Karin Jensen
Assistant Professor of Clinical Neuroscience, leader of the Pain Neuroimaging Lab, Karolinska Institute, Stockholm, Sweden.

The knife and the word: Surgeons’ attitudes and usage of placebo effects in clinical practice.

In a series of studies we are exploring the possible mechanisms of placebo effects in surgical treatments. Information on surgeons’ attitudes towards non-specific treatment effects and placebo (sham) surgery is scarce. In a nationwide survey among Swedish surgeons we asked questions about attitudes and clinical practices. The results suggest that surgeons have a strong belief that non-specific treatment factors, such as the doctor-patient relationship, has an impact on treatment outcomes in surgery. These beliefs have impact on the way surgical treatments are delivered. 97% of Swedish surgeons believe that non-specific treatment factors affect outcomes in surgery. When asked about placebo effects, 91% of surgeons believe that the placebo effect is genuine, has a scientific explanation and therapeutic benefits. When asked if they believe there are surgical treatments where the entire treatment effect is due to placebo, 78% said yes. While a majority of surgeons believe that sham surgery should be performed when there is uncertainty of the mechanism of an established surgical procedure (71%), they were more reluctant to refer patients to sham controlled trials (46%), mainly due to ethical considerations. In sum, surgeons believe that their words and behaviors are important components of their professional competence. We are now exploring the neural mechanisms of sham surgery among patients with chronic back pain in a multicenter trial in Sweden and Norway. The increased awareness about placebo effects in surgery has stimulated new collaborations that allow for systematic investigation of placebo mechanisms.



Karin Jensen is an Assistant Professor of Clinical Neuroscience at the Karolinska Institute, Stockholm, Sweden. She is the leader of the Pain Neuroimaging Lab at Karolinska Institutet – a research group focusing on brain mechanisms involved in pain control. Her team uses laboratory pain testing and brain scans in order to study the neural correlates of pain, and has specific focus on finding early predictors and biomarkers of chronic pain, as well as cognitive modulation of pain. Her lab also investigates placebo effects and has a research line that focuses on placebo effects in individuals with limited cognitive abilities, for example intellectual disability and dementia. In 2018 she was awarded the prestigious Pro Futura Fellowship from the Swedish Collegium & Foundation for Humanities and Social Sciences for her interdisciplinary placebo studies. The fellowship provides Jensen with resources to pursue curiosity-driven placebo research during five years.