Several points concerning the present study should be mentioned. First, prayer by and for the control group (by persons not in conjunction with this study) could not be accounted for. Nor was there any attempt to limit prayer among the controls. Such action would certainly be unethical and probably impossible to achieve. Therefore, "pure" groups were not attained in this study — all of one group and part of the other had access to the intervention under study. This may have resulted in smaller differences observed between the two groups. How God acted in this situation is unknown; i.e., were the groups treated by God as a whole or were individual prayers alone answered? Second, whether patients prayed of themselves and to what degree they held religious convictions was not determined. Because many of the patients were seriously ill, it was not possible to obtain an interview extensive enough to answer these two questions. Furthermore, it was thought that discussions concerning the patients' relationship to God might be emotionally disturbing to a significant number of patients at the time of admission to the coronary care unit, though it was generally noted that almost all patients in the study expressed the belief that prayer probably helped and certainly could not hurt.
   The data presented in this report show that the initial randomization resulted in two statistically similar groups as judged by the results of univariate and multivariate. Prayers to the Judeo-Christian God were made on behalf of the patients in the prayer group by "born again" believers in Jesus Christ. Analysis of events after entry into the study showed the prayer group had less congestive heart failure, required less diuretic and antibiotic therapy, had fewer episodes of pneumonia, had fewer cardiac arrests, and were less frequently intubated and ventilated. Even though for these variables the P values were <.05, they could not be considered statistically significant because of the large number of variables examined. I used two methods to overcome this statistical limitation: incorporation of the outcome

variable into a severity score, and multivariate analysis. Both of these methods produced statistically significant results in favor of the prayer group. The severity score showed that the prayer group had an overall better outcome (P < .01) and the multivariate analysis produced a P value of <.0001 on the basis of the prayer group's lesser requirements for antibiotics, diuretics, and intubation/ventilation.
   In this study I have attempted to determine whether intercessory prayer to the Judeo- Christian God has any effect on the medical condition and recovery of hospitalized patients. I further have attempted to measure any effects, if present, of those prayers. Based on these data there seemed to be an effect, and that effect was presumed to be beneficial.

Acknowledgments. I thank the numerous people involved in this project, whose names are too many to list. I also thank Gunnard W. Modin, BS, Department of Cardiology, San Francisco General Medical Center, for statistical review, and Mrs. Janet Greene for her dedication to this study. In addition, I thank God for responding to the many prayers made on behalf of the patients.

References

1. Spivak CD: Hebrew prayers for the sick. Ann Med Hist 1:83-85, 1917
2. Galton F: Statistical inquiries into the efficacy of prayer. Fortnightly Rev 12:125-135, 1872
3. Galton F: Inquiries into Human Faculty and Its Development. London Macmillan Co, 1883, pp 277-294
4. Joyce CRB, Welldon RMC: The efficacy of prayer: a double-blind clinical trial. J Chronic Dis 18:367-377, 1965
5. Collipp PJ: The efficacy of prayer: a triple blind study. Med Time 97:201-204, 1969
6. Rosner F: The efficacy of prayer: scientific vs religious evidence. J Rev Health 14:294-298, 1975
7. Biomedical Data Processing Statistical Software. Dixon WJ (ed). Berkeley, University of California Press, 1981
8. Press SJ, Wilson S: Choosing between logistic regression and discrimnant analysis. J Am Stat Assoc 73:699-705, 1978
9. Lee ET: Statistical Methods for Survival Data Analysis. Belmont, Lifetime Learning Publications, 1980, pp 338-365
10. Roland CG: Does prayer preserve? Arch Intern Med 125:580-587, 1977

Byrd • INTERCESSORY PRAYER 829

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