Near Death Experiences
Is there a life after death?

Differences between the AWARE Study
& other studies of NDE during Cardiac Arrest

©G.M. Woerlee, 2005–2022

The publication of the “AWARE study” by Doctor Sam Parnia (Parnia 2014), revealed that 39% of interviewed survivors experienced some sort of consciousness during cardiac arrest and resuscitation, and while only about 6% of these survivors reported experiencing a near-death experience (NDE) (read an analysis of the AWARE study HERE).

AWARE study results differ from earlier studies!

The results of the Sam Parnia AWARE study are surprising, because they seem to differ considerably from those reported by other prospective cardiac arrest studies. This point was not raised in the discussion of their study results by Sam Parnia and his colleagues, and has as yet not been raised in other serious discussions on this matter. Nonetheless the results of the AWARE study do contrast with other prior studies of the occurrence of consciousness and NDE's during cardiac arrest (Greyson 2003, Greyson 2006, Lommel 2001, Schwaninger 2002). The researchers publishing these earlier studies used strict protocols, and did their best to be as impartial as possible. But why do the study results of these earlier studies differ from those of the Sam Parnia AWARE study? So it is well worth examining the methodology of these various earlier studies to find answers to this question. For faster navigation, here is a menu of the various comparable studies, and a table comparing the results of different related studies with the AWARE study of Sam Parnia published during 2014.

The Greyson 2003 study

This was an interesting study. However, when examining the methodology, we read the following;

Prospective subjects were all patients admitted to the cardiac intensive care unit (CCU) or the cardiology stepdown unit of the University of Virginia Hospital who were not too ill, psychotic, or cognitively impaired to be interviewed. Patients were approached as soon after admission as their condition had stabilized, by study personnel who explained the project and invited them to participate.
Eligible patients who signed informed consent agreements to participate in the study were given a 15-min screening interview that included questions about sociodemographic variables and the acute cardiac event that led to hospitalization, and the NDE Scale [6], a 16-item multiple choice instrument that significantly differentiates persons who have near-death experiences during a close brush with death from those who do not. The scale includes questions about cognitive processes (e.g., sense of time speeding or slowing), affective processes (e.g., feelings of peace or pleasantness), purportedly paranormal experiences (e.g., sense of separation from the physical body), and experienced transcendence (e.g., sense of being in an unearthly realm or dimension of existence).
(Page 270 in Greyson 2003)

The persons studied were ALL persons admitted to the coronary care unit. So what are the figures reported by this study?

Part of the reason was that the interviewers and screening persons were a small, single, homogenous group working directly under a single project leader, and mainly examining for NDE's.

The Greyson 2006 study

This was a prospective study of 25 persons undergoing testing of special pacemaker devices called ICD's (implantable cardioverters/defibrillators). Testing of these devices consisted of inducing a short period of anesthesia, during which a malignant and deadly heart rhythm was induced, to test whether the device would function by administering an electic shock to stop the rhythm. Greyson resoned that an NDE might well occur during the period of absent heart rhythm. So what was the methodology?

The ICD implantation and testing was carried out by cardiac electrophysiologists and their clinical support personnel at the University of Virginia Health System in one of two procedure rooms designed for that purpose. Patients were premedicated with midazolam and/or fentanyl, and received anesthesia with propofol and/or etomidate during the procedure. The procedure took approximately one hour, during which the patient was typically unconscious for about 10 minutes. During that 10-minute period of unconsciousness, ventricular fibrillation was typically induced twice in order to test and calibrate the ICD. Physiological variables were routinely documented in the patients' medical record, including the duration of the cardiac arrest (both ventricular fibrillation and cardiac asystole) and medications administered during the procedure. (Page 88 in Greyson 2006)

So what are the figures reported by this study?

Once again, here was a small dedicated team of interviewers mainly searching for NDEs, all working under a single project leader. Furthermore, all these patients received drugs such as midazolam and/or propofol. Both drugs are powerful inhibitors of long term memories. So it is not at all surprising that few people remembered any experiences.

The Pim van Lommel 2001 study

This was a landmark study in which 344 consecutive patients surviving a period of cardiac arrest within a single region in the Netherlands were interviewed. The methodology was a follows.

We included consecutive patients who were successfully resuscitated in coronary care units in ten Dutch hospitals during a research period varying between hospitals from 4 months to nearly 4 years (1988-92). The research period varied because of the requirement that all consecutive patients who had undergone successful cardiopulmonary resuscitation (CPR) were included. If this standard was not met we ended research in that hospital. All patients had been clinically dead, which we established mainly by electrocardiogram records. All patients gave written informed consent. We obtained ethics committee approval.
We did a short standardised interview with sufficiently well patients within a few days of resuscitation. We asked whether patients recollected the period of unconsciousness, and what they recalled. Three researchers coded the experiences according to the weighted core experience index. In this scoring system, depth of NDE is measured with weighted scores assigned to elements of the content of the experience. Scores between 1 and 5 denote superficial NDE, but we included these events because all patients underwent transformational changes as well. Scores of 6 or more denote core experiences, and scores of 10 or greater are deep experiences. We also recorded date of cardiac arrest, date of interview, sex, age, religion, standard of education reached, whether the patient had previously experienced NDE, previously heard of NDE, whether CPR took place inside or outside hospital, previous myocardial infarction, and how many times the patient had been resuscitated during their stay in hospital.
(Page 2040 in Lommel 2001)

So what are the figures reported by this study?

Once again, part of the reason for the difference with the Sam Parnia AWARE study was that the interviewers and screening persons were a small, single, homogenous group working directly under a single project leader, and mainly examining for NDE's.

The Janet Schwaninger 2002 study

This was another prospective study of the incidence of consciousness and NDE's in cardiac arrest survivors. So what was the methodology?

Patients who suffered a cardiac arrest were approached no sooner than 24 hours after the arrest, to allow confusion or lethargy to resolve and to permit stabilization of their medical problems, but before their discharge from the hospital. The average time period was 2 to 3 days following the cardiac arrest. Patients were interviewed by a member of the study team to determine their eligibility; all patients who were eligible based on the inclusion criteria consented to participate in the protocol, which was approved by the Human Studies Committee (Institutional Review Board) of Washington University Medical Center. Those patients who reported no subjective experience during their cardiac arrest were included in the study but did not undergo the complete interview. Those who recalled any subjective experience, including those with an NDE before the index cardiac arrest, were asked all of the interview questions. In order to avoid influencing responses, we allowed the patients to report their experience subjectively before starting the structured interview. The interview was tape recorded or taken in written form, at the patient's request. The average interview lasted 30 minutes, and could be extended at the patient's request.
The interview protocol was based on Kenneth Ring's interview schedule consisting of 14 multi-part questions regarding the experience and five questions regarding religious beliefs and practices before and after the experience (Ring, 1980, pages 265-270). The interview rating form was used to analyze the experience (Ring, 1980, pages 275- 279). Greyson's NDE Scale (Greyson, 1983b) was used to determine which patients satisfied empirical criteria for having had an NDE. At the request of the Washington University Medical Center Human Studies Committee, to avoid influencing patients' responses the NDE scale was not administered directly but rather was completed by study personnel based on each patient's recorded interview. NDE Scale items are categorized into cognitive, affective, paranormal, and transcendental components, with each component comprised of four items. Each item has three possible responses: a strongly positive response given 2 points, a moderately positive response given 1 point, and a negative response given no points. Patients with a total score less than 7 points were defined as not meeting criteria for an NDE.
(Pages 217-218 in Schwaninger 2002)

So what are the figures reported by this study?

Once again, part of the reason for the difference with the Sam Parnia AWARE study was that the interviewers and screening persons were a small, single, homogenous group working directly under a single project leader, and mainly examining for NDE's.

The Sam Parnia 2014 AWARE study

The Sam Parnia AWARE study was a large multinational study of the incidence of consciousness and NDE's during cardiac arrest (CA), performed according to a strict protocol in 15 different hospitals in 3 different countries (USA, UK and Austria).

When possible, interviews were completed by a research nurse or physician while the CA survivor was still an inpatient. The interviewers all underwent dedicated training regarding the interview methodology by the study chief/principle investigator. Informed consent was obtained when patients were deemed medically fit to complete an in-person interview prior to discharge. For patients who could not be interviewed during their hospital stay, a telephone interview protocol was established to consent and inter-view these patients by telephone to minimize losses to follow up. Given the severity of the condition, the study provided for a large proportion of patients being unable to participate due to ill health in the sample size calculations.
Using a three stage interview process, patients were asked general and focused questions about their remembrances during cardiac arrest. Stage 1 of the interviews included demographic questions as well as general questions on the perception of awareness and memories during CA. Stage 2 interviews probed further into the nature of the experiences using scripted open ended questions and the 16 item Greyson NDE scale. This validated NDE scale was used to define NDE's in this study. For each of the 16 items in the NDE scale, responses were scored 0 (not present), 1 (weakly present) or 2 (strongly present). Out of a possible maximum score of 32, a NDE was considered present with a score of =7, while experiences <7 are not compatible with NDE. Patients with detailed auditory and visual recollections relating to their period of cardiac arrest were flagged for a further in-depth interview (stage3) to obtain details of their experience. This later interview was conducted by the study principal investigator (PI).
(Pages 1800-1801 in Parnia 2014)

So what are the figures reported by this study?

The Parnia AWARE study was truly a landmark study. One of the main differences is that the interviews were performed by separate individuals in 15 different hospitals in 3 different countries. True the protocols were the same, as was the prior training. However, the interpretation of the interviews would differ somewhat. Furthermore, this study was not primarily directed to finding NDE's, although this was one of the objectives. This difference meant that all persons paid more attention to the occurrence of any form of consciousness during the cardiac arrest, as well as any memory of consciousness after recovery. These differences of methodology largely explain the differences between the reported incidence of consciousness during cardiac arrest and resuscitation.


Put into table form, these differences actually reveal a degree of uniformity, together with some hitherto unmentioned insights.



Number of Patients Interviewed

% Conscious without NDE

% Conscious with NDE

Observed Consciousness during Resuscitation

Greyson 2003




not investigated

Greyson 2006




not investigated

Lommel 2001




not investigated

Schwaninger 2006




not investigated

Parnia 2014




did not occur


This table reveals the difference between these studies are actually smaller than apparent. Furthermore they reveal an insight, either ignored in much NDE literature, or vociferously denied—the occurrence of consciousness without an NDE during cardiac arrest and resuscitation.

The reality of unrecognized consciousness during cardiac arrest and resuscitation has been vociferously denied by many believers in the immaterial reality of the NDE, but has finally been demonstrated as a real clinical entity. This is one of the many conclusions from the Sam Parnia AWARE study, and confirmed by these other prior studies. This is the ultimate, and most interesting conclusion of the AWARE study.


Anesthesia & the Soul is an important new, and free, online book discussing the reality of the soul from the evidence revealed by anesthesia.

Near-Death Experiences
Pam Reynolds
Other NDEs
Cardiac Arrest & NDEs


Mortal Minds is a step-by-step analysis of near-death experiences revealing the unlikelihod of a human soul with the properties as revealed by NDEs and OBEs. (Published 2005, and available worldwide as printed book, as well as electronic Kindle format from Amazon)