Surgeons’ behaviors and beliefs regarding placebo effects in surgery

Figures & data

Table 1. Survey content: short description of the questions in the national survey to surgeons in Sweden, divided by topic ^a

The impact of the doctor–patient relationship (patient scenario)

Do you believe that the described scenario may impact the treatment outcome? (Y/N) ^b

Non-specific treatment effects in surgery

Do you believe that non-specific treatment effects play a role in surgical treatment? (Y/N)

Which of the following factors do you believe affect treatment outcomes (multiple choice)? ^b

Do you deliberately harness non-specific treatment effects in treatment of patients? (Y/N)

If yes, which non-specific treatment factors have you used? (multiple choice) ^b

Framing and communication of treatment outcomes

How would you describe the information you give to your patients regarding expected outcomes of the surgical treatment? (multiple choice) ^b

Performing surgery that includes placebo components

How often do you perform surgery that you believe includes a placebo component? (multiple choice)

Are there, in your view, surgical treatments that have no specific component, where the treatment outcome is entirely due to the placebo effect? (Y/N) ^b

Placebo-controlled surgical trials

Sham surgery can only be used if there is no other effective treatment to compare a new treatment with (agree/disagree)

Sham surgery can only be used if there is no risk for adverse events in the placebo group (agree/disagree)

Sham surgery can only be used in trials of non-life-threatening conditions (agree/disagree)

Sham surgery is permissible when there is uncertainty about a specific treatment effect (agree/disagree)

What can, in your view, be problematic when using sham-controlled study designs? (multiple choice) ^b

Would you personally be able to recruit patients to a sham-controlled surgical trial? (Y/N)

Sham surgery in clinical routine

Are there, in your view, clinical situations when sham surgery might be warranted as it has been proven effective in sham-controlled trials? (Y/N)

Placebo definition, clinical value, and possible mechanisms

Do you agree with the following definition of the placebo effect? (Y/N) ^b

Do you agree with the following definition of placebo effects in surgery? (Y/N) ^b

What mechanisms do you believe explain the placebo effect? (multiple choice) ^b

Do you believe that the placebo effect is true, i.e., has a scientific explanation? (Y/N)

Do you believe that the placebo effect may have a therapeutic benefit? (Y/N)

^aFor a full version of the survey, see Supplementary data.

^bSpace provided for additional comments.

(Y/N) = Yes or No question; forced choice

Table 2. Demographics ^a

Mean age (SD) [range]	47 (11) [31–69]
Years since MD license was obtained, mean (SD) [range]	18 (10) [2–40]
Mean number of patients seen/week (SD) [range]	24 (14) [0–60]
Sex (men/women) (%)	68/32
Type of surgical unit (%) City hospital/Small community/Rural setting	62/34/4

^a Basic information regarding the surgeons who responded to the survey (n = 105), obtained via self-report. The “number of patients seen per week” is an approximation of each surgeon’s degree of patient contact.