>Consider an alternative paradigm.
>Perhaps there is a divine force who does listen to special pleading, and
>wants to become known by the results of that pleading.
>The difficulty then comes in study design. One would have to choose a
>population in which the presence of the intervention in question was known.
> For studies of drug intervention, etc., it is relatively easier to be
>sure that the drug has not been administered to the control group. For
>intercessory prayer, one never knows when, where, or by whom prayer has
>been lifted.
Though our students have not critically appraised the article yet the above
criticism appears to have been largely taken care of by the authors as shown
by their following statement.
"In evaluating the results of this trial, it is important to note that we
were most likely studying the effects of supplementary intercessory prayer.
Since at least 50% of patients admitted to this hospital state that they
have a religious preference, it is probable that many if not most patients
in both groups were already receiving intercessory and/or direct prayer from
friends, family, and clergy during their hospitalization. Thus, there was an
unknowable and uncontrollable (but presumed similar) level of "background"
prayer being offered for patients in both groups; whatever impact that group
assignment had on healing was over and above any influence background prayer
may have had".(? random misclassification biasing the results towards null)
The blinding was absolute since the patients and those who were praying did
not even know the existence of this trial and there is no chance for a
biased contamination. The authors took a lot of trouble to gain exemption
from obtaining informed consent as they hought that seeking consent itself
might introduc some bias.
Two possible explanations are provided in the paper. One is to attribute the
beneficial effects of intercessory prayer to "real" but currently unknown
physical forces that are "generated" by the intercessors and "received" by
the patients; the second explanation would be, by definition, beyond the ken
of science. However, according to the authors they designed the trial to
explore not a mechanism but a phenomenon.
As I said in my initial mail, we cannot ask for a better design and
scientific rigour apart from the non validated instrument used to measure
the outcome. As scientists irrespective of our (religious) beliefs should we
not accept the results of a sound scientific study even though we cannot yet
figure out the (biological) plausibility.
In the initial days of tobacco/lung cancer studies did we not think that the
ill effects of tobacco were due to pesticides sprayed on these plants!!!
Anyway I thoroughly enjoyed the discussion around this trial.
Cheeeeers and thanks to every one who contributed/listened to these
argument.
Badri
Dr.P.Badrinath M.D.,M.Phil.,(Epid) PhD(Cantab)
Assistant Professor and Epidemiologist,
Department of Community Medicine,
UAE University, PO Box 17666, Al Ain,
United Arab Emirates.
Tel: 00 971 3 5039 652
Fax: 00 971 3 672022.
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