Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping
Objective: This study explored if the patient-experience and the affect heuristic influenced improvements in painful symptoms, in response to open label placebo injections in patients with knee OA. It furthermore explored if other cognitive biases or heuristics were involved in the response to open-...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Osteoarthritis and Cartilage Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266591312500010X |
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| author | Tommy Kok Annfeldt Elisabeth Ginnerup-Nielsen Eva Elisabeth Wæhrens Lene Vase Lars Erik Kristensen Tanja Schjødt Jørgensen |
| author_facet | Tommy Kok Annfeldt Elisabeth Ginnerup-Nielsen Eva Elisabeth Wæhrens Lene Vase Lars Erik Kristensen Tanja Schjødt Jørgensen |
| author_sort | Tommy Kok Annfeldt |
| collection | DOAJ |
| description | Objective: This study explored if the patient-experience and the affect heuristic influenced improvements in painful symptoms, in response to open label placebo injections in patients with knee OA. It furthermore explored if other cognitive biases or heuristics were involved in the response to open-label placebo. Method: A mixed method study in a pre-specified knee OA cohort. The influence of patient-experience, and the affect heuristic, on change in painful symptoms in response to an open-label placebo injection, were assessed using a questionnaire and multivariate linear regression. The group concept mapping method was used to characterise the expectations and hopes regarding the effect of an open-label placebo injection in non-responders and responders, defined as the lower- and upper quartile of the ΔVAS pain scores. Results: 103 participants received the questionnaire, and 60 finalised questionnaires were included in the analysis showing that the reduction in pain was associated with the patient-experience and that the affect heuristic acted as an effect modifier. Three workshops were held for non-responders (n = 13) and responders (n = 15) each generating respectively 113 and 119 statements. It was found that the two groups reported different expectations and hopes for the open label placebo injections. Conclusions: The patient-experience influenced the response to an open label placebo injection in patients with knee OA, and this influence was moderated by the strength of the affect heuristic. Furthermore, non-responders and responders reported different hopes and expectation towards the open label placebo injection indicating the presence of the optimism bias in the responder group. |
| format | Article |
| id | doaj-art-adf3cc71b15f4880a89f753e7ed1b3bb |
| institution | Kabale University |
| issn | 2665-9131 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj-art-adf3cc71b15f4880a89f753e7ed1b3bb2025-02-02T05:29:18ZengElsevierOsteoarthritis and Cartilage Open2665-91312025-03-0171100574Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mappingTommy Kok Annfeldt0Elisabeth Ginnerup-Nielsen1Eva Elisabeth Wæhrens2Lene Vase3Lars Erik Kristensen4Tanja Schjødt Jørgensen5The Parker Institute at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark; Corresponding author. The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.The Parker Institute at Copenhagen University Hospital, Bispebjerg and Frederiksberg, DenmarkThe Parker Institute at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark; Department of Public Health, University of Southern, DenmarkDepartment of Psychology and Behavioural Sciences, Aarhus University, DenmarkThe Parker Institute at Copenhagen University Hospital, Bispebjerg and Frederiksberg, DenmarkThe Parker Institute at Copenhagen University Hospital, Bispebjerg and Frederiksberg, DenmarkObjective: This study explored if the patient-experience and the affect heuristic influenced improvements in painful symptoms, in response to open label placebo injections in patients with knee OA. It furthermore explored if other cognitive biases or heuristics were involved in the response to open-label placebo. Method: A mixed method study in a pre-specified knee OA cohort. The influence of patient-experience, and the affect heuristic, on change in painful symptoms in response to an open-label placebo injection, were assessed using a questionnaire and multivariate linear regression. The group concept mapping method was used to characterise the expectations and hopes regarding the effect of an open-label placebo injection in non-responders and responders, defined as the lower- and upper quartile of the ΔVAS pain scores. Results: 103 participants received the questionnaire, and 60 finalised questionnaires were included in the analysis showing that the reduction in pain was associated with the patient-experience and that the affect heuristic acted as an effect modifier. Three workshops were held for non-responders (n = 13) and responders (n = 15) each generating respectively 113 and 119 statements. It was found that the two groups reported different expectations and hopes for the open label placebo injections. Conclusions: The patient-experience influenced the response to an open label placebo injection in patients with knee OA, and this influence was moderated by the strength of the affect heuristic. Furthermore, non-responders and responders reported different hopes and expectation towards the open label placebo injection indicating the presence of the optimism bias in the responder group.http://www.sciencedirect.com/science/article/pii/S266591312500010XOpen-label placeboPainCognitive biasHeuristicKnee OAPlacebo response |
| spellingShingle | Tommy Kok Annfeldt Elisabeth Ginnerup-Nielsen Eva Elisabeth Wæhrens Lene Vase Lars Erik Kristensen Tanja Schjødt Jørgensen Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping Osteoarthritis and Cartilage Open Open-label placebo Pain Cognitive bias Heuristic Knee OA Placebo response |
| title | Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping |
| title_full | Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping |
| title_fullStr | Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping |
| title_full_unstemmed | Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping |
| title_short | Do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo? The CHIPS study - An exploratory study using questionnaire and group concept mapping |
| title_sort | do cognitive bias and heuristics influence improvement in knee pain in patients with knee osteoarthritis treated with open label placebo the chips study an exploratory study using questionnaire and group concept mapping |
| topic | Open-label placebo Pain Cognitive bias Heuristic Knee OA Placebo response |
| url | http://www.sciencedirect.com/science/article/pii/S266591312500010X |
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