Commentary on the AHRQ report on research on meditation practices in health.

The Agency for Healthcare Research and Quality (AHRQ) report is a major reference point for establishing where the research on meditation stands and where it should go from here. This commentary argues that double blinding, a major component of the report\'s evaluation criteria, is not an appropriate control for placebo in meditation research. A viable alternative is to make the treatment and control groups equivalent on nonspecific therapeutic attention factors and expectation. High quality meditation research must also use qualified instructors, have high compliance levels, insure proficient practice, use state-of-the-art measurement methodology, and make sure control subjects are not inadvertently practicing the same or another form of meditation. None of these determinants of research quality was assessed by the AHRQ report. It is noteworthy that whereas randomized controlled trials have their place in demonstrating clinical efficacy, few if any of the major ideas in the basic or behavioral sciences have come from randomized trails. A wide range of study designs have demonstrated that the traditional goal of meditation, a state of inner silence called \"transcendental consciousness,\" has unique physiological characteristics with far ranging implications for health, cognition, and behavior. Such studies need to be included in future reviews of meditation techniques.