When strict protocols are followed for making diagnoses, applying treatments, and assessing clinical changes, observational studies can be as helpful as RCTs.

To examine whether conclusions of observational studies differ from those of RCTs, Arthur J. Hartz and Kjell Benson compared observational studies and RCTs on cardiovascular and other diseases published since 1984. Surveying 3,868 observational studies, they found 19 for which there was also an RCT for similar problems. Only one of these pairs had a discrepancy, and this was just in the magnitude of the effects of treatment.

Another review found similar concurrences (Lawler, et al).

In many other parts of the world (outside the US), observational studies are considered sufficient for accepting treatment efficacies.

A particular advantage of observational studies is that they cost far less, are easier to run than RCTs, and provide answers to questions of efficacy much more quickly.

Helpful refs:

Benson, Kjell and Hartz, Arthur J. A comparison of observational studies and randomized, controlled trials, New England J Medicine 2000, 342(25), 1878-1886.

Black, N. Why we need observational studies to evaluate the effectiveness of health care, British Medical Journal 1996, 312, 1215-1218

Lawlor, D. et al. Observational versus randomised trial evidence, Lancet, 2004, 364(9436),  755-755

Multiple Case Studies

It is common for clinicians to report on groups of people who have been given a particular treatment, particularly when it is a new or uncommon one for that treatment setting or for a specific range of problems. This is how progress is made in clinical practice.

A series of people with similar problems (meeting the criteria for impressive single case studies) who respond to spiritual healing will be even more impressive. This is usually difficult to organize without the collaboration of a health care professional.

A series of people with different problems responding to healing is helpful in demonstrating the spectrum of healing abilities of a given healer or healing approach. A healer will often find that people with particular problems respond to her or his treatments, while people with other problems do not respond. Healees may find that they have a dramatic response to one of a series of treatments, with more modest or minimal responses to other treatments from the same healer.

With a sufficiently large number of subjects with chronic disease, it is possible to measure changes from before to after treatment and run statistical analyses on the results. The assumption would be that with chronic disease the symptoms are likely to remain unchanged over time, so significant changes might be attributed to the healing treatments. However, without a control group, the skeptics will always raise questions as to whether these results could have occurred by chance or could be due to some unnoticed agents other than the healing.

Single Case Studies

Individual case studies can provide details of how healing worked in a particular individual, with a particular approach, applied by a particular healer, as interpreted by the writer. This approach allows for a great richness of detail in all of these aspects of the study of healing. It has the weakness that it may represent biases of any of the participants rather than findings that might be found by other participants.

This is a worth-while beginning for the study of healing, particularly when the observer and reporter is a health care professional who can place the findings in the context of conventional medical care. The danger here is that a conventional observer may miss details that are relevant to healers, healees, and the process of healing. The anthropological literature is rife with such observations, where the scientists presumed that the interventions of shamans and medicine men were no more than rote rituals, and completely missed the biological energy medicine and spiritual components of the interventions.

This is likewise a worth-while beginning when the observer is a healer or healee, because these participants may provide subjective details that would otherwise be unavailable to the reader. The danger here is that people who are not medically trained may mistake a placebo reaction or normal waxing and waning of illness for a healing effect. For instance, I have repeatedly had healers tell me that they have excellent results with curing warts. The fact is, warts respond to almost any form of suggestion.

There are more general problems with single case studies. If one person responds to a particular treatment there will always be questions about whether any improvements might have been due to spontaneous remission of the problem. That is, there could be something peculiar to that person which made it possible for her or him to change, regardless of any treatments that might have been given.

Many diseases have irregular courses of progression. Arthritis may be terrible for months and years and then ease up, stop its progress, or remit.

Similarly, symptoms of multiple sclerosis, a neurological disease with sensory and muscular problems, can wax and wane over periods of months and years.

Some of the factors that may help to substantiate a single case report of spiritual healing success include:

- a diagnosis of the person made by a doctor

- symptoms are chronic

- the disease is not generally known for waxing and waning of symptoms or for spontaneous remissions

- previous conventional treatments failed

- there was no other treatment given concurrently

- there were no dramatic changes in psychological, relational, social, or other conditions around the time of the healing that could have contributed to the observed changes

- improvements occurred immediately following spiritual healing

- improvements include objective, measurable changes (not just "feeling better")

- changes include objective observations

- changes are confirmed by a doctor or other health care professional

- laboratory tests confirm the reported changes

 
References

See annotated bibliography of single-case studies