StATS: Ten research studies that anyone teaching EBM should be familiar with (January 17, 2005) Category: Teaching resources

When I get a chance, I want to write a paper with a title along the lines of "Ten research studies that anyone teaching EBM should be familiar with". These would be studies that are

One of the studies would be

This is a very simple study that was originally performed as a science fair experiment by a fourth grade student, Emily Rosa. I describe the experiment in an earlier weblog entry.

Interesting is the criticisms of this study, such as the following:

Some proponents now insist that the “intentionality” of the practitioner is essential for TT to work. Healing takes place, in other words, only when the person performing the technique sincerely intends to heal a patient. If that's true, conducting a placebo-controlled study is virtually impossible, which means the only evidence for efficacy will remain largely anecdotal: compelling to advocates but unconvincing to skeptics.

TT practitioners say the therapy is based on a fluid energy field, which is why a therapist constantly moves hands over the patient.

Dolores Krieger, co-founder of TT criticized the study. "It's poor in terms of design and methodology." She said that someone other than the designer should have conducted the test, and that the 21 test subjects were too few and unrepresentative. She said that the validity of TT has been established in many doctoral dissertations and "innumerable" clinical studies. Referring to the study, she said "It's a cute idea, but it's not valid. The way her subjects sat is foreign to TT, and our hands are moving, not stationary. You don't just walk into a room and perform--it's a whole process."

Proponents of touch therapy argue that Emily's study does not disprove the value of the procedure. Dr. Delores Krieger, an emeritus professor of nursing at New York University, and the developer of touch therapy, thought it was an April Fool's joke when she first heard about the study. She and other practitioners argue that the study means nothing because the technique relies on more than just touch to sense the human energy field. Practitioners also use the senses of intuition and sight.

It is the JAMA-reported study itself that is less than honest. In her response to JAMA, Cynthia Poznanski Hutchinson, DNSc, RN, CHTP/I, Research Coordinator for Healing Touch International, delineates the study's problems. Among them, that TT involves five factors-and that the ability to sense the client's energy field, the least important of the factors, is the only one JAMA investigated. As Hutchinson writes: "The critical variables of practitioner compassion and holding the intentionality for the highest good of the recipient was not part of the study. In the study setting, no healing was sought. Their method was biased, unnatural and fragmented. The five steps of TT in clinical practice is done as a process and as a whole."

A couple of defenses of the Rosa et al study are also worth reading:

A discussion of the findings of this paper and the criticisms will help illustrate why proponents of alternative medicine will often find themselves at odds with proponents of evidence based medicine.

Here are some of the other articles that I might want to highlight in the top ten list. I will try to describe some of these articles in future weblog entries.

Issues involving placebos:

Issues involving concealed allocation

Issues involving the hierarchy of evidence

Issues involving publication bias

Issues involving conflict of interest

Other interesting studies

This page was written by Steve Simon while working at Children's Mercy Hospital. Although I do not hold the copyright for this material, I am reproducing it here as a service, as it is no longer available on the Children's Mercy Hospital website. Need more information? I have a page with general help resources. You can also browse for pages similar to this one at Category: Teaching resources.