Madhav Goyal

Who they are

Goyal was at the Johns Hopkins University School of Medicine, in the Department of Medicine, when the review was published, and it is the piece of work he is known for. The review was commissioned as an evidence report, and it was built to the standards that implies rather than to the looser conventions of the meditation literature it was reviewing.

The method is the reason it carries weight. Goyal and his colleagues screened 18,753 citations and kept 47 randomised trials with 3,515 participants in total, restricting inclusion to trials with an active control, meaning a comparison group that also received something plausibly therapeutic rather than a waiting list. That restriction is what separates the review from most of what preceded it. A meditation programme compared against nothing will beat nothing, and a great deal of the enthusiasm around mindfulness rested on exactly that comparison.

The results were moderate and honest. Mindfulness meditation programmes showed an effect size of 0.38 for anxiety at eight weeks, with a confidence interval of 0.12 to 0.64, and 0.30 for depression, with an interval of 0.00 to 0.59. At three to six months the figures were 0.22 and 0.23. The review found low evidence of improvement in stress and distress and in mental-health-related quality of life, and no evidence that meditation programmes were better than other active treatments such as drugs, exercise or other behavioural therapies. Something in the room is working. Nothing in these numbers says what, and that is the honest position the review leaves the field in.

Key papers

Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B., & Haythornthwaite, J. A. (2014), "Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis," JAMA Internal Medicine, 174(3), 357-368. The review: 18,753 citations screened, 47 trials with 3,515 participants analysed, active controls required.

Key ideas

Requiring an active control changes the answer. Against a waiting list almost any structured programme looks effective, which is how the meditation literature had accumulated its optimism.

The effects on anxiety and depression at eight weeks are real and small, at 0.38 and 0.30, and they shrink at three to six months.

There is no evidence that meditation programmes outperform other active treatments. This is the clause most often dropped when the review is cited approvingly.

The review measures whether the programmes work, not why. Nothing in it identifies the ingredient doing the work, which is what a dismantling design would be for.

Concepts on this site

Dismantling Design

Meditation-Related Adverse Effects

Find them elsewhere

The Stanford profile confirms the Johns Hopkins fellowship and matches the meta-analysis author. No social or Scholar profile is linked from it, so none was recorded

Checked 2026-09-10. Handles and affiliations go out of date, so treat this block as a snapshot rather than a standing fact.

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