Influence of biased clinician statements on patient report of referred pain

Aims: The purpose of this study runs to examine the influence of clinician bins on patients' reports of referred pain. Diagnosis of temporomandibular disorders is dependent on subjective reports of pain and referred pain upon manual muscle palpation. The influence of biased clinician statements in s uch subjective reports has not been previously investigated. Methods: Forty subjects with pain and who met specific inclusion criteria were randomly a ssigned to 1 of 2 experimental groups. One group was subjected to a standar dized biasing statement, while the other group was not. Tender points in th e masseter muscle were then stimulated with a pressure algometer to the pre ssure-pain threshold. Subjects then recorded the presence or absence, locat ion, intensify, and unpleasantness of any referred pain. State-trait anxiet y and social desirability were also assessed to explore the possibility tha t anxiety levels or subjects' desires to please the experimental influenced results. Results: The biased group reported increased presence (P < 0.01), intensity (P < 0.001), and unpleasantness (P < 0.003) of referred pain as compared to the,lon-biased group. There were no differences between groups on state-trait anxiety or social desirability (P > 0.05). Conclusion: These data suggest that patient reports of pain referral may be subject to clini cian bias, mid recommendations to control this bias are offered.