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PMID 24395196 is a newly published systematic review and meta-analysis of meditation's effect on stress and well-being, funded by AHRQ and conducted by a team at Johns Hopkins. One of its central findings is that "mantra meditation programs did not improve any of the outcomes examined". (In contrast, there was some evidence that mindfulness-based meditation was superior to non-specific controls, although not superior to specific active controls like exercise). The lack of evidence for mantra meditations persisted when TM was considered in isolation. How should we reflect this new secondary source in our article? MastCellTalk 01:26, 9 January 2014 (UTC)
Note that the way the review was done, ONLY studies that evaluated psychological effects were cited, and even in those studies, ONLY psychological effects were counted. For example, the review referred to Effects of a randomized controlled trial of transcendental meditation on components of the metabolic syndrome in subjects with coronary heart disease.. Since the psychological test for anxiety revealed that none of the TM subjects were anxious at the beginning of the study, or at the end, the study was counted as showing that TM had no effect on anxiety. The study also reported that the TM group showed beneficial changes on measures of heart-rate variability, adjusted systolic BP and insulin resistance, but since none of these were psychological measures of anxiety, the review counted this as "no effect," leading to the report that only mindfulness practices had ANY effect on "well being." As to how to cite it, note that of 17,000+ meditation citations examined by the reviewers, only 47 of them made the cut, and despite one of the TM researcher participants submitting 50 TM studies for use in the review, the reviewers only used 8 of them (Orme-Johnson, personal communication, but I'm sure he'll put it up on his blog soon)Sparaig2 (talk) —Preceding undated comment added 19:28, 15 January 2014 (UTC)
A key part of any meta-analysis or systematic review is to assess the quality of the literature and high-quality studies. If you include low-quality studies, then you get garbage in, garbage out. The fact that very few TM studies qualified is not an indication of a problem with the systematic review. It's an indication of the flaws and weaknesses of the TM literature (as other systematic reviews have routinely noted).
The vast majority of TM studies are methodologically flawed to the point that they can't be meaningfully interpreted, and are thus excluded from any well-conducted systematic review. You seem very focused on the raw quantity of TM studies, but piling up huge numbers of flawed studies is like multiplying zeroes. It's important to understand that 50 flawed studies are no more useful than 1 flawed study, at least in science (obviously, in marketing the equation may be substantially different). MastCellTalk 23:49, 15 January 2014 (UTC)
I like it how you only responded to Sparaig2 last sentence. Also I had a quick look at the review and doesn't it only look at stress and well-being in a clinical setting?--Uncreated (talk) 19:33, 17 January 2014 (UTC)
I didn't see much else in Sparaig2's post to respond to. I understand that a pseudonymous Wikipedia editor disagrees with the paper's methodology, but that carries zero weight when it comes to our content policies. His main objection seemed to be based on a fundamentally faulty understanding of how systematic reviews work, so I tried to clarify that. I'm not sure what you mean by "only" looking at "clinical settings"; could you clarify? MastCellTalk 23:32, 17 January 2014 (UTC)
By Clinical Setting I mean the review only looked at studies in which the subjects had been diagnosed with a medical or psychiatric problem. --Uncreated (talk) 07:47, 8 February 2014 (UTC)
You said: "The fact that very few TM studies qualified is not an indication of a problem with the systematic review. It's an indication of the flaws and weaknesses of the TM literature (as other systematic reviews have routinely noted." This statement suggests a bit of bias on your part for several reasons: firstly, in most of the reviews I have seen, reviewers don't single out TM research as the worst of all worlds, which your statement implies; secondly, in reference to the most recent review from the American Heart Association, lead author Robert Brook said that studies on TM were unique in the quality of research on hypertension, which goes against the general implication of your comment; finally, on a purely numerical level, the pubmed search string, "transcendental meditation" ("well being" OR anxiety OR depression) yields 50 hits, while the search string, mindfulness meditation ("well being" OR anxiety OR depression) yields 320 hits. 8 out of 50 TM studies made the grade, while 20 out of 320 mindfulness studies made the grade. That's 16% of the TM studies were sufficiently high quality to be included, while only 6.25% of the mindfulness studies were sufficiently high quality to be included, assuming that only pubmed citations were used. Surely you can see that singling out TM studies the way you appear to be is not warranted? 14:44, 23 January 2014 (UTC) — Preceding unsigned comment added by Sparaig2 (talk • contribs)
I added 5 tildes by accident and it said I didn't sign the commentSparaig2 (talk) 14:48, 23 January 2014 (UTC)
┌────────────────────────────────────────────────────────────────────────────────────────────────────┘ Not really following the argument here. What change is being proposed, exactly? Alexbrntalk|contribs|COI 14:51, 23 January 2014 (UTC)
I was simply noting what appears to be a bug. I suppose I should have tested in a sandbox rather than in public. I've sent an email about it, though its a wiki bug, and the authors of the original software need to be told --not obvious how to go about doing that, however.Sparaig2 (talk) 15:14, 23 January 2014 (UTC)
I was pointing out to MastCell that I thought his attitude towards TM research is biased. It is up to MastCell to decide what, if anything, to do about his bias and how it affects his handling of the citation of TM research in wikipedia. Sparaig2 (talk) 16:20, 23 January 2014 (UTC)
I don't think I've ever claimed that TM research was uniquely worse than other meditation research. As you note, meditation research is pretty poor across the board in terms of quality. This page is about TM specifically; hence the focus on TM here. You're welcome to follow up on your concerns about bias on my talkpage or in whatever venue you see fit, although I find it somewhat ironic to be accused of bias on an article dominated by a group of single-purpose TM-affiliated accounts. MastCellTalk 18:36, 23 January 2014 (UTC)
And yet, one man's "deeply flawed" can make another man's list of "most important studies published in 2012." Specifically, when the study by Schneider et al was pulled from publication in the journal hypertension just moments before the journal went online, a number of bloggers made note of the incident, and decried it as an awful study. A little over a year later, the study was published in the American Heart Association journal, and is now listed as: "Circulation: Cardiovascular Quality and Outcomes Editors' Picks: Most Important Articles Published in 2012". None of the bloggers or the people who gave impromptu critiques of the study were willing to go on the record by writing a Letter to the Editor of _Circulation_. Which are we to believe, the journal editors or a bunch of bloggers, and why?Sparaig2 (talk) 19:25, 23 January 2014 (UTC)
Actually, a number of people went on record as critical, or at least skeptical, of the way that article was handled (and we've still never gotten an actual explanation for why Archives of Internal Medicine pulled the paper 12 minutes before it was set to go live—an unprecedented occurrence). Independent experts described the study as "too small to be conclusive", and Larry Husten and Sanjay Kaul at CardioBrief have written extensively about the paper's mysterious disappearance and re-appearance, as well as its methodologic quality (e.g. , ). But we're jumping around a bit here—I initially opened this thread to discuss how we should incorporate the new JAMA Internal Medicine/ARHQ systematic review. MastCellTalk 21:41, 23 January 2014 (UTC)
They went on the record in *blogs*, but in the year since it was published, not a single one of them "went on the record" by writing a Letter to the Editor concerning its dubiousness. And, as I said, the editors of the journal went on the record as listing it as one of the most important papers published in the journal in 2012. And, this article in _The Scientist_ provides some explanation of why it was pulled:
According to Jann Ingmire, director of media relations for the Archives journal series as well as the Journal of the American Medical Association (JAMA), the decision was made after the authors informed Archives editors that new, potentially relevant data existed. “At that point, the journal felt it was necessary to review the new data” prior to publishing the study, said Ingmire, adding that it is not yet known whether the new data will affect the study’s findings.
The new data came to light after the study authors invited the National Heart, Lung, and Blood Institute (NHLBI), which funded the study, to comment on the accepted manuscript for a press release. Upon seeing the final paper, project officer Peter Kaufmann reminded the authors of the additional data collected since the original manuscript was submitted, “and the importance of including all available data in publications,” Kaufmann told The Scientist in an email. Though he did not specifically recommend that it be included, the authors decided to send the most recent data to the journal.— Preceding unsigned comment added by Sparaig2 (talk • contribs) Sparaig2 (talk) 06:18, 24 January 2014 (UTC)
They focused on psychological markers of stress and well-being because if a patient is just as depressed after therapy, what good is a chart demonstrating improved heart-rate variability?? However, the authors of the review do acknowledge that leaving out trials that measured biological markers may "disappoint some readers", and they then mention the hypothesis (from the paper cited above) that mantra-meditation may independently influence the body's stress response.
This review should be given primary weight here, but it may be worth asking whether a few sentences should be said about the impact of this restriction on TM, based on the words of the review authors themselves. My own opinion, as an episodic single-purpose account, is that it would probably not hurt to clarify that this review focused on psychological markers only, so that the AHA's relatively more positive evaluation does not seem too contradictory. Vesal (talk) 07:48, 24 January 2014 (UTC)
Fair enough. From a true believer's perspective, however, it is frustrating to see that many/most of the TM research that "made the grade" were studies where the subjects were already rated as "non-anxious" or "non-depressed" on psychological tests so that the lack of change in pre and post-test was counted as "TM has no effect on anxiety or depression." Most TM research in the past few years has focused on physiological changes as that is where the major grant money for MUM (the TM university) is coming from. It is a numbers game that is very hard to play. A pubmed search string on research published on (mindfulness meditation) in the last 10 years yields 704 hits. The same search string for ("Transcendental Meditation") yields 90 hits, and the ratio of published mindfulness meditation studies to published TM studies studies is getting larger every year (I project that more mindfulness studies will be indexed in pubmed in 2014 than are indexed for the 40 years history of TM research: 305). It is a given that an arbitrary review of some arbitrary set of variables will almost certainly yield more mindfulness meditation hits than "transcendental meditation" hits, and meta-analysis is very much a numbers game: the results will tend to favor whichever therapy has the most randomly designed studies to look at, unless those variables happen to be exactly what the limited number of TM studies are looking at, as is the case with the AHA hypertension report. Sparaig2 (talk) 17:19, 24 January 2014 (UTC)
By the way, the claim that they focused on mental health, so any study that wasn't on mental health was eliminated, ignores the fact that what they said was:
We aimed to determine the efficacy and safety of meditation programs on stress-related outcomes (e.g., anxiety, depression, stress, distress, well-being, positive mood, quality of life, attention, health-related behaviors affected by stress, pain, and weight) compared with an active control in diverse adult clinical populations
paired associate learning; 2 measures of cognitive flexibility; mental health; systolic blood pressure; and ratings of behavioral flexibility, aging, and treatment efficacy'
but as this study didn't use an active control group, but instead did a head-to-head comparison of three different treatments and a no-treatment control group, it didn't qualify to be included in the meta-analysis. I just have to ask you, in all seriousness: can you take seriously a meta-analysis that refuses to include the results of head-to-head studies between two of the treatment modalities that it otherwise analyzes? Sparaig2 (talk) 21:49, 3 February 2014 (UTC)
Does someone want to propose some text based on the systematic review? IRWolfie- (talk) 23:55, 4 February 2014 (UTC)
It's a single study (i.e primary source) of a rather paltry 40 individuals. Let the Secondary sources sort these out. Incidentally, Phys.org is also a rather poor website, IRWolfie- (talk) 00:01, 5 February 2014 (UTC)
It's not the place of wikipedia to try to provide balance in the face of this kind of imbalance in number of studies for opposing practices/treatments but the typical methodology used in science to compare treatment modalities assumes there the number of studies for each modality is within an order of magnitude or 2. That is no longer the case with TM vs mindfulness, as that little graph of the number of studies indexed in pubmed shows. I have no idea how anyone can address such an issue. Of course, for those who think TM is worthless (or that all meditation practices are worthless or equivalent), it obviously doesn't matter. But here's a thought: even now, it appears like new research on mindfulness doesn't overturn the AHA's conclusion from last year, despite the avalanche of new research... Sparaig2 (talk) 08:25, 10 February 2014 (UTC)
Sorry I have no idea what you are talking about nor do I see the relevance to your initial post. I'm not sure what you are extrapolating from the AHA statement of evidence being "unknown/unclear/uncertain or not well-established". IRWolfie- (talk) 20:12, 10 February 2014 (UTC)
As I pointed out before, the lead author of the AHA study. Richard Brook, has commented to me in email that "they did not use our words" when the WIkipedia entry claims that a LOE (Level of Effect) "type IIb" means "unknown/unclear/uncertain or not well-established". That was an alternate form of wording that the AHA writing committee chose NOT to use. It merely appears in the graphic that gives all the possible wordings that could have been used in connection with the LOE designation the writing committee chose to use. Instead, they chose to use the wording "may be used in clinical practice," which gives an entirely different interpretation of the official designation. What the Richard Brook also said in an exchange of Letters to the Editor of the AHA journal (which I also quoted in this talk page) is that We do agree that TM is unique in the robustness and quality of evidence among meditation technqiues for BP-lowering and that a reassessment of the LOE may be warranted should future studies, particularly using home or ambulatory BP monitoring as the primary outcome, more consistently corroborate its efficacy. I typed out the entire letter in a reddit discussion in case you are interested in the context. Sparaig2 (talk) 22:58, 10 February 2014 (UTC)
When I said in context I was referring to your initial post. I thought you were suggesting an edit based on it, but your above comment appears to be moving off topic. IRWolfie- (talk) 23:08, 10 February 2014 (UTC)
I was merely pointing out a philosophical issue that is probably beyond the scope of Wikipedia to deal with: when you have a publication ratio of 25 to 1 (currently a 41 to 1) for one treatment vs another treatment, typical scientific protocols like meta-analysis, start to fall apart. There's been about 100 studies on TM published in the past 10 years, as indexed by pubmed. There's been over 1000 studies on mindfulness practices published, and the number is growing possibly more than exponentially, every year, while the growth in the number of TM studies published per year has been flat. Without any ill-intent, it is almost certainly the case that there will be hundreds of mindfulness studies published in the next few years that meet criteria for inclusion in some arbitrary meta-analysis, while the TM research pool will simply be lacking. The recent meta-analysis on anxiety is a good example: There's almost no TM studies that qualified, and of those that did, at least a few were on populations that were not anxious or depressed in the first place, so of course, a test on anxiety or depression would show "no effect" simply because there was no possible way to show an effect: zero minus zero = zero. and when you average in such studies, the calculated TM effect-size, whatever it might actually be, becomes meaningless. Sparaig2 (talk) 23:22, 10 February 2014 (UTC)
Research on PTSD is a big new field of research for TM
Please do not use this page as a soap box for promoting TM. This page is for article suggestions. Thanks, IRWolfie- (talk) 00:53, 11 February 2014 (UTC)
Are you aware that you come across as slightly biased, even hostile, at least to me? When David Spectre mentioned a new study, you shot him down because it was only a single study published in a not-so-reputatable journal. When I mention a new series of studies that are coming out about TM research, rather than addressing whether or not such a series should be included in the research section on TM, you accuse me of soapboxing about TM. So... Here's my pitch: as I said above, PTSD research is turning out to be a big thing in TM research. $2.4 million has explicitly been granted, as I understand it, by relevant US government agencies, to investigate TM's effects on PTSD. Given that you don't want ANY research that isn't mentioned in a "secondary source" to be mentioned, how should an on-going, multi-study research project such as the effects of TM on PTSD be handled by Wikipedia when there aren't enough studies yet to inspire a new "secondary source" meta-analysis? Sparaig2 (talk) 02:54, 11 February 2014 (UTC)
We don't interpret primary studies, we look to the secondary sources. I've no interest in looking through more methodologically weak studies and picking them apart. Trivially to see is that the first has an embarrassingly low 11 subjects and the third has 18 people split between psychotherapy and TM (I don't even know why you mention them at all; those numbers are embarassing) and the second doesn't have an adequate control group to account for placebo effects. But we don't do original research here. I'd be happy to include a study if I can pick through every fault and mention them all explicitly, but that would be against policy. You find them exciting, good for you. I don't share your enthusiasm. Wait until the secondary sources get there, if they didn't qualify for a relevant meta-analysis as you point out its because they were methodologically shit. Regards, IRWolfie- (talk) 00:24, 12 February 2014 (UTC)
So you're saying that a robustly done, large, head-to-head study is trumped by meta-analyses of numerous smaller studies that are not head-to-head? I'm not asserting that such studies exist, but in fact, that is what the American Heart Association is calling for. Such a study isn't a "secondary source" and yet, I've always understood that a single, large, well-done study is thought to automatically trump a meta-analysis that doesn't include it. 22.214.171.124 (talk) 13:42, 19 February 2014 (UTC)
In the second paragraph under maharishi effect, "the square root of 1 percent" is used as a figure. Just from a mathematical POV, this needs clarification.
Is it intended to mean [ (SQRT(1)/100)*population ] or [ (SQRT(1/100))*population ]? If the former, then somebody is an idiot. If the latter, then it should say "one hundredth of one percent". If we don't know what it means, then this phrase needs to cite its own source and be in quotation marks so we know who originally said it. If there is no source to cite and somebody just wrote it here to sound dumb, then we should remove it.
The claim that 1% of a population doing TM would have a noticible effect on that population is called "The Maharishi Effect." The "Extended Maharishi Effect" refers to the claim that group practice of TM and the TM-SIdhis by the square root of 1% of a population would have the same effect and when it was first introduced, the world's population was just under 5,000,000,000, so the required number to effect the world was 7,000 and a logo for the campaign to establish a permanent group of people included that number. The formula used is: sqrt(population * 1/100). Sparaig2 (talk) 08:23, 27 July 2014 (UTC)