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Monthly Archives: October 2011
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Parachute use to prevent death and major trauma related to gravitational
British Medical Journal
December 2003, Volume 32, pp. 1459–61
Gordon C S Smith, Jill P Pell
FROM ABSTRACT
Objectives: To determine whether parachutes are effective in preventing major
trauma related to gravitational challenge.
Design: Systematic review of randomised controlled trials.
Data sources: Medline, Web of Science, Embase, and the Cochrane Library
databases; appropriate internet sites and citation lists.
Study selection: Studies showing the effects of using a parachute during free fall.
Main outcome measure: Death or major trauma, defined as an injury severity score
> 15.
Results: We were unable to identify any randomised controlled trials of parachute
intervention.
Conclusions: As with many interventions intended to prevent ill health, the
effectiveness of parachutes has not been subjected to rigorous evaluation by using
randomised controlled trials.
Advocates of evidence-based medicine have criticised the adoption of interventions
evaluated by using only observational data. We think that everyone might benefit if
the most radical protagonists of evidence based medicine organised and
participated in a double blind, randomised, placebo controlled, crossover trial of the
parachute.
THESE AUTHORS ALSO NOTE:
The parachute is used to reduce the risk of orthopaedic, head, and soft tissue
injury after gravitational challenge, typically in the context of jumping from an
aircraft.
“The perception that parachutes are a successful intervention is based largely
on anecdotal evidence.”
2
These authors undertook a systematic review of randomised controlled trials
of parachutes. They excluded studies that had no control group. The major
outcomes studied were death or major trauma. “Our search strategy did not find
any randomised controlled trials of the parachute.”
“It is a truth universally acknowledged that a medical intervention justified by
observational data must be in want of verification through a randomised controlled
trial.”
“Parachutes reduce the risk of injury after gravitational challenge, but their
effectiveness has not been proved with randomised controlled trials.”
We accept that common sense might be applied when considering the
potential risks and benefits of interventions.
“We feel assured that those who advocate evidence based medicine and
criticise use of interventions that lack an evidence base will not hesitate to
demonstrate their commitment by volunteering for a double blind, randomised,
placebo controlled, crossover trial.”
COMMENTS FROM DAN MURPHY
Every now and then I am asked if an opinion I express has been supported by
a double blind, randomized, placebo controlled clinical trial. The point of this
satirical article is that not everything can or needs be investigated with the holy
grail of assessment protocols. Sometimes, common sense must be used. It is
obvious that there are no double blind, randomized, placebo controlled clinical trials
of the effectiveness of parachutes.
Chiropractors and others often base their clinical protocols on anecdotal
evidence. As these authors note, “The perception that parachutes are a successful
intervention is based largely on anecdotal evidence.”
