Highlights
- •This review examined psychological predictors of surgery outcomes.
- •Depression predicted postsurgical pain intensity and function.
- •Anxiety predicted postsurgical pain intensity and function.
- •Pain catastrophizing predicted postsurgical pain intensity.
- •Optimism did not clearly predict outcomes.
Abstract
Patients’ presurgical psychological profiles have been posited to predict pain and
function following arthroplastic surgery of the hip and knee. Nevertheless, findings
are conflicting, and this may be rooted in biased reporting that makes the determination
of evidential value difficult. This ambiguity may have negative consequences for researchers
and governmental agencies, as these rely on findings to accurately reflect reality.
P-Curve analyses were used to establish the presence of evidential value and selective
reporting in a sample of studies examining the effect of presurgical psychological
predictors on outcomes following knee and hip arthroplastic surgery. A systematic
search of the literature revealed 26 relevant studies. The examined sets of studies
indicate that there is evidential value for the effect of depression on pain intensity
and function, anxiety on pain intensity and function, pain catastrophizing on pain
intensity, as well as the combined effects of all psychological predictors on pain
intensity and function. The presence of evidential value was inconclusive for the
effect of optimism on pain intensity. There were no signs that any results were influenced
by biased reporting. The results highlight the importance of patients’ psychological
profiles in predicting surgical outcomes, which represent a promising avenue for future
treatment approaches.
Perspective
The effects of P-hacking are difficult to detect and might be at the root of conflicting findings pertaining
to the predictive properties of presurgical psychological variables on postsurgical
outcomes. P-Curve analysis allows the determination of evidential value underlying these relationships
and detection of P-hacking to ensure that findings are not the result of selective reporting.
Key Words
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Article info
Publication history
Published online: October 20, 2020
Footnotes
Disclosures: The authors have no financial interest in the results of this research and report no conflict of interest.
Identification
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© 2020 by United States Association for the Study of Pain, Inc.
