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What Forty Years of Trials Show, and Where the Evidence Runs Thin

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What Forty Years of Trials Show, and Where the Evidence Runs Thin

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Few meditation-derived programs have been studied as extensively as MBSR, in large part because its manualised, repeatable eight-week format made it unusually easy to run as a clinical trial in the first place. The most comprehensive independent assessment remains a 2014 meta-analysis by Madhav Goyal and colleagues at Johns Hopkins University, published in JAMA Internal Medicine, pooling 47 randomised trials of meditation programs, MBSR prominent among them, covering more than three thousand participants.

Its finding was a real but bounded one. The pooled trials showed moderate evidence that mindfulness meditation programs improve anxiety, depression and pain, evidence solid enough to support the programs' widespread adoption in medical and mental health settings. What the same analysis did not find was any evidence that these programs outperformed other active treatments, structured exercise, cognitive behavioural therapy, on the same outcomes, and it found only low evidence of any effect on stress and general quality of life. That distinction, a real effect on specific outcomes rather than a superior effect over other established treatments, is the part most popular coverage of the research drops, reporting the finding of benefit while leaving out the comparison it was measured against.

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