One of the more interesting research studies from an Evidence-Based
Medicine perspective started out as a simple science fair project by a fourth
grade student. Emily Rosa wanted to see if practitioners of Therapeutic Touch
could detect the energy fields in a carefully controlled condition. The topic
of this project was not too surprising, since her parents both worked for the
QuackWatch website, but Emily came up with the idea entirely on her own. The
science project received a lot of publicity and Emily was encouraged to
publish here results in a medical journal. With the assistance of several
adults, the publication,
appeared, giving Emily Rosa something nice to put on her resume when she
applies to college. I'm still waiting for my first publication in an "A
journal" like JAMA, so I am quite jealous.
Here are a few excerpts from the publication:
In 1996 and 1997, by searching for advertisements and following other
leads, 2 of us (L.R. and L.S.) located 25 TT practitioners in northeastern
Colorado, 21 of whom readily agreed to be tested. Of those who did not, 1
stated she was not qualified, 2 gave no reason, and 1 agreed but canceled
on the day of the test.
The reported practice experience of those tested ranged from 1 to 27
years. There were 9 nurses, 7 certified massage therapists, 2 laypersons, 1
chiropractor, 1 medical assistant, and 1 phlebotomist. All but 2 were
women, which reflects the sex ratio of the practitioner population. One
nurse had published an article on TT in a journal for nurse practitioners.
There were 2 series of tests. In 1996, 15 practitioners were tested at
their homes or offices on different days for a period of several months. In
1997, 13 practitioners, including 7 from the first series, were tested in a
single day.
The test procedures were explained by 1 of the authors (E.R.), who
designed the experiment herself. The first series of tests was conducted
when she was 9 years old. The participants were informed that the study
would be published as her fourth-grade science-fair project and gave their
consent to be tested. The decision to submit the results to a scientific
journal was made several months later, after people who heard about the
results encouraged publication. The second test series was done at the
request of a Public Broadcasting Service television producer who had heard
about the first study. Participants in the second series were informed that
the test would be videotaped for possible broadcast and gave their consent.
During each test, the practitioners rested their hands, palms up, on a
flat surface, approximately 25 to 30 cm apart. To prevent the
experimenter's hands from being seen, a tall, opaque screen with cutouts at
its base was placed over the subject's arms, and a cloth towel was attached
to the screen and draped over them (Figure 1).
Each subject underwent a set of 10 trials. Before each set, the
subject was permitted to "center" or make any other mental preparations
deemed necessary. The experimenter flipped a coin to determine which of the
subject's hands would be the target. The experimenter then hovered her
right hand, palm down, 8 to 10 cm above the target and said, "Okay." The
subject then stated which of his or her hands was nearer to the
experimenter's hand. Each subject was permitted to take as much or as
little time as necessary to make each determination. The time spent ranged
from 7 to 19 minutes per set of trials.
To examine whether air movement or body heat might be detectable by
the experimental subjects, preliminary tests were performed on 7 other
subjects who had no training or belief in TT. Four were children who were
unaware of the purpose of the test. Those results indicated that the
apparatus prevented tactile cues from reaching the subject.
The odds of getting 8 of 10 trials correct by chance alone is 45 of
1024 (P=.04), a level considered significant in many clinical trials. We
decided in advance that an individual would "pass" by making 8 or more
correct selections and that those passing the test would be retested,
although the retest results would not be included in the group analysis.
Results for the group as a whole would not be considered positive unless
the average score was above 6.7 at a 90% confidence level.
A nice graphic showing the experimental setup is on the web at
and I am going to try to get permission to use this figure on one of my web
page.
The results of the experiment were not good. In the original series of
trials, only 70 of the 150 guesses were correct (47%, 95% CI 37% to 57%). In
the second series, only 53 of 130 guesses were correct (41%, 95% CI 32% to
50%).
I talk about this study on several places on these web pages:
I mostly repeat the same point, which is that this experiment, while
possibly oversimplifying the conditions under which, does still provide
convincing evidence against Therapeutic Touch.
When I used this example in a talk that I gave this week, someone asked an
interesting question. Even though the average performance was very poor, was
it possible that some of the participants performed very well? After all, you
only need one person who can reliably detect energy fields to prove that
there is something interesting going on.
This is sometimes called the "White Crow" argument, which was based on the
quote
To upset the conclusion that all crows are black, there is no need to
seek demonstration that no crows are black; it is sufficient to produce one
white crow; a single one is sufficient. William James, as quoted at
www.prairieghosts.com/piper.html.
There is some plausibility to this quote, and it is often used in an
attempt to salvage an otherwise negative research finding. As the website
above notes, if you find one honest Spiritualist medium, that refutes the
charge that all mediums are fakes. Perhaps so, but a reasonable person should
also infer that in any area that is rife with fraud, you should be extremely
careful in examining the evidence. As the number of documented fraudulent
cases increases, the standard of proof should become increasingly high for
any future claim made by a spiritual medium.
Not knowing the individual results of the Emily Rosa study off the top of
my head, I did point out that any discipline where the average practitioner
performs more poorly than a coin flip is a discipline that cannot be trusted
in general. In particular, I would demand that a practitioner of Therapeutic
Touch demonstrate their ability in a blinded experiment before I would
consider giving them money for their services.
Going back today and re-reading the article, I noticed that the authors set
up individual thresholds of 8 correct responses out of 10 trials as being an
interesting individual result that would warrant replication. The authors
note that
Only 1 subject scored 8, and that same subject scored only 6 on the
retest.
which pretty much demonstrates that none of the 21 people tested could
reliably detect energy fields in a carefully controlled condition.
The reaction of the Therapeutic Touch community was either to attack the
research or ignore it. The attacks were quite vicious, actually, and
unwarranted. It reminds me of a quote by someone else confronted with
convincing evidence from a carefully controlled experiment that discredited
his fervently held beliefs:
You see, that is why we never do double-blind testing anymore. It
never works! as quoted on
www.quackwatch.org/01QuackeryRelatedTopics/ideomotor.html.
07/08/2008.
