Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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142 <strong>Alternative</strong> <strong>Cardiovascular</strong> <strong>Medicine</strong><br />
accompanied by insightful discussion. Byrd acknowledged that a limitation<br />
of the study design was that it did not control for other prayer not<br />
associated with the study. In other words, patients in both groups, their<br />
friends, and family likely prayed for them during the course of the study,<br />
and there was no attempt to prevent such activity or even account for it.<br />
As such, the study was essentially examining only the role of “supplementary”<br />
intercessory prayer. With this important observation, Byrd<br />
defined the landscape of clinical trials of prayer where scientific study<br />
could never expect to absolutely test the healing power of prayer. With<br />
so much “ambient” and unaccounted-for prayer in cultures in the world,<br />
the only appropriate query for a scientifically based hypothesis would be<br />
as an assessment of incremental benefit from systematically added spiritual<br />
interventions, with uncontrolled prayer activity adjusted for by the<br />
use of prospectively designed, randomized treatment assignments.<br />
The next trial that sought to define the effect of prayer on CCU patients<br />
was published in 1999 (11). One thousand thirteen patients were randomized<br />
to receive standard CCU care, with or without teams of intercessors<br />
praying for them. Extending Byrd’s observations about the landscape of<br />
clinical trials of healing prayer, Harris and colleagues were concerned<br />
that the spiritual terrain of an intensive care unit would change if staff<br />
and patients even knew a study was ongoing. That consideration was<br />
taken to the institutional ethics board/review board at the Mid-America<br />
Heart Institute, which granted permission for the study to go forward<br />
without getting informed consent from patients and without the awareness<br />
of staff.<br />
In this study by Harris et al., teams of intercessors were given the first<br />
name of the patient only, without knowledge of the type of illness or<br />
severity of disease. They were instructed to pray for 28 d for “a speedy<br />
recovery with no complications” and “anything else that seemed appropriate<br />
to them” (11). The primary end point in this study was a predefined<br />
CCU score that sought to quantify the severity of the illness, the hospital<br />
course, and the procedures used.<br />
The authors found an 11% reduction in the weighted CCU score (indicating<br />
better outcome) in the 484 patients in the prayer treatment group,<br />
as compared to the 529 in the control group. In an unweighted score,<br />
which merely totaled the number of events, procedures, and prescriptions,<br />
the prayer treatment group had 10% fewer elements. For both of<br />
these comparisons the p value was 0.04, indicating a statistically significant<br />
intervention benefit. Length of stay between the two groups was not<br />
statistically different. Attempts to replicate the Byrd study’s findings in<br />
CCU patients by using the “good” vs “bad” hospital score showed no<br />
difference between the treatment and the control group. Like the Byrd