There are numerous challenges to the design and conduct of a study of IP. First, because there is... more There are numerous challenges to the design and conduct of a study of IP. First, because there is no accepted scientific basis for the potential effect of IP on illness, it is difficult or impossible to select a biologically plausible patient outcome to study in a clinical trial. Because the selected outcome may not be relevant to effects of IP, it is difficult to interpret any study result. Second, the timing, amount, and duration of IP that should be provided are unknown, in part because of the lack of biologic basis for the possible effect of IP. Because IP provided in a study may be inadequate to achieve the study outcome, absence of effect could be interpreted as inadequate treatment. Similarly, although it may be appealing to consider whether there is a dose-response relationship between IP and outcome, the lack of hypothesized mechanism for IP does not provide a basis for conducting such an analysis. Third, because it is impossible (and not desirable) to limit prayer provided by family, friends, and others, a study of IP can only evaluate the effects of additional IP, not the effects of prayer in general. Similarly, the intervention can only be described as the IP provided by the intercessors, not as an effect or result of communication with God. Fourth, documenta-The belief that prayer heals the sick is widespread. Recent national surveys indicate that 90% of Americans pray daily 1 and more than 70% believe that prayer can help cure illness. 2,3 Although there are many different forms of prayer, intercessory prayer (IP; or distant healing) is one type of prayer that is organized, regular, and committed to setting time aside with the belief that the prayers are communicating with God. Previous studies indicate that IP has significant beneficial effects in cardiac patients 4,5 and in patients with AIDS. 6 However, methodologic concerns have limited the scientific and medical communities' acceptance of the reported beneficial effects of IP. 7-20
There are numerous challenges to the design and conduct of a study of IP. First, because there is... more There are numerous challenges to the design and conduct of a study of IP. First, because there is no accepted scientific basis for the potential effect of IP on illness, it is difficult or impossible to select a biologically plausible patient outcome to study in a clinical trial. Because the selected outcome may not be relevant to effects of IP, it is difficult to interpret any study result. Second, the timing, amount, and duration of IP that should be provided are unknown, in part because of the lack of biologic basis for the possible effect of IP. Because IP provided in a study may be inadequate to achieve the study outcome, absence of effect could be interpreted as inadequate treatment. Similarly, although it may be appealing to consider whether there is a dose-response relationship between IP and outcome, the lack of hypothesized mechanism for IP does not provide a basis for conducting such an analysis. Third, because it is impossible (and not desirable) to limit prayer provided by family, friends, and others, a study of IP can only evaluate the effects of additional IP, not the effects of prayer in general. Similarly, the intervention can only be described as the IP provided by the intercessors, not as an effect or result of communication with God. Fourth, documenta-The belief that prayer heals the sick is widespread. Recent national surveys indicate that 90% of Americans pray daily 1 and more than 70% believe that prayer can help cure illness. 2,3 Although there are many different forms of prayer, intercessory prayer (IP; or distant healing) is one type of prayer that is organized, regular, and committed to setting time aside with the belief that the prayers are communicating with God. Previous studies indicate that IP has significant beneficial effects in cardiac patients 4,5 and in patients with AIDS. 6 However, methodologic concerns have limited the scientific and medical communities' acceptance of the reported beneficial effects of IP. 7-20
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