Anecdotally, practitioners of point of care ultrasound (POCUS) describe instances where patients appear to experience a placebo-like response after the examination, also described as a positive care effect. Extensive study of therapeutic ultrasound has yet to reveal differences between intervention and placebo, both of which respond to therapy. Indeed, POCUS is exemplary in incorporating many components known to modulate placebo-like effects. Patient expectations, ritualistic aspects of hands-on care, symbolic power of sophisticated medical instruments, the power of real-time POCUS images, therapeutic practitioner-patient communication, and the effect of cultural and linguistic concordance all have significant potential to modulate positive or negative care effects of POCUS. Drawing from complementary and alternative medicine's discussion of characteristic and incidental factors, this review argues that POCUS should be studied as a complex medical intervention intertwined with and inextricable from diagnostic and care processes in the hospital setting. Since POCUS is a diagnostic tool with care effect potential, its similarity to the physical exam can guide preliminary ethical guidance on disclosure of potential placebo effects or efforts to maximize that potential effect. However, more data is needed to balance the benefits and risks of effective diagnosis and overdiagnosis, respectively.

中文翻译：

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床旁超声潜在安慰剂效应的伦理意义

有趣的是，床旁超声 (POCUS) 的从业者描述了患者在检查后出现类似安慰剂的反应的情况，也被描述为积极的护理效果。对治疗性超声的广泛研究尚未揭示干预和安慰剂之间的差异，两者都对治疗有反应。事实上，POCUS 在整合许多已知可调节安慰剂样作用的成分方面堪称典范。患者的期望、动手护理的仪式性方面、复杂医疗器械的象征性力量、实时 POCUS 图像的力量、治疗师与患者的交流以及文化和语言一致性的影响都具有调节正面或负面影响的巨大潜力POCUS 的护理效果。借鉴补充和替代医学' 在对特征性和偶然性因素的讨论中，本综述认为 POCUS 应作为一种复杂的医疗干预措施进行研究，与医院环境中的诊断和护理过程相互交织且密不可分。由于 POCUS 是一种具有护理效果潜力的诊断工具，它与体检的相似性可以指导关于披露潜在安慰剂效应或最大化该潜在效应的努力的初步伦理指导。然而，需要更多的数据来分别平衡有效诊断和过度诊断的益处和风险。它与体检的相似性可以指导关于披露潜在安慰剂效应或最大化该潜在效应的努力的初步道德指导。然而，需要更多的数据来分别平衡有效诊断和过度诊断的益处和风险。它与体检的相似性可以指导关于披露潜在安慰剂效应或最大化该潜在效应的努力的初步道德指导。然而，需要更多的数据来分别平衡有效诊断和过度诊断的益处和风险。