STEP Study

[FunctionalAtheist]

This is a mid-term study that concluded some 8 years ago, but I'm sure there are a number of individuals who have not seen this. It speaks to discussion in a few other threads, namely, can science address issues of the so called divine sphere or the supernatural. It's my take the science can in no way address something that is not there, but science can address anything which makes an observable prediction.

No, you can't prove what is not there (in the here after). But you can prove what is not here (in the here and now)!

I would like to here critiques of this study. Full study is linked while the abstract is copyied.

(Please note the affiliations and degrees several of the authors have, including MDiv)

http://deploy.extras.ufg.br/projetos/adrimelo/filo/2-aula-STEP_paper.pdf

Study of the Therapeutic Effects of Intercessory
Prayer (STEP) in cardiac bypass patients:
A multicenter randomized trial of uncertainty and
certainty of receiving intercessory prayer​

Herbert Benson, MD,

a,4 Jeffery A. Dusek, PhD,a,4 Jane B. Sherwood, RN,y Peter Lam, PhD,y

​

​

Charles F. Bethea, MD,​

​

b William Carpenter, MDiv,c Sidney Levitsky, MD,d Peter C. Hill, MD,e

​

​

Donald W. Clem, Jr, MA,​

​

f Manoj K. Jain, MD, MPH,g David Drumel, MDiv,g,h Stephen L. Kopecky, MD,i

​

​

Paul S. Mueller, MD,​

​

j Dean Marek,k Sue Rollins, RN, MPH,b and Patricia L. Hibberd, MD, PhD4,y

​

​

Boston, MA; Oklahoma City, OK; Washington, DC; Memphis, TN; and Rochester, MN
Background ​

​

Intercessory prayer is widely believed to influence recovery from illness, but claims of benefits are not

supported by well-controlled clinical trials. Prior studies have not addressed whether prayer itself or knowledge/certainty that
prayer is being provided may influence outcome.Weevaluated whether (1) receiving intercessory prayer or (2) being certain of
receiving intercessory prayer was associated with uncomplicated recovery after coronary artery bypass graft (CABG) surgery.
​

​

Methods ​

​

Patients at 6 US hospitals were randomly assigned to 1 of 3 groups: 604 received intercessory prayer after

being informed that they may or may not receive prayer; 597 did not receive intercessory prayer also after being informed
that they may or may not receive prayer; and 601 received intercessory prayer after being informed they would receive
prayer. Intercessory prayer was provided for 14 days, starting the night before CABG. The primary outcome was presence of
any complication within 30 days of CABG. Secondary outcomes were any major event and mortality.
​

​

Results ​

​

In the 2 groups uncertain about receiving intercessory prayer, complications occurred in 52% (315/604)

of patients who received intercessory prayer versus 51% (304/597) of those who did not (relative risk 1.02, 95%
CI 0.92-1.15). Complications occurred in 59% (352/601) of patients certain of receiving intercessory prayer compared
with the 52% (315/604) of those uncertain of receiving intercessory prayer (relative risk 1.14, 95% CI 1.02-1.28). Major
events and 30-day mortality were similar across the 3 groups.
​

​

Conclusions ​

​

Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of
receiving intercessory prayer was associated with a higher incidence of complications. (Am Heart J 2006;151:934-42)

​

 

[Quintessence]

Wow. This is... amusing. The limitations of the study mostly make me find it... quaint? It tells us a whole lot of nothing? Major problems I see with the study:

• Prayers were methodologically limited to Christian groups only, and on top of that, to three specific Christian groups whose methods don't seem to have been closely monitored (i.e., we have no idea what prayer methods these groups actually used).
• Prayers were delivered by perfect strangers, as opposed to people who have an actual connection and concern for the patients; having prayers delivered by actual relations in the patient's life would much more closely resemble real-life prayer situations (doubly so for people who *gasp* aren't Christian!).
• As noted in the study, no controls were made for "background noise" for metaphysical activities outside of those provided by these three Christian groups (which again, we have to guess at what they actually did, since no details are provided).
• Scope is limited to extreme medical conditions rather than the full array of life-situations a person might utilize prayer for.

 

[George-ananda]

I've seen other studies showing prayer does work.

So people will gravitate to the study whose conclusion they like. The other sides' studies are always flawed of course.

 

[FunctionalAtheist]

Wow. This is... amusing. The limitations of the study mostly make me find it... quaint? It tells us a whole lot of nothing? Major problems I see with the study:

LOL, 'amusing,' 'quaint?' OK, not the tone I'm used to when discussing academic papers but whatever.

• Prayers were methodologically limited to Christian groups only, and on top of that, to three specific Christian groups whose methods don't seem to have been closely monitored (i.e., we have no idea what prayer methods these groups actually used).

100% correct and absolutely essential to point out. But not a flaw with the method. Hardly a 'major problem.' There is no study that covers every piece of information. Every study is limited in scope. As my first year bio proff said to me 30 years ago, collecting ALL the data would mean counting and weighing every single grain of sand on every beach. What is essential is that the discussion following a study refrain from making unfounded inferences beyond the scope of the study. That does not invalidate any results obtained within the scope of the study. Perhaps next time the will find the 'real' believers and study them. They do note that they were not able to find any other groups other than the 2 catholic and 1 protestant group that could commit to the length of study, including jewish groups they contacted.

• Prayers were delivered by perfect strangers, as opposed to people who have an actual connection and concern for the patients; having prayers delivered by actual relations in the patient's life would much more closely resemble real-life prayer situations (doubly so for people who *gasp* aren't Christian!).

I'm not sure about your parenthetical so I'll ignore it for now. Again you are correct. This is a BLIND study. It should be fairly obvious that this speaks to your next bullet, background noise. But this study looks at intercession on behalf of strangers. Again, hardly a flaw in the design. Just a limit in scope and another name for a limit is control. It may certainly be possible to design further studies to assess god's desire to intervene on behalf of close family, if not for strangers. Note that the researchers specifically did not ask any of the patience to ask their family and loved ones to alter any intercessory behavior for ethical reasons. It's quite possible that all groups had family praying for them.

• As noted in the study, no controls were made for "background noise" for metaphysical activities outside of those provided by these three Christian groups (which again, we have to guess at what they actually did, since no details are provided).

Can you point me to where this was noted? I searched for background (only one hit in the abstract), noise, and metaphysical and found zero references. But if I understand what you are implying this would actually only be a concern if the study had resulted in significant difference between populations. In other words, if one group had shown significantly reduced incidence of complications, then the control would have eliminated whatever 'background noise' had been controlled.

• Scope is limited to extreme medical conditions rather than the full array of life-situations a person might utilize prayer for.

Again this is absolutely 100% correct, but is not a flaw in the study, merely an essential detail that must be considered when considering the results.

None of your concerns (other than other metaphysical activities???) were glossed over in the paper. The authors discussed each one these points in detail. No where does it say "we proved" or anything of the sort. They provide at least 3 possible explanations for their results. They discuss 4 previous studies, 2 of which resulted in 'prayer has an effect' and 2 of which resulted in no effect.

Here is how science works; These researchers pointed out problems with each of the previous studies. The positive studies had more than their share of sampling and randomization problems, the negative studies did not that the statistical resolution power to reach any results. Issues being pointed out, the authors improved design and overcame the issues.

Now when issues are pointed out with this study, someone else will come along and overcome them, and the resolving power of science advances, step by step.

You made essential points, but they are not 'major problems' in the least.

 

[FunctionalAtheist]

I've seen other studies showing prayer does work.

So people will gravitate to the study whose conclusion they like. The other sides' studies are always flawed of course.

George I have to ask you to please share these papers so we can look at them. This post is about issues with this paper.

You imply that when presented with a paper, you will read only the brief results in the abstract and if you like what it says you will say it's true, if you do not like what it says, you will say it is not. I hope you do not take offense if I say this is the first time I have found you to be irrational and unreasonable.

Please not that this paper itself discusses two previous works which resulted in affirmatives, and two in negatives. The analysis shows the difficulties with the previous methodology and scope and overcomes it. That does not mean it's the final word by any means. What I would like people to understand is that this work is open, honest, and available for criticism.

 

[George-ananda]

You imply that when presented with a paper, you will read only the brief results in the abstract and if you like what it says you will say it's true, if you do not like what it says, you will say it is not.

I never implied anything about what I would do in the following quote.

So people will gravitate to the study whose conclusion they like. The other sides' studies are always flawed of course.

This quote was worded as a generalization in the way generalizations are worded. And I will stick by this generalization and not say it applies to any one particular person.

I hope you do not take offense if I say this is the first time I have found you to be irrational and unreasonable.

One example please of where I have ever been 'irrational' before.


All that being said I will apologize by saying that your OP wanted to discuss a particular study and I never should have contributed to this thread.

 

[FunctionalAtheist]

I never implied anything about what I would do in the following quote.



This quote was worded as a generalization in the way generalizations are worded. And I will stick by this generalization and not say it applies to any one particular person.



One example please of where I have ever been 'irrational' before.


All that being said I will apologize by saying that your OP wanted to discuss a particular study and I never should have contributed to this thread.

My apologies, i took your statement to mean you would gravitate to the conclusion you like, as opposed to a general statement. I believe, generally speaking, that is irrational.

 

[shawn001]

I just want to say that Herbert Benson, MD, is famous for his work on the "relaxation response."

This reminds me somewhat of when they PET and FMRI scanned the Buddhist Monks and the Dali Lama to see about meditation and its effect on the brain. It was having a positive effect on their brains.

The study was back in 2006 do you know how far they followed up on it?

 

[FunctionalAtheist]

No I don't, but I'm going to spend some time looking for more recent work when I get a chance. I'll look into the studies you reference as well. Sounds interesting.

 

[Quintessence]

LOL, 'amusing,' 'quaint?' OK, not the tone I'm used to when discussing academic papers but whatever.

Compared to others I've read, yeah, it's quaint. That's a polite way of saying that I've seen worse, but that this one is pretty bad in that it really doesn't tell us much of anything useful.

100% correct and absolutely essential to point out. But not a flaw with the method. Hardly a 'major problem.' There is no study that covers every piece of information.

You don't consider the epic failure to document the methodology of the prayers to be a serious over sight? Dear gods, I do. It's enough to easily invalidate the entire study. It's tantamount to going "we told a bunch of volunteers to treat these people for their colds, but didn't give them any standards or guidance about how to do this in a controlled fashion." The volunteers could have done anything from serve chicken soup to prescribe bed rest! You can't do a study on the efficacy of prayer on serious medical conditions and then not bother to document the actual prayer methods used. It's sloppy.

Ah, and there are studies that cover more pieces of information. I presume you're familiar with metanalyses? I like them. They're spiffy.

At any rate, aside from this particular point I made, I didn't mean to suggest that the study is "invalid." I'm a scientist, sir. I get all the such and such about scope and framing and the like. You asked for a critique, so I gave one. I pointed out some problems and limitations of the study.

Can you point me to where this was noted?

I was talking about this paragraph:

We did not request that subjects alter any plans for family, friends, and/or members of their religious institutions to pray for them, because to do so would have been unethical and impractical. At enrollment, most subjects did expect to receive prayers from others regardless of their participation in the study. We also recognize that subjects may have prayed for themselves. Thus, our study subjects may have been exposed to a large amount of non–study prayer, and this could have made it more difficult to detect the effects of prayer provided by the intercessors.

Background noise. This is the other aspect I regard as a serious issue, but it's one of those unfortunate confounding factors that there is probably no reasonable way to control for.

 

[shawn001]

Meditation and the Brain
New imaging technology makes it possible for scientists to document the brain activity of Buddhist monks.

Meditation and the Brain | MIT Technology Review



Dalai Lama visits brain imaging facility

Dalai Lama visits brain imaging facility (May 21, 2001)


What the Dalai Lama Has to Say About Neuroscience

"I feel very strongly that the application of science to understanding the consciousness of meditators is very important… if the good effects of quieting the mind and cultivating wholesome mental states can be demonstrated scientifically, this may have beneficial results for others." – Dalai Lama


If you ever get a chance watch the episode "Through the Wormhole Mysteries of the Subconscious" Its excellent.


Herbert Benson led a study to determine if prayers by congregations who did not know heart bypass patients would reduce the complications of surgery. They didn't. In fact, some prayed-for patients fared worse than those who did not receive prayers. (Staff file photo Jon Chase/Harvard News Office)

Prayers don't help heart surgery patients Some fare worse when prayed for

By William J. Cromie
Harvard News Office

Harvard Gazette: Prayers don't help heart surgery patients

 

[Monk Of Reason]

I've seen other studies showing prayer does work.

So people will gravitate to the study whose conclusion they like. The other sides' studies are always flawed of course.

I've seen studies showing that placebos work. Typically they are viewed as the same result.


To truly have a good study they must have 8 groups of people.

Group 1- Prays and is prayed for by others. They let them know they are being prayed for.

Group 2- Prays and is prayed for by others. They are not aware anyone is praying for them.

Group 3- Prays and is not prayed for by others. They are told they are being prayed for by others.

Group 4- Prays and is not prayed for by others. They are aware they are not being prayed for by others.

Group 5- Does not pray. Is prayed for by others and is aware of it.

Group 6- Does not pray. Is prayed for by others but are not aware.

Group 7- does not pray. Is not prayed for by others. They are told however that they are being prayed for.

Group 8- Does not pray. Is not prayed for by others and are aware.


Then you cover all angles of possibility.

Is it the act of prayer itself that causes the benefit (if any)? If so then we should see all instances where prayer is involved to have higher rates of healing or whichever variable we choose. And there should be no difference between those who know they are being prayed for and those that aren't.

Is it the act of praying itself that is therapeutic? Then we should see only instances when someone actually prays have the benefits. The ones where they are prayed for should have no inadvertent affect.

Is it simply the knowledge that they are being prayed for or that their own prayers would have a difference and its some kind of psychological placebo? Then we should see benefits ONLY when they think that they are being prayed for or when they pray regardless if they do or do not have people praying for them.

And if there is no difference what so ever then it should be either random or uniform across the board. If we had a decent enough sample size (at least 100) for each then we could start drawing some conclusions. Many of the so called "studies" we have now are picked afterwards. As in its mostly just a survey taken after the fact and not a controlled experiment. Such things are far less accurate usually.

 

[FunctionalAtheist]

Compared to others I've read, yeah, it's quaint. That's a polite way of saying that I've seen worse, but that this one is pretty bad in that it really doesn't tell us much of anything useful.



You don't consider the epic failure to document the methodology of the prayers to be a serious over sight? Dear gods, I do. It's enough to easily invalidate the entire study. It's tantamount to going "we told a bunch of volunteers to treat these people for their colds, but didn't give them any standards or guidance about how to do this in a controlled fashion." The volunteers could have done anything from serve chicken soup to prescribe bed rest! You can't do a study on the efficacy of prayer on serious medical conditions and then not bother to document the actual prayer methods used. It's sloppy.

Ah, and there are studies that cover more pieces of information. I presume you're familiar with metanalyses? I like them. They're spiffy.

At any rate, aside from this particular point I made, I didn't mean to suggest that the study is "invalid." I'm a scientist, sir. I get all the such and such about scope and framing and the like. You asked for a critique, so I gave one. I pointed out some problems and limitations of the study.



I was talking about this paragraph:



Background noise. This is the other aspect I regard as a serious issue, but it's one of those unfortunate confounding factors that there is probably no reasonable way to control for.

I don't think it is necessary to document more than 1000 individuals specific prayer methodology. Whether x individuals got on their knees, folded their hands, prayed in the morning, etc, is mostly useless data, unless these methods are to be controlled. But this study was not comparing the differences in efficacy of getting on one's knees rather than standing during prayer.

Assuming god hears all prayers, and there's no wrong way to pray, i don't think the data collected here is invalid. It is what it is and, agreed, improvements could be made. Science builds on itself. Small steps result in long journeys.

I can understand how developing a specific prayer methodology and having each intercessor adhere to it may add depth to similar studies. I don't think there is enough information yet to develop such a method.

I'm not aware of any significant meta-analysis of intercessory studies. If you have a reference it would be appreciated.

 

[FunctionalAtheist]

I've seen studies showing that placebos work. Typically they are viewed as the same result.


To truly have a good study they must have 8 groups of people.

Group 1- Prays and is prayed for by others. They let them know they are being prayed for.

Group 2- Prays and is prayed for by others. They are not aware anyone is praying for them.

Group 3- Prays and is not prayed for by others. They are told they are being prayed for by others.

Group 4- Prays and is not prayed for by others. They are aware they are not being prayed for by others.

Group 5- Does not pray. Is prayed for by others and is aware of it.

Group 6- Does not pray. Is prayed for by others but are not aware.

Group 7- does not pray. Is not prayed for by others. They are told however that they are being prayed for.

Group 8- Does not pray. Is not prayed for by others and are aware.


Then you cover all angles of possibility.

Is it the act of prayer itself that causes the benefit (if any)? If so then we should see all instances where prayer is involved to have higher rates of healing or whichever variable we choose. And there should be no difference between those who know they are being prayed for and those that aren't.

Is it the act of praying itself that is therapeutic? Then we should see only instances when someone actually prays have the benefits. The ones where they are prayed for should have no inadvertent affect.

Is it simply the knowledge that they are being prayed for or that their own prayers would have a difference and its some kind of psychological placebo? Then we should see benefits ONLY when they think that they are being prayed for or when they pray regardless if they do or do not have people praying for them.

And if there is no difference what so ever then it should be either random or uniform across the board. If we had a decent enough sample size (at least 100) for each then we could start drawing some conclusions. Many of the so called "studies" we have now are picked afterwards. As in its mostly just a survey taken after the fact and not a controlled experiment. Such things are far less accurate usually.

Unfortunately it's much easier to design such an experiment than it is to overcome the logistical hurdles. But I believe this shows that there is no reason that any hypothesis that makes an observable prediction is beyond the scope of science, and that any relevant religion makes observable predictions. It may be very difficult to tease apart the factors, but it is within reach of mortals.

 

[Quintessence]

To truly have a good study they must have 8 groups of people.

Group 1- Prays and is prayed for by others. They let them know they are being prayed for.

Group 2- Prays and is prayed for by others. They are not aware anyone is praying for them.

Group 3- Prays and is not prayed for by others. They are told they are being prayed for by others.

Group 4- Prays and is not prayed for by others. They are aware they are not being prayed for by others.

Group 5- Does not pray. Is prayed for by others and is aware of it.

Group 6- Does not pray. Is prayed for by others but are not aware.

Group 7- does not pray. Is not prayed for by others. They are told however that they are being prayed for.

Group 8- Does not pray. Is not prayed for by others and are aware.


Then you cover all angles of possibility

I like it. The only angle it doesn't cover is the method of prayer, which in these case, would need to be uniform and to the same deity within a particular study group.

There is the other problem of how one measures "benefits." I mean, sure, there's the obvious "getting better" that is simple to quantify, but I don't think we should overlook psychological benefits either. Feeling loved is important. For most humans, at any rate.

I don't think it is necessary to document more than 1000 individuals specific prayer methodology. Whether x individuals got on their knees, folded their hands, prayed in the morning, etc, is mostly useless data, unless these methods are to be controlled. But this study was not comparing the differences in efficacy of getting on one's knees rather than standing during prayer.

Sure, I understand that; my suggestion was that they control for methods by making them identical across the board, because I really see not controlling for the possible differences associated with methods is sloppy. I see things this way in particular because I come from a religious background that where it is not at all reasonable to assume that different methods are equivalent. I understand that the Abrahamic religions are not particularly orthopraxic, but even outside of Paganisms, there is emphasis placed on the proper way of doing a ritual/prayer. What kind of incense you burn, what candles you light, what invocation you speak, or even what language you speak that invocation in can all be considered important... especially to religions that emphasize ritual efficacy. Because of this, I have a really hard time overlooking the lack of detail on the prayer methods used. I have no idea what the Christian god prefers for its offerings and rituals, but I would never assume that all methods of attempting to placate that deity are equal.

I'm not aware of any significant meta-analysis of intercessory studies. If you have a reference it would be appreciated.

Ah, if I was still in grad school. Alas, my happy access to a plethora of peer-reviewed articles is considerably more hampered nowadays. Anybody want to hack at some Web of Science and get us a sense of how many articles have even been published under the relevant keywords over the past three decades? This journal probably has something, but it's got some sturdy, locked gates.

Must...not...rant...about...the gates....

 

[FunctionalAtheist]

I
Sure, I understand that; my suggestion was that they control for methods by making them identical across the board, because I really see not controlling for the possible differences associated with methods is sloppy. I see things this way in particular because I come from a religious background that where it is not at all reasonable to assume that different methods are equivalent. I understand that the Abrahamic religions are not particularly orthopraxic, but even outside of Paganisms, there is emphasis placed on the proper way of doing a ritual/prayer. What kind of incense you burn, what candles you light, what invocation you speak, or even what language you speak that invocation in can all be considered important... especially to religions that emphasize ritual efficacy. Because of this, I have a really hard time overlooking the lack of detail on the prayer methods used. I have no idea what the Christian god prefers for its offerings and rituals, but I would never assume that all methods of attempting to placate that deity are equal.

I agree with this. While letting practitioners do what they do is fine, I agree that documenting the exact parameters of what that entails would be very valuable.

 

[Thief]

Did see a tv science documentary about prayer.

Hook up a believer (during prayer) to a brain wave scan....and you see a change.
Hook up a non-believer in quiet meditation....and nothing happens.

So....maybe.....
Believers are using the speech portion of their brains as they do believe they are speaking to Someone.

Non-believers do no more than meditate....so nothing seems to happen.

Maybe...just maybe....belief is needed to get the action up and running?

 

[FunctionalAtheist]

Did see a tv science documentary about prayer.

Hook up a believer (during prayer) to a brain wave scan....and you see a change.
Hook up a non-believer in quiet meditation....and nothing happens.

So....maybe.....
Believers are using the speech portion of their brains as they do believe they are speaking to Someone.

Non-believers do no more than meditate....so nothing seems to happen.

Maybe...just maybe....belief is needed to get the action up and running?

Makes sense as there is already a known difference between the two populations. I wonder if you asked non-believers to pretend to be talking to an imaginary friend, or a relative, if they'd have a similar reaction.

 

[shawn001]

I have done a lot of research into a lot of this with some top doctors who study it all.

Practices such as Prayer, meditation, clinical hypnosis, relaxation techniques all have some similar psycophysiological underpinnings with the mind body. The neuroscience behind a lot of this is extremely interesting. They can cause physical changes in the brain and the body. The subconscious also protects us and is connect to the "illusion" of free will.

"But now, scientists say that mediators like my husband may be benefiting from changes in their brains. The researchers report that those who meditated for about 30 minutes a day for eight weeks had measurable changes in gray-matter density in parts of the brain associated with memory, sense of self, empathy and stress. The findings will appear in the Jan. 30 issue of Psychiatry Research: Neuroimaging.

M.R.I. brain scans taken before and after the participants’ meditation regimen found increased gray matter in the hippocampus, an area important for learning and memory. The images also showed a reduction of gray matter in the amygdala, a region connected to anxiety and stress. A control group that did not practice meditation showed no such changes."

Mingyur Rinpoche’s “Science of Happiness:” Buddhism, brain scans, and quantum physics collide - One City


VS Ramachandran is one of the top neuroscientist on the planet.

Here is one to contemplate.

Neurologist VS Ramachandran explains the case of split-brain patients with one hemisphere without a belief in a god, and the other with a belief in a god. (Clip taken from talk at 2006 Beyond Belief Conference, link below)

[youtube]PFJPtVRlI64[/youtube]
Split brain with one half atheist and one half theist - YouTube

 

[FunctionalAtheist]

Wow, that is amazing.