This paper critically analyzes the Study of the Therapeutic Effects of Intercessory Prayer (STEP), a multicenter randomized trial examining whether intercessory prayer improves outcomes for coronary artery bypass graft (CABG) surgery patients. The paper outlines the study's three-group design, explains the statistical thresholds used to define significance, and evaluates the experimental results — notably that patients who both expected and received prayer experienced the highest complication rate. It then assesses the study's statistical significance and raises conceptual criticisms about the research design, including the uncontrollable presence of outside prayer and the researchers' inability to explain a key anomalous finding.
The paper demonstrates critical appraisal of quantitative research design. Rather than accepting reported statistical significance at face value, the writer interrogates the a priori assumptions embedded in the threshold-setting process (e.g., the arbitrary 10% expectation adjustment) and questions whether the study's conceptual framework was sound enough to support meaningful conclusions — a hallmark of graduate-level empirical critique.
The paper moves through five clearly labeled sections: an introduction defining intercessory prayer and the study's purpose; a detailed explanation of the three-group experimental design and statistical thresholds; a summary of the numerical results; an assessment of what those results do and do not prove; and a two-part conceptual critique targeting flaws in the study's design logic. The structure mirrors the standard research critique format — description before evaluation.
Benson, H.; Dusek, J.A.; and Sherwood, J.B. "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in Cardiac Bypass Patients: A Multicenter Randomized Trial of Uncertainty and Certainty of Receiving Intercessory Prayer." American Heart Journal, Vol. 151 (2005): 934–42. Reported by Carey in "Long-Awaited Medical Study Questions the Power of Prayer," The New York Times, March 31, 2006.
Intercessory prayer in medicine is the use of prayer to divine powers to assist and benefit the welfare of patients in clinical circumstances. Various studies have produced conflicting results, with some purporting to demonstrate a benefit toward positive clinical outcomes and others concluding that praying for medical patients is without effect. This study sought to examine the issue empirically through a formal quantitative analysis designed to compare the medical outcomes of surgery patients who received intercessory prayer and those who did not.
The patients selected for the study were all pre-scheduled for elective coronary artery bypass graft (CABG) surgery. Their recovery over the initial 30 days following surgery was measured and compared in terms of relative rates of post-surgical complications, relative rates of major post-surgical medical events, and respective mortality rates.
The first group of patient-subjects were unknowing recipients of intercessory prayer. The second group received no intercessory prayer and were never informed about whether or not they would be recipients of intercessory prayer. The third group received both intercessory prayer and advance notification that someone would be praying on their behalf. The prayers on behalf of the two patient-subject groups receiving intercessory prayer were delivered by members of a local religious group who agreed to add a request to their usual prayers asking that the patients on their lists be blessed with "successful surgery with a quick, healthy recovery and no complications." Those prayers were delivered daily for two weeks beginning on the evening before the scheduled surgery.
The statistical basis of the study was predicated on the known post-operative complication rate of approximately 50% among patients experiencing CABG surgery complications within the first thirty days. That general statistic provided the basis for the initial assumption that complication rates would be approximately fifty percent among patient-subjects in the second group, who received no prayers and were not expecting any. The researchers postulated that a complication rate differential of ten percent or more in this group would be considered statistically significant. Specifically, complication rates of forty percent or less would be considered to support the hypothesis that intercessory prayers had benefited surgical outcome.
With respect to the patient-subject group receiving — and expecting to receive — intercessory prayer, the researchers postulated that a complication rate differential of twenty percent or more would be considered statistically significant. Specifically, complication rates of thirty percent or less would be considered to support the hypothesis that intercessory prayers had benefited surgical outcome in this group. The stricter burden of statistical significance was predicated on the need to counter the potentially beneficial effect that the expectation of receiving prayer might have on patient outcomes.
In principle, that method of guarding against the influence of external independent variables was appropriate. However, it represents a purely arbitrary choice on the part of the researchers, one that presupposes the influence of expectation on outcome would be approximately ten percent. That limitation would be most consequential if the differential between groups very nearly approached the arbitrary ten-percent threshold.
The findings were statistically significant in an unexpected direction: the group of patient-subjects experiencing the highest rate of post-surgical complications (59%) were those who both expected and received intercessory prayer. Patient-subjects who received intercessory prayer without expecting it suffered the second-highest rate of post-surgical complications (52%), which was approximately what would be expected based on general statistics about CABG surgical recovery. Finally, patient-subjects who had no prior expectation of receiving prayers and who did not receive intercessory prayer suffered the lowest rate of post-surgical complications (51%), which was also approximately what would be expected statistically in connection with CABG surgery generally.
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