Review and analysis
In the article, Harris et al. (1999) uses parallel group trial, randomised, controlled and double-blind designs with the intention of providing comprehensive and unswerving data. I find it rather unsatisfactory to use such designs in a small sample size of only 990 patients in a single hospital (Harris et al., 1999). The clarity, reliability and dependability of the data could have been improved by using the various designs in different hospitals or areas to increase the coverage and enable comparison. It would also have eliminated the financial constraint that seems to have adversely affected the final analysis of the data and the conclusion derived.
Additionally, requiring that the intercessors must not belong to a particular denomination but must believe in God so as to carry out the study contravenes the freedom of the researcher. Randomly assigning the teams to leaders who are unfamiliar to the team members affected the coordination among the team members (Aviles et al., 2001).
The patient admission and demographics were obtained from the computer records of the hospital. This is a secondary source which was prepared by undetermined persons and was not structured for the study. Additionally, recording as new events patients who developed coronary angiogram, had a revascularization procedure, and or unstable angina was discreditable as it resulted in double-counting. The CCU must develop a modern computerised system that would eliminate any inaccuracies in the CCU. It is also outrageous that the research was unable to establish any validated, standardised, statistics to quantitate the severity of the cardiovascular patients but still used the same results to formulate a conclusion (Aviles et al., 2001). Additionally, the intercessors supervened the speedy offering of prayers and expected no complications or effects of the prayer on the various categories of patients. This is a prejudiced view that is not acceptable and is against the global research standards. This threatens the validity of the data and the ultimate deduction.
The prognostic tools (APACHE and Charlson scale) are not designed for a CCU course. They are rather designed for predicting significant health outcomes for individual patients. The research should, therefore, have used a better tool that could provide an overall diagnosis in the CCU. Baseline variables were analysed by X2 and fisher exact test (Harris et al., 1999). The form of analysing the variables is unsatisfactory since it does not provide fine details about the samples. However, acceptance of P <.005 to be within the acceptable range is statistically acceptable (Aviles et al., 2001). However, conducting the research on a blind sample compromises the validity of the data and should be avoided at all costs.
Letter to the editor
THE EDITOR
JAMA NETWORK READER
805 S ARLINGTON BLVD APT 1A
ARLINGTON VA 22200-1100
Dear Editor,
As an esteemed reader, I’m writing to express my concern over the Harris et al. (1999) article that strives to establish the relationship between intercessory prayers and healing duration. Using the Byrd score method produces a statistical significance that is immaterial, provides a better outcome in the prayer groups, is categorical and averts any discrepancies that might arise if MAHI-CCU is used (Harris et al., 1999).
Additionally, the study used patients who were not pre-screened for their enthusiasm to be prayed for, and this might not have impacted into them the required psychological sense. The methods used are substantially feeble and made it difficult for many women to accept that they have PND (Aviles et al., 2001). This is disreputable and objectionable in the contemporary civilised society. The intercessors prayed continuously for 28 days without receiving any patient feedback, and this affects the internal validity of the data. The prayer sessions should have been broken into short durations. They also failed to collect any other data beyond that collected for any other patients in the hospital. With all the inconsistencies of the study, it is, therefore, reasonable to conclude that additional, blinded, isolated, intercessory prayers provide improvement in medical upshots of patients. A different prayer strategy needs to be incorporated into the research; more funds and time devoted into it, and any discrepancies sidestepped (Aviles et al., 2001). A mild international intervention for the study is also required.
I urge you to take the necessary steps and correct the highlighted discrepancies which are a disgrace to the society and also invite other readers and specialists to give their contribution.
JOHN CLIFFORD
764, 653,222 CALTEX STREET, 23 CALIFORNIA
References
Aviles JM, Whelan SE, Hernke DA, et al. (December 2001). "Intercessory prayer and cardiovascular disease progression in a coronary care unit population: a randomized controlled trial". Mayo Clinic Proceedings 76 (12): 1192–8. doi:10.4065/76.12.1192. PMID 11761499
Harris WS, Gowda M, Kolb JW, et al. (October 1999). "A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit". Archives of Internal Medicine 159 (19): 2273–8. doi:10.1001/archinte.159.19.2273. PMID 10547166
