法,而且在荟萃分析中尚未对期望的直接贡献进行估算。本荟萃分析和系统综述采用不同的方法,探讨了在安慰剂研究中期望对疼痛的影响程度:方法:我们在 PubMed、PsycINFO、Embase 和 Web of Science 等数据库中搜索了安慰剂镇痛机制研究,并对期望值和疼痛进行了数字测量。共纳入 31 项研究,包括 34 个独立的研究人群(1566 人,包括患者和健康参与者)。进行了两项荟萃分析:荟萃分析 1 使用研究层面的数据,在不考虑期望值测量(假设期望值)的情况下估算期望值干预的效果。Meta 分析 2 使用个人层面的数据,估算了参与者的期望对疼痛的直接影响(评估期望)。使用科克伦偏倚风险工具对偏倚风险进行了评估:Meta 分析 1 显示,与无预期干预相比,预期干预对疼痛强度的影响适中(Hedges g = 0.45,I2 = 54.19)。基于提供个体水平数据的 10 项研究,荟萃分析 2 显示,在安慰剂组和对照组中,期望可预测疼痛强度(b = 0.36,SE = 0.05),但不同研究方法的预测结果并不一致:结论:在安慰剂镇痛研究中,参与者的期望对疼痛的影响不大。然而,这可能在很大程度上受到我们如何测量期望值以及如何对其贡献进行概念化和分析的影响--无论是在研究内部还是在不同的研究之间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Conclusions Regarding the Role of Expectations in Placebo Analgesia Studies May Depend on How We Investigate It: A Meta-Analysis, Systematic Review, and Proposal for Methodological Discussions.

Objective: Expectations are highlighted as a key component in placebo effects. However, there are different approaches to whether and how placebo studies should account for expectations, and the direct contribution has yet to be estimated in meta-analyses. Using different methodological approaches, this meta-analysis and systematic review examines the extent to which expectations contribute to pain in placebo studies.

Methods: The databases PubMed, PsycINFO, Embase, and Web of Science were searched for placebo analgesia mechanism studies with numerical measures of both expectations and pain. Thirty-one studies, comprising 34 independent study populations (1566 subjects: patients and healthy participants) were included. Two meta-analyses were conducted: meta-analysis 1, using study-level data, estimated the effect of expectation interventions without taking measures of expectations into account (expectations assumed); and meta-analysis 2, using individual-level data, estimated the direct impact of participants' expectations on pain (expectations assessed). Risk of bias was assessed using the Cochrane risk-of-bias tool.

Results: Meta-analysis 1 showed a moderate effect of expectation interventions over no expectation intervention on pain intensity (Hedges g = 0.45, I2 = 54.19). Based on 10 studies providing individual-level data, meta-analysis 2 showed that expectations predicted pain intensity in placebo and control groups ( b = 0.36, SE = 0.05), although inconsistently across study methodologies.

Conclusions: Participants' expectations contributed moderately to pain in placebo analgesia studies. However, this may largely be influenced by how we measure expectations and how their contribution is conceptualized and analyzed-both within and across studies.

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来源期刊
Psychosomatic Medicine
Psychosomatic Medicine 医学-精神病学
CiteScore
5.10
自引率
0.00%
发文量
258
审稿时长
4-8 weeks
期刊介绍: Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings. Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.
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