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:
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…