Music, Imagery, Touch, and Prayer as Adjuncts to Interventional Cardiac Care: The Monitoring and Actualisation of Noetic Trainings (MANTRA) II Randomised Study
๐ Original study โ๐ Appears in:
Plain English Summary
This was the biggest rigorous trial ever done to test whether prayer and bedside healing therapies actually help heart patients โ 748 people across nine US hospitals, published in The Lancet. Patients undergoing heart procedures were randomly assigned to receive (or not) off-site prayer from strangers and a bedside combo of music, guided imagery, and healing touch (MIT). The headline result? Neither prayer nor MIT made a meaningful difference on the main outcome โ complications, death, or hospital readmission over six months. However, there was a tantalizing twist: MIT patients were significantly less stressed before their procedures, and a secondary analysis hinted at dramatically lower death rates in the MIT group. But that mortality finding was based on just 27 deaths total, making it statistically shaky. This study perfectly captures a recurring pattern in healing research โ the primary result says "no effect," but a secondary finding whispers "maybe something interesting is happening here."
Actual Paper Abstract
Background Data from a pilot study suggested that noetic therapiesโhealing practices that are not mediated by tangible elementsโcan reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. We undertook a multicentre, prospective trial of two such practices: intercessory prayer and music, imagery, and touch (MIT) therapy. Methods 748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centres were assigned in a 22 factorial randomisation either off-site prayer by established congregations of various religions or no off-site prayer (double-blinded) and MIT therapy or none (unmasked). The primary endpoint was combined in-hospital major adverse cardiovascular events and 6-month readmission or death. Prespeci๏ฌed secondary endpoints were 6-month major adverse cardiovascular events, 6-month death or readmission, and 6-month mortality. Findings 371 patients were assigned prayer and 377 no prayer; 374 were assigned MIT therapy and 374 no MIT therapy. The factorial distribution was: standard care only, 192; prayer only, 182; MIT therapy only, 185; and both prayer and MIT therapy, 189. No signi๏ฌcant difference was found for the primary composite endpoint in any treatment comparison. Mortality at 6 months was lower with MIT therapy than with no MIT therapy (hazard ratio 0ยท35 (95% CI 0ยท15โ0ยท82, p=0ยท016). Interpretation Neither masked prayer nor MIT therapy signi๏ฌcantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention.
Research Notes
The definitive MANTRA II trial โ the largest multicenter RCT of intercessory prayer in cardiac care, published in The Lancet. Its null primary results for both prayer and MIT therapy are central to Controversy #5 (distant healing/prayer). The secondary mortality finding for MIT, based on only 27 deaths, illustrates the common tension between null primaries and suggestive secondaries in healing research.
A multicenter 2x2 factorial RCT tested whether bedside music, imagery, and touch (MIT) therapy or double-blind off-site intercessory prayer improved outcomes in 748 patients undergoing cardiac catheterization or PCI at nine US centers. Neither MIT therapy nor prayer significantly affected the primary composite endpoint of in-hospital MACE plus 6-month death or readmission (MIT: HR 1.09, 95% CI 0.86-1.39; prayer: HR 0.97, 95% CI 0.77-1.24). A secondary analysis found significantly lower 6-month mortality with MIT therapy (HR 0.35, 95% CI 0.15-0.82, p=0.016). MIT therapy also significantly reduced pre-procedural distress (p < 0.0001). The authors concluded that neither therapy significantly improved clinical outcome after elective catheterization or PCI.
Links
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Companion
- Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial โ Leibovici, Leonard (2001)
- The Efficacy of "Distant Healing": A Systematic Review of Randomized Trials โ Astin, John A (2000)
- Distant Healing of Surgical Wounds: An Exploratory Study โ Schlitz, Marilyn (2012)
- 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 โ Benson, Herbert (2006)
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๐ Cite this paper
Krucoff, Mitchell W, Crater, Suzanne W, Gallup, Dianne, Blankenship, James C, Cuffe, Michael, Guarneri, Mimi, Krieger, Richard A, Kshettry, Vib R, Morris, Kenneth, Oz, Mehmet, Pichard, Augusto, Sketch, Michael H. Jr, Koenig, Harold G, Mark, Daniel, Lee, Kerry L (2005). Music, Imagery, Touch, and Prayer as Adjuncts to Interventional Cardiac Care: The Monitoring and Actualisation of Noetic Trainings (MANTRA) II Randomised Study. The Lancet. https://doi.org/10.1016/S0140-6736(05)67014-7
@article{krucoff_2005_music,
title = {Music, Imagery, Touch, and Prayer as Adjuncts to Interventional Cardiac Care: The Monitoring and Actualisation of Noetic Trainings (MANTRA) II Randomised Study},
author = {Krucoff, Mitchell W and Crater, Suzanne W and Gallup, Dianne and Blankenship, James C and Cuffe, Michael and Guarneri, Mimi and Krieger, Richard A and Kshettry, Vib R and Morris, Kenneth and Oz, Mehmet and Pichard, Augusto and Sketch, Michael H. Jr and Koenig, Harold G and Mark, Daniel and Lee, Kerry L},
year = {2005},
journal = {The Lancet},
doi = {10.1016/S0140-6736(05)67014-7},
}