Clarifying the definition of neuropathic pain.

As regards the power calculation, a change in eight units in PRIT is what can reasonably be expected from any 'treatment' for pain judging from previous clinical trials using this outcome measure. The statistical power was, as recommended, at least 80% in order to detect a reasonable departure from the null hypothesis: this power level is not, in fact, asking healing to be more effective than any known intervention, just to show some effect (as claimed by many of the 12,000 healer-members of healing organisations in the UK) over and above a 'control' arm in a trial. Lastly, The SD of ten units is an acceptable one based on other studies using the MPQ. 5. Specific and non-specific effects Dr Walach and colleagues seem to suggest that the overall result is a false negative, given the hurdles placed by the chronic condition of the patients and the power of the study. The results speak for themselves. In the event – leaving formal statistics to one side – the actual outcome was that about 25% of the 'active' groups and 25% of the 'placebo groups reported a clinically meaningful 50% reduction in pain. Yet, these are the very patients healers see and charge for their services day after day. In our trial the claimed results did not materialise, and we hope that healers will moderate their claims in light of this evidence. It is true that the question of whether spiritual healing has a specific effect is still open. However, we submit that – along with the results of our study-the open door is slowly closing. The results of two systematic reviews of the literature (Astin et al., 2000; Abbot, 2000) show the kind of unclear picture that would be expected from an ineffective 'therapy' given the effects of positive publication bias. As regards non-specific effects, the correspondents suggest that 'healing' may be a vehicle for harnessing them. But that is not the point. The point is that many 'healers' claim to heal symptoms, directly or indirectly, by channelling a force from a source to a patient. Rather than falling back on 'non-specific' effects, isn't it time healing and its allies faced up to an uncomfortable fact, namely, that specific or not, healing is not exactly all it is sometimes purported to be. The efficacy of 'Distant Healing': a systematic review of randomized trials. Ann Intern Med 2000;132: 903–910. Abbot NC. …