***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To determine the effect of intercessory prayer , a widely practice d complementary therapy , on cardiovascular disease progression after hospital discharge . PATIENTS AND METHODS In this r and omized controlled trial conducted between 1997 and 1999 , a total of 799 coronary care unit patients were r and omized at hospital discharge to the  intercessory prayer group  or to the  control group . Intercessory prayer , ie , prayer by 1 or more persons on behalf of another , was administered at least once a week for 26 weeks by 5 intercessors per patient . The primary end point after 26 weeks was any of the following : death , cardiac arrest , rehospitalization for cardiovascular disease , coronary revascularization , or an emergency department visit for cardiovascular disease .  Patients were divided into a high-risk group based on the presence of any of 5 risk factors ( age = or > 70 years , diabetes mellitus , prior myocardial infa rct ion , cerebrovascular disease , or peripheral vascular disease ) or a low-risk group ( absence of risk factors ) for subsequent primary events . RESULTS At 26 weeks , a primary end point had occurred in 25.6 % of the intercessory prayer group and 29.3 % of the control group ( odds ratio [ OR ] , 0.83 [ 95 % confidence interval ( CI ) , 0.60 - 1.14 ] ; P=.25 ) . Among high-risk patients , 31.0 % in the prayer group vs 33.3 % in the control group ( OR , 0.90 [ 95 % CI , 0.60 - 1.34 ] ; P=.60 ) experienced a primary end point . Among low-risk patients , a primary end point occurred in 17.0 % in the prayer group vs 24.1 % in the control group ( OR , 0.65 [ 95 % CI , 0.20 - 1.36 ] ; P=.12 ) . CONCLUSIONS As delivered in this study , intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit OBJECTIVE Little is known about the effects of distant healing in chronically ill patients , the population most likely to see a healer in practice . This study investigated whether distant healing as found in normal practice with patients representative of those seeking treatment from healers changes patients ' quality of life substantially . METHOD R and omized , waiting-list controlled study of distant healing ( anonymous , amulet , and allowing for personal contact ) in chronically ill patients . OUTCOME MEASURE Patient-reported quality of life as expressed by the sum of all MOS SF-36 health survey items . RESULTS Sixty patients were treated by various methods of distant healing over 5 months ; 59 patients were put on a waiting list ( control ) .  Quality of life improved significantly ( p < 0.0005 ) in the treated group ( 10 points ) , while it remained stable in the control group . Positive expectation was significantly correlated with outcome . CONCLUSION Chronically ill patients who want to be treated by distant healing and know that they are treated improve in quality of life The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas The therapeutic effects of intercessory prayer ( IP ) to the Judeo-Christian God , one of the oldest forms of therapy , has had little attention in the medical literature . To evaluate the effects of IP in a coronary care unit ( CCU ) population , a prospect i ve r and omized double-blind protocol was followed . Over ten months , 393 patients admitted to the CCU were r and omized , after signing informed consent , to an intercessory prayer group ( 192 patients ) or to a control group ( 201 patients ) . While hospitalized , the first group received IP by participating Christians praying outside the hospital ; the control group did not . At entry , chi-square and stepwise logistic analysis revealed no statistical difference between the groups . After entry , all patients had follow-up for the remainder of the admission . The IP group subsequently had a significantly lower severity score based on the hospital course after entry ( P<.01 ) . Multivariant analysis separated the groups on the basis of the outcome variables ( P<.0001 ) . The control patients required ventilatory assistance , antibiotics , and diuretics more frequently than patients in the IP group . These data suggest that intercessory prayer to the Judeo-Christian God has a beneficial therapeutic effect in patients admitted to a CCU OBJECTIVE To conduct a pilot study of the effect of intercessory prayer on patients entering treatment for alcohol abuse or dependence . DESIGN In addition to st and ard treatment , 40 patients admitted to a public substance abuse treatment facility for treatment of alcohol problems who consented to participate were r and omized to receive or not receive intercessory prayer ( double-blind ) by outside volunteers . Assessment s were conducted at baseline , 3 months , and 6 months . RESULTS No differences were found between prayer intervention and nonintervention groups on alcohol consumption . Compared with a normative group of patients treated at the same facility participants in the prayer study experienced a delay in drinking reduction . Those who reported at baseline that a family member or friend was already praying for them were found to be drinking significantly more at 6 months than were those who reported being unaware of anyone praying for them . Greater frequency of prayer  by the participants themselves was associated with less drinking , but only at months 2 and 3 . CONCLUSION Intercessory prayer did not demonstrate clinical benefit in the treatment of alcohol abuse and dependence under these study conditions . Prayer may be a complex phenomenon with many interacting variables BACKGROUND The effect of intercessory prayer ( IP ) on outcome in cardiac cases has been evaluated previously , but results are controversial . The goals of the Study of the Therapeutic Effects of Intercessory Prayer ( STEP ) are to evaluate the effects of receipt of additional study IP and awareness of receipt of additional study IP on outcomes in patients undergoing coronary artery bypass graft surgery . STEP is not design ed to determine whether God exists or whether God does or does not respond to IP . METHODS STEP is a multicenter , controlled trial of 1802 patients in 6 US hospitals , r and omized to 1 of 3 groups . Two groups were informed that they may or may not receive 14 consecutive days of additional IP starting the night before coronary artery bypass graft surgery ; Group 1 received IP , Group 2 did not . A third group ( Group 3 ) was informed that they would receive additional IP and did so . Three mainstream religious sites provided daily IP for patients assigned to receive IP . At each hospital , research nurses blinded to patient group assignment review ed medical records to determine whether complications occurred , on the basis of the Society for Thoracic Surgeons definitions . A blinded nurse auditor from the Coordinating Center review ed every study patient 's data against the medical record before release of study forms . RESULTS The STEP Data and Safety Monitoring Board review ed patient safety and outcomes in the first 900 study patients . Patients were enrolled in STEP from January 1998 to November 2000 Abstract Objective : To determine whether remote , retroactive intercessory prayer , said for a group of patients with a bloodstream infection , has an effect on outcomes . Design : Double blind , parallel group , r and omised controlled trial of a retroactive intervention . Setting : University hospital . Subjects : All 3393 adult patients whose bloodstream infection was detected at the hospital in 1990 - 6 . Intervention : In July 2000 patients were r and omised to a control group and an intervention group . A remote , retroactive intercessory prayer was said for the well being and full recovery of the intervention group . Main outcome measures : Mortality in hospital , length of stay in hospital , and duration of fever . Results : Mortality was 28.1 % ( 475/1691 ) in the intervention group and 30.2 % ( 514/1702 ) in the control group ( P for difference=0.4 ) . Length of stay in hospital and duration of fever were significantly shorter in the intervention group than in the control group ( P=0.01 and P=0.04 , respectively ) . Conclusions : Remote , retroactive intercessory prayer said for a group is associated with a shorter stay in hospital and shorter duration of fever in patients with a bloodstream infection and should be considered for use in clinical practice . What is already known on this topic Two r and omised controlled trials of remote intercessory prayer ( praying for persons unknown ) showed a beneficial effect in patients in an intensive coronary care unit A recent systematic review found that 57 % of the r and omised , placebo controlled trials of distant healing showed a positive treatment effect What this study adds Remote intercessory prayer said for a group of patients is associated with a shorter hospital stay and shorter duration of fever in patients with a bloodstream infection , even when the intervention is performed 4–10 years after the Various forms of distant healing ( DH ) , including prayer and " psychic healing , " are widely practice d , but insufficient formal research has been done to indicate whether such efforts actually affect health . We report on a double-blind r and omized trial of DH in 40 patients with advanced AIDS . Subjects were pair-matched for age , CD4 + count , and number of AIDS-defining illnesses and r and omly selected to either 10 weeks of DH treatment or a control group . DH treatment was performed by self-identified healers representing many different healing and spiritual traditions . Healers were located throughout the United States during the study , and subjects and healers never met . Subjects were assessed by psychometric testing and blood draw at enrollment and followed for 6 months . At 6 months , a blind medical chart review found that treatment subjects acquired significantly fewer new AIDS-defining illnesses ( 0.1 versus 0.6 per patient , P = 0.04 ) , had lower illness severity ( severity score 0.8 versus 2.65 , P = 0.03 ) , and required significantly fewer doctor visits ( 9.2 versus 13.0 , P = 0.01 ) , fewer hospitalizations ( 0.15 versus 0.6 , P = 0.04 ) , and fewer days of hospitalization ( 0.5 versus 3.4 , P = 0.04 ) . Treated subjects also showed significantly improved mood compared with controls ( Profile of Mood States score -26 versus 14 , P = 0.02 ) . There were no significant differences in CD4 + counts . These data support the possibility of a DH effect in AIDS and suggest the value of further research BACKGROUND Patients undergoing percutaneous coronary intervention ( PCI ) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications . Noetic ( nonpharmacologic ) therapies may reduce anxiety , pain and distress , enhance the efficacy of pharmacologic agents , or affect short- and long-term procedural outcomes . METHODS The Monitoring and Actualization of Noetic Training ( MANTRA ) pilot study examined the feasibility of applying 4 noetic therapies-stress relaxation , imagery , touch therapy , and prayer-to  patients in the setting of acute coronary interventions . Eligible patients had acute coronary syndromes and invasive angiography or PCI . Patients were r and omized across 5 treatment groups : the 4 noetic and st and ard therapies . Question naires completed before PCI reflected patients ' religious beliefs and anxiety . Index hospitalization end points included post-PCI ischemia , death , myocardial infa rct ion , heart failure , and urgent revascularization . Mortality was followed up for 6 months after hospitalization . RESULTS Of eligible patients , 88 % gave informed consent . Of 150 patients enrolled , 120 were assigned to noetic therapy ; 118 ( 98 % ) completed their therapeutic assignments . All clinical end points were available for 100 % of patients . Results were not statistically significant for any outcomes comparisons . There was a 25 % to 30 % absolute reduction in adverse periprocedural outcomes in patients treated with any noetic therapy compared with st and ard therapy . The lowest absolute complication rates were observed in patients assigned to off-site prayer . All mortality by 6-month follow-up was in the noetic therapies group . In patients with question naire scores indicating a high level of spiritual belief , a high level of personal spiritual activity , a low level of community-based religious involvement , or a high level of anxiety , noetic therapies appeared to show greater reduction in absolute in-hospital complication rates compared with st and ard therapy . CONCLUSIONS Acceptance of noetic adjuncts to invasive therapy for acute coronary syndromes was excellent , and logistics were feasible . No outcomes differences were significant ; however , index hospitalization data consistently suggested a therapeutic benefit with noetic therapy . Of all noetic therapies , off-site intercessory prayer had the lowest short- and long-term absolute complication rates . Definitive demonstr 
    Output:
    
Individual studies did find some effects .
However it is impossible to prove or disprove in trials any supposed benefit that derives from God 's response to prayer