Influence of Biased Clinician Statements on Patient Report of Referred Pain

Morris A. Branch, Charles R. Carlson, Jeffrey P. Okeson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Aims: The purpose of this study was to examine the influence of clinician bias 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 such subjective reports has not been previously investigated. Methods: Forty subjects with pain and who met specific inclusion criteria were randomly assigned to 1 of 2 experimental groups. One group was subjected to a standardized biasing statement, while the other group was not. Tender points in the masseter muscle were then stimulated with a pressure algometer to the pressure-pain threshold. Subjects then recorded the presence or absence, location, intensity, and unpleasantness of any referred pain. State-trait anxiety and social desirability were also assessed to explore the possibility that anxiety levels or subjects' desires to please the experimenter influenced results. Results: The biased group reported increased presence (P < 0.01), intensity (T < 0.001), and unpleasantness (V < 0.003) of referred pain as compared to the non-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 clinician bias, and recommendations to control this bias are offered.

Original languageEnglish
Pages (from-to)120-127
Number of pages8
JournalJournal of Orofacial Pain
Issue number2
StatePublished - 2000


  • Bias
  • Muscular pain
  • Pain measurement
  • Referred pain
  • Temporomandibular joint disorders

ASJC Scopus subject areas

  • Dentistry (all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


Dive into the research topics of 'Influence of Biased Clinician Statements on Patient Report of Referred Pain'. Together they form a unique fingerprint.

Cite this