Erik Rauterkus, 9th grader, did his long term project on the power of prayer by doing a systematic review of the scientific literature and evaluation of the evidence.

1. Does intercessory prayer impact health
outcomes?
A Systematic Review of the Literature
Erik Rauterkus
Obama Academy of International Studies
LTP
April 13, 2010

2. 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

3. Time to Think
Questions!!

4. Questions
No
Answers
Religion!!

5. Religion Develops
• Prayer becomes an aspect of religion
• The first written record of prayer dates back to
circa 2700 BCE
• Homer
• Shakespeare
• Much more

6. Different Types of Prayer

7. 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 

8. 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

9. Later Science Comes Along
Questions
No
Answers
Science

10. Prayer to
help others
(intercessory
Prayer)
Science
My
LTP

11. 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.

12. Question for my Systematic Review
• Does intercessory prayer impact health
outcomes?

13. Methods
• PubMed
– National Institute of Health
– Strict procedure for works of research to be
included in PubMed

14. 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.

15. 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 trials
3. Non-randomized controlled trials
4. Descriptive studies (cross-sectional surveys,
cohort studies, case-control designs)
5. Case studies
6. Expert Opinion

16. Grades of Recommendation
A. Consistent level 1 or 2 studies
B. Consistent level 3 or 4 studies
C. Level 5 studies or extrapolations from level 3
or 4 studies
D. Level 6 evidence or troubling inconsistencies
or inconclusive studies at any level

17. 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

18. Studies that were Reviewed
• Byrd
• Sicher
• Harris
• Aviles
• Lebovici
• Palmer
• Benson
• Astin
• Lesniak

19. Studies that found that IP is beneficial
Grade Received
• Byrd C
• Sicher C
• Harris B
• Leibovici B
• Lesniak A

20. 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 designed
Trend, but no sign.
difference
Sicher et al
(1998)
2 groups 1 group with IP,
1 group no IP
2,C Well designed
Randomized, double
blind, sign difference
in AIDs patients
Harris et al
(2000)
2 groups 1 group with IP
1 group no IP
2,B Well designed,
controlled
Prayer over short
time, sign. difference
Leibovici
(2001)
2 groups 1 group with IP
1 group no IP
2,B Well controlled
Large # of subjects
Small difference
Lesniak
(2006)
2 groups of bush
babies (non-
human
primates)
1 group had
drug and IP
1 group had
drug only
2,A Controlled for other
prayers, only the
prayers of the study
group, blinded

21. Studies that found IP as having no
benefit
Grade Received
• Aviles A
• Palmer C
• Benson B
• Astin B

22. Study Subjects/Groups What they did Level of
Evidence
Comments/
Issues
Aviles et al
(2001)
2 groups 1 group with IP
1 group no IP
2,A Well controlled
No difference
Palmer et al
(2004)
2 groups 1 group with IP
1 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

23. 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

24. Study Randomized
Controlled
Control
Group
# of
subjects
# of
outcomes
Double-
blinded
Result
Byrd
(1988)
+ + 200 IP
200 no IP
26 + +
Sicher et
al (1998)
- + 20 IP
20 no IP
11 + +
Harris et
al (2000)
+ + 495 IP
495 no IP
10 + +
Aviles et
al (2001)
+ + 400 IP
400 no IP
6 + -
Leibovici
(2001)
+ + 1700 IP
1700 no IP
3 + +
Palmer et
al (2004)
+ + 45 IP
42 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 IP
52 no IP
Not
detailed
+ ~
Lesniak
(2006)
+ + 11 with IP
11 no IP
8 + +

25. Conclusion
J M
Aviles
K T
Lesniak

26. 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