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AWARE II is not powered to validate an OBE

I am currently revising a chapter in my book on NDEs, and having reviewed some of the videos of Sam Parnia and the various presentations he has given, and the posters from AHA, I have come to conclusion that the AWARE II study is not powered to validate a visual OBE. Moreover, despite some enthusiasm over the patients in the AHA poster, I am not convinced that they are validated auditory OBEs. However, I am of the view that something has either already occurred or will occur, from this study, or another study, that will provide new evidence.

To my first point, and the title of this post. In autumn 2017 Dr. Parnia presented a slide showing current status of the study. In it he said that 300 patients had been included. This caused us considerable excitement as it suggested that he would have had a few hits if he had only included subjects in the way that I suggested on here after AWARE I. I realize now that this is not the case. This is the update from may 2019:

half Money slide

In the year since his March 2018 update there had been just under another 100 patients recruited. The target number  is 1500. They have increased the number of sites over 2019 and were aiming to complete recruitment by the end of this year, but with COVID, their attention for the next few months will be rightly on other things. These guys will be at the frontline, putting themselves at risk every day, and will have other things on their mind than AWARE II. However, it really doesn’t matter whether the results come this year, or five years from now, as I think it is quite unlikely now that we will see a validated visual OBE. Auditory OBEs I am not sure of, and will get onto in a moment.

So if you look at the flow chart you can see why I might be concerned that this study is not sufficiently powered to generate scientifically confirmed visual OBEs. Patients are included in the study if they have a CA and the crash cart with the kit arrives before resuscitation occurs. As Parnia has said, this in itself has proved a rate limiting step for the AWARE team due to lack of research staff, and the fact that many of the patients come round before the special cart arrives. However, and this was my aha moment as i was reviewing all the bits and pieces related to this, this is still the main inclusion criteria. Patients are still included in the study if they die before being interviewed, which was the reason why AWARE I did not produce any hits (as well as the targets being in a few specific locations).

In the AHA analysis presented in November 2019, the dataset used in the slide above was the one used as it had all the same numbers, with the exception of the number of patients interviewed, which was 22, although only 19 were counted for the data analysis. Going back to NDE stats, only 10% of CA survivors have NDEs, of these 25% have visual OBEs. If everyone who had an OBE saw the image on the ipad, then the chances of a visual OBE hit would be roughly 50% – 19X2.5%. Of course, we have often said that the chances of someone actually observing the image would be quite low, despite the position of the ipad, probably less than 50%. Therefore if you had 100 interviews from CA survivors you might get 1 or 2 visual OBEs (2.5/2).

Since Dr Parnia said they were intending to recruit 1500 patients, and in the May 2019 data they were a third of the way there, then going by their current rate, they will have about 150 survivors, and 60 interviews. In my view you would be very fortunate to get even one visual OBE from 60 interviews considering only 6 of those would have had NDEs, maybe 2 OBEs if you are lucky, and if you were super lucky one who saw the image. This of course would not be enough to convince even the most moderate skeptic.

When the number 1500 was originally announced, I assumed this would be 1500 who survived to be interviewed, other wise what is the point of including them in the study? With 1500 you could expect 150 NDEs and possibly upwards of 5-10 validated visual OBEs. Now I am seeing that actually the true objective of the study is possibly to look at EEG and oxymetry and determine what effects CPR have on this and the potential for Awareness. I wish I had a laptop made out of chocolate…I said I would eat my laptop if AWARE II didn’t get a hit based on the understanding that only patients who had been interviewed would be included.

To my second point, the auditory OBEs. Looking at the presentation in 2017, and picking up on other things that have been said, we only know that sounds were “timed”. Also, we don’t know if headphones were put in both ears. My feeling is that timed means they may have been playing intermittent sounds, and if that is the case, then they would have been able to hear the conversations in the room if they had sufficient oxygen to produce some consciousness. This last point relates to the second AHA poster in which it was postulated that in some patients CPR produced enough circulating oxygenated blood to produce EEG activity that might support consciousness. What has never been discussed by Dr Parnia, despite repeated requests for clarification, is exactly what is going with the sounds (i.e. would it have been possible for the patients to hear conversations or not) and whether there was any overlap between the 2 sets of subjects in the two AHA posters, and therefore the ability to correlate, or not, the ability to make auditory observations and the potential for consciousness.

It is very frustrating that these questions have never been cleared up. I have approached all the names on the posters, and I know that a couple sniffed around my LinkedIn profile, but no one has ever responded. I posed these questions at the November meeting, and they were ignored. As I have said, it is one thing being patient about the progress of the study given the restraints they operate under, but another to know that a burning question could be answered with currently available data. It begs the question why not? I have some thoughts on this, but won’t go into them here.

At the end of the day it may all be irrelevant though. As we have said countless times, Dr Parnia has stated unequivocally on numerous TV shows in recent years that the consciousness persists beyond death for at least a short while. He doesn’t say that we have evidence that it does, he just states it as fact, which makes me think he does have some evidence in his pocket. Also, I think that AWARE II may become irrelevant. The DHCA study, which is under controlled conditions, and possibly with prior consent from the patients, may be the one to watch, and may yield results much more efficiently, and therefore quickly than the AWARE II study…depending on how many of these procedures occur a week, and how many of the patients consent. They may even be told to look at the ipad! So if you had 3 of these procedures a week, and 60% consented to be involved, you would have 100 subjects in a year, which should yield 2-3 visual OBE hits.

Anyway, this may not be news to some here, and maybe I am a bit slow, but the penny only really dropped recently about the powering. Lastly , please be civil in the discussions…

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28 thoughts on “AWARE II is not powered to validate an OBE

  1. Paul Battista on said:

    I really wish Dr. Parnia would post the results of aware 2 real soon. Even if theres no hits for an obe, there may be other things that come out of this study hopefully. Dr. Parnia says that consciousness can continue after death for a while. He has said this many times. I hope he’s right. Looking forward to the results of aware 2 soon. Other studies could also come out of this. Maybe even aware 3. I’m following closely.


  2. Eduardo Jorge Fulco on said:

    Ben, Narional Post said: His goal is to study 1,500 people in cardiac arrest. When a “code” is called, participating researchers will be alerted and dispatched to resuscitation rooms carrying backpacks consisting of portable brain oxygen monitoring devices. The plan is to measure, second by second, the oxygen levels inside the brain. There will also be a portable EEG to measure whether the brain is functioning. As well, patients will be fitted with wireless headphones, through which random words and sounds (which need to remain secret until the study is over) will be transmitted via a tablet. Images will also be beamed upwards as people undergo CPR. Parnia doesn’t expect anyone to open their eyes. No one ever does in cardiac arrest.


  3. Hi Eduardo, that is an excellent summary, I think I read it before but still assumed that they wanted just more than “cardiac arrest” survivors. It is clear in this that any confirmed OBE would just be a nice by product of the study. The key for me is whether the sounds in the headphones (and are they in each ear?) are continuous. Anyway, we will see as time goes by.


  4. Ben, this is not a criticism; I understand you have to post content to discuss but isn’t what you’re doing only really adding more speculation to the previous speculation and the speculation before that ?

    I get the sense you’re becoming despondent and yet I don’t see any good reason why you should be. Just to deal with the headphones or are they speakers inserted ? I find it highly unlikely that only one of the patient’s ears would be utilised.

    I mean, wouldn’t that be like placing the lap top in front of the patient’s face ? Maybe a bit of an exaggeration, but I can’t see what the point of that would be. Can you elaborate?

    As I understand it (might be wrong) this second Aware study is trying to obtain definitive data on the ‘state’ and ‘capacity to function’ (if any) of the brain during cardiac arrest, so that he can answer the sceptical objections as to the timing and cause (in the brain or out) of veridical OBE’s.

    Are your numbers (of NDE’s in cardiac arrests) not a bit low BTW ? 10-20% is more on the average according to other prospective studies, but whatever it is, it is.

    Irrespective of whether or not he is lucky enough to have someone see the target, even (1) timed, veridical out of body experience, with accurate observation of events going on around a patient with a measured flat EEG, will be enough to get plenty more funding power !

    But until then, underpowered or not, the tortoise gets there in the end, just the same, does it not?


    • @Tim, you are of course right, I just want to draw a line under it for now from my perspective since I had reviewed all the data afresh. I agree, it is getting a bit repetitive, and will be my last post on the AHA data, or the AWARE II study design etc until new data emerges. Thanks for your patience!


  5. Eduardo Jorge Fulco on said:

    I don’t see the need for continuous auditory stimuli. According to abstract 387 it can be seen that 20 people out of 21 in cardiac arrest did NOT hear the auditory stimuli… Only 1 person said they heard them… I don’t understand…


    • @Eduardo. Until we see the full dataset, I guess we won’t completely get what is going on, but all these patients had CAs and were undergoing CPR, and presumably had flatline EEGs.


  6. Alejandro Agudo Crespo on said:

    – Yes Ben. AWARE II numbers seem too low to get a good number of visual OBEs hits.
    It all depends on which of those blue boxes in the diagram is thought to store that 1500 target. If it is the “recruited” box, which gives you those low numbers, or Parnia’s objective points to another box.
    – It is a pitty that almost half of the “Not Recruited” CAs in the slide above are due to “No staff to attend”. I wonder if that points to a lack of funds to contract more people for the study or if it is a not very realistic design.
    – @Eduardo: I think the continuous auditory stimuli is needed if the heared sounds during CA are room conversations more than the stimuli themselves. Ideally auditori stimuli should be quick and loud enough to block any room sounds (like in Pam Reynolds case). Thus, any recalled room conversations should be attributed to “non-physiological consciousness”. But if auditori stimuli are intermitent and non-blocking, those recalls could be due to physiological hearing in moments of low consciousness during CPR (if that is possible)
    – @Ben:
    – Blog question: How can I see a list of all your posts from the let’s say, last year….or even the beginning of your blog?
    – Really awaiting your NDE book. I enjoyed your elephant in the lab so much that you will have a here a sure reader.


    • Hi Alejandro, if scroll down to the bottom of the blog, below the last post is a link to previous posts…I think that’s the only way to do it. Thanks for the complements about my book on DNA! I’ve had a lot of people say they really enjoyed it, but the sales have been a bit rubbish unfortunately.


  7. Eduardo Jorge Fulco on said:

    Alejandro agreed that if the sounds are continuous, fast, strong and permanent, the test would be safer, but it is striking that only one declared that they heard the auditory stimuli (random words and sounds). These stimuli were timed (as stated in the video of Dr. Oz’s program, minute 2.04), and, in principle, they could have been compared with the data of the cerebral oximetry (since according to the National Post, the idea was to measure second by second the levels of oxygen in the brain). If not, how is it understood that Parnia has declared External Consciousness?


    • Alejandro Agudo Crespo on said:

      Yes, I agree, Eduardo. If the memories of the audio stimuli (or room conversations) match with moments of not-enough-oxygen for physiological consciousness, then another type of consciousness must be present. We should know if that is the case for the 20 patients and for the 21st that remembered the audio stimuli.
      Un abrazo!


    • Eduardo..he’s saying that ventilators reduce mortality…although in the UK they are delaying putting people on ventilators now in some hospitals as despite them having crazy low oxygen levels, they are able to talk and stay conscious and they want to avoid the risks that come with inducing a coma and interbating.


  8. If Jens reads these comments, please check your junk email for my reply…it will come from my real name…orson.


  9. JP Rand on said:

    Oh my god. I just answered a question on Quora that was how do you deal with the elderly bully who thinks he knows everything? I was like “Elderly bully? You mean Ian Sawyer? Ignore him and don’t give him attention.” Ooooooh…that was a slick burn right there.


  10. New web presense as per twitter


    • Thanks Z. That’s really strange as I had been looking at the NYU research page the past few days and noticed it had been stripped bare in terms of details on the consciousness studies, which had got me all tin foil hat as I was worried he his work had been stopped…very intriguing that he has his own lab and that it is named after him. Will have a look through and create a post.


      • No bother. Few interesting videos posted too including one from a talk I think from may 2019. Looks like many studies etc going on within the lab too.

        Liked by 1 person

  11. Werner Bartl on said:

    I read the new website attentively, it is noticeable that new things have been added, that the resuscitation measures, no electrical activity in the brain, can create awareness, this has often been said by critics, it looks like they have become safer,


  12. Werner Bartl on said:

    Some critics have said that the cardiac massage is sufficient to produce enough oxygen and thus electrical activity for awareness, in this new text, they explicitly say that it is not enough and that the consciousness cannot be explained in this way when the heart stops.


  13. DJ Kadagian on said:

    I understand the intent of the study but question the methodology. While watching and reading hundreds of testimonials of those who have had an NDE and experienced an OBE, it is clear that once the patient “orients” themselves to their surroundings, their full attention is almost always directed towards their body and the activity going on around it. That is certainly where my attention would be. The last thing I would be looking at/for would be an iPad, or any other object, sitting above a shelf on only one side or corner of the room that may or may not have ever entered my field of vision.

    OBE’s, as I have come to understand them, do not last an exceptionally long time (whatever time means in that state). These accounts don’t describe people flying around the room in all directions over a very extended period of time. Depending on height and direction, how many would even be in a position to see the target at all? Especially with such a small sampling size.

    If confirming a visual hit of an iPad was the intent of the study, placing that face-up and near the patient, with clear and noticeable content – a word, object, or name flashing, would certainly have a better chance of yielding a positive hit. A face-up iPad could not be seen by a face-up patient, conscious or not. That would be an interesting parlor trick.

    There have been many audiovisual accounts by those having an OBE that is corroborated by those in the room – both doctors and nurses. These are certainly disinterested, unbiased parties who gain nothing by verbally verifying the phenomenon. If someone having an OBE is looking down or standing to the side of the operation with something that had a strong visual draw within clear site, it would likely have a much better chance of being noticed. This is all important – not where in the room an iPad is located for a face-up, conscious or unconscious patient.


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