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Updated: Jan 5, 2026

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Hawthorne effect on surgical studies.

Charis Demetriou1, Lisi Hu1, Toby O Smith2

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ANZ Journal of Surgery
|October 18, 2019
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Summary
This summary is machine-generated.

The Hawthorne effect, a change in behavior due to observation, impacts clinical trial results. This study found it

Keywords:
Hawthorne effectbiasobserver effectsurgerysurgical studies

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Area of Science:

  • Clinical Research Methodology
  • Surgical Trials
  • Bias Assessment

Background:

  • The Hawthorne effect describes behavioral changes when individuals know they are observed.
  • This observer effect can influence outcome estimates in clinical trials.
  • Its impact on surgical studies requires investigation.

Purpose of the Study:

  • To determine if the Hawthorne effect is documented as a risk of bias in surgical studies.
  • To assess the reporting and consideration of the Hawthorne effect in surgical trial design.

Main Methods:

  • A systematic literature search (PRISMA compliant) was conducted until March 2019 across 11 databases.
  • 16 eligible studies were identified and reviewed by two independent reviewers.
  • Study quality was appraised using the Newcastle Ottawa Scale or Cochrane risk of bias tool.

Main Results:

  • Of 16 eligible studies, 6 directly measured the Hawthorne effect, with 5 attributing outcome improvements to it.
  • 10 studies used the Hawthorne effect to explain improvements in control groups or for comparative analysis.
  • Significant heterogeneity exists in how the Hawthorne effect relates to surgical outcomes.

Conclusions:

  • The Hawthorne effect's influence on surgical outcomes shows considerable heterogeneity.
  • Improved reporting and consideration of the Hawthorne effect in surgical trial design are necessary.
  • Further research is warranted to understand and mitigate its impact.