Evaluation and interpretation of Hawthorne and other trial-related effects in Celiac Disease: A systematic review and meta-analysis.

Dig Liver DisJul 24, 2026 (epub)
Clinical ResearchGastroenterology

Dorina Pjetraj, Elena Lionetti, Alfredo Pulvirenti et al.

✦ AI-curated · Sources linked

In 30 seconds

This systematic review and meta-analysis evaluated the Hawthorne effect in celiac disease (CeD) by analyzing histological changes in patients on a gluten-free diet. The study included ten qualitative studies and three studies with histological data from 168 participants. The meta-analysis revealed a significant increase in the villous height-crypt depth (Vh/Cd) ratio of +0.25, indicating that observation may influence outcomes.

Key findings

  • Placebo or control groups showed improvements in symptoms and mucosal morphology.
  • Meta-analysis indicated a significant increase in Vh/Cd ratio of +0.25 (95% CI 0.11-0.39; p < 0.001).
  • Low heterogeneity was observed in the meta-analysis results.

Why it matters

Understanding the Hawthorne effect is crucial for interpreting clinical trial outcomes in celiac disease, as it highlights the impact of observation on patient-reported and histological improvements.

Source

PubMed · PMID 42498599

Published in Dig Liver Dis. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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