Does intercessory prayer impact health outcomes?

A Systematic Review of the Literature

Erik RauterkusObama Academy of International Studies

LTPApril 13, 2010

Path of Religion

Creation of Universe

Big Bang

Life forms on earth

Evolution of Life

Early Humans develop

Hunter and Gathers SURPLUS

Civilizations

Time to Think

Time to Think

Questions!!

Questions

No Answers

Religion!!

Religion Develops

• Prayer becomes an aspect of religion• The first written record of prayer dates back to

circa 2700 BCE

• Homer • Shakespeare • Much more

Different Types of Prayer

To pray for their health (intercessory prayer)

Best way to help a sick friend at the

time

People don’t like that their friends

are sick

People are sick

National Research on Prayer

• The National Institutes of Health has concluded that Prayer is the most commonly used form of alternative medicine.

• NIH found– 55% of Americans have used prayer for health– 31% of Americans have asked someone to pray for

their health– 23% of Americans partake in some sort of prayer

group

Later Science Comes Along

Questions

No Answers

Science

Prayer to help others

(intercessory Prayer)

Science

My LTP

Systematic Review

• A specific review of literature trying to answer a specific question.

• It only reviews high levels of scientific research and analyzes all research papers on the topic.

• Main purpose of a systematic review is to validate previous research on the topic, and to conclude based on the combination of information that each experiment presents.

Question for my Systematic Review

• Does intercessory prayer impact health outcomes?

Methods

• PubMed– National Institute of Health – Strict procedure for works of research to be

included in PubMed

Acceptable studies for systematic review

• Level 1 (systematic reviews/meta analysis)

• Level 2 (randomized controlled trials)

• One level 3 study was included, it had no control group, however, was acceptable.

Levels of Evidence

• Table 1. Levels of evidence and grade recommendations (Sackett et al, 2000).

1. Systematic Review and meta analysis of randomized controlled trials

2. Randomized controlled trials3. Non-randomized controlled trials4. Descriptive studies (cross-sectional surveys, cohort

studies, case-control designs)5. Case studies6. Expert Opinion

Grades of Recommendation

A. Consistent level 1 or 2 studiesB. Consistent level 3 or 4 studiesC. Level 5 studies or extrapolations from level 3

or 4 studiesD. Level 6 evidence or troubling inconsistencies

or inconclusive studies at any level

Investigation Process

Potentially relevant studies identified using key words in PubMed Search N=25

Studies excluded n=14 Reasons for exclusion:

Review articles, not English, opinion pieces, reducing

stress with prayer pieces.

Potentially relevant studies retrieved for more detailed

review n=11

Studies excluded n=1 Reason for exclusion: used

direct prayer

Studies included in review n=10 1 meta analysis, 1

non-primate study, 8 human studies

Studies that were Reviewed

• Byrd• Sicher• Harris• Aviles• Lebovici• Palmer• Benson• Astin • Lesniak

Studies that found that IP is beneficial

Grade Received • Byrd C• Sicher C• Harris B• Leibovici B• Lesniak A

Study Subjects/Groups What they did Level of Evidence

Comments/Issues

Byrd (1988) 2 groups 1 group with IP, 1 group no IP

2,C Well designedTrend, but no sign. difference

Sicher et al(1998)

2 groups 1 group with IP,1 group no IP

2,C Well designedRandomized, double blind, sign difference in AIDs patients

Harris et al(2000)

2 groups 1 group with IP1 group no IP

2,B Well designed, controlledPrayer over short time, sign. difference

Leibovici(2001)

2 groups 1 group with IP1 group no IP

2,B Well controlledLarge # of subjectsSmall difference

Lesniak (2006) 2 groups of bush babies (non-human primates)

1 group had drug and IP1 group had drug only

2,A Controlled for other prayers, only the prayers of the study group, blinded

Studies that found IP as having no benefit

Grade Received • Aviles A• Palmer C• Benson B• Astin B

Study Subjects/Groups What they did Level of Evidence

Comments/Issues

Aviles et al(2001)

2 groups 1 group with IP1 group no IP

2,A Well controlledNo difference

Palmer et al(2004)

2 groups 1 group with IP1 group no IP

2,C Lacking details. If patients thinks they can recover and receive prayer – better outcome

Benson et al(2006)

3 groups 1 group told they might have IP but did not; 1 group told they might have IP and did; 1 group told they would definitely have IP

2,B Group that knew they would have IP did worse. Small number of outcome variables.

Astin et al(2006)

3 groups 1 group with IP from trained individuals; 1 group with IP from untrained; 1 group with no IP

2,B Strong study.No difference

Types of Problems in Research

• Who else is praying?• Number of outcomes (Type 1 error)• Related outcomes • Randomization can by chance be unbalanced • Averaged data ignores individual

Study RandomizedControlled

ControlGroup

# of subjects

# of outcomes

Double-blinded

Result

Byrd (1988)

+ + 200 IP200 no IP

26 + +

Sicher et al (1998)

- + 20 IP20 no IP

11 + +

Harris et al (2000)

+ + 495 IP495 no IP

10 + +

Aviles et al (2001)

+ + 400 IP400 no IP

6 + -

Leibovici (2001)

+ + 1700 IP1700 no IP

3 + +

Palmer et al (2004)

+ + 45 IP42 no IP

2 + ~

Benson et al (2006)

+ - 604 IP; 597 no IP, 601 IP

2 minor outcomes

+ ~

Astin et al (2006)

+ + 52 IP (prof)52 IP52 no IP

Not detailed

+ ~

Lesniak (2006)

+ + 11 with IP11 no IP

8 + +

Conclusion

J M Aviles

K T Lesniak

Where we must go

Now

•A lot of poorly conducted research

•Two good studies

Next

•More research

•ONLY well conducted research

Future

•Conclusion

•Impact medical community differently from the general population