Attitudes and beliefs about placebo surgery among orthopedic shoulder surgeons in the United Kingdom

Karolina Wartolowska, David J Beard, Andrew J Carr, Karolina Wartolowska, David J Beard, Andrew J Carr

Abstract

Objectives: To survey surgeons on their beliefs and attitudes towards the use of placebo in surgery.

Methods: British orthopedic shoulder surgeons, attending a national conference in the United Kingdom, were asked to complete a self-report online questionnaire about their beliefs and attitudes towards the use of placebo related to surgical intervention. The survey included questions about ethical issues, the mechanism of placebo effects, and any concerns regarding its use.

Results: 100 surgeons who participated in the survey believed that placebo surgery is ethically acceptable (96%), especially as a part of a clinical trial (46%). Respondents thought that a placebo effect in surgery is real i.e. has a scientific basis (92%), that placebo can be therapeutically beneficial (77%), and that it involves psychological mechanisms (96%). Over half of the respondents (58%) have used a surgical procedure with a significant placebo component at least once in their professional career. Their main concern about placebo use in surgery was that it might involve an element of deception.

Conclusions and implications: Surgeons generally agreed that a placebo component to surgical intervention might exist. They also supported placebo use in clinical trials and considered it ethical, providing it does not involve deception of patients. More studies are needed, particularly among other surgical specialties and with larger numbers of participants, to better understand the use of placebo in surgery.

Trial registration: ClinicalTrials.gov NCT01623011.

Conflict of interest statement

Competing Interests: The authors have the following interests: This survey was performed in relation to a placebo-controlled surgical trial on shoulder pain (NCT01623011), in which all the authors are involved. There are no patents, products in development, or marketed products to declare. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1. Respondent characteristics.
Figure 1. Respondent characteristics.
Figure 2. Frequency of placebo use and…
Figure 2. Frequency of placebo use and ethical stance of respondents.

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