BMJ  2003;327:1459-1461 (20 December), doi:10.1136/bmj.327.7429.1459

Hazardous journey

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

Gordon C S Smith, professor1, Jill P Pell, consultant2

1 Department of Obstetrics and Gynaecology, Cambridge University, Cambridge CB2 2QQ, 2 Department of Public Health, Greater Glasgow NHS Board, Glasgow G3 8YU

Correspondence to: G C S Smith gcss2{at}cam.ac.uk

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.


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Rapid Responses:

Read all Rapid Responses

Uh huh
Joseph E Morales
bmj.com, 19 Dec 2003 [Full text]
Parachutes, padded pants and beneficence
Peter Griffiths
bmj.com, 19 Dec 2003 [Full text]
inherently dangerous behaviors
Emily Jane Woo, MD, MPH
bmj.com, 19 Dec 2003 [Full text]
Parachute trials
Allen J Parmet, MD
bmj.com, 19 Dec 2003 [Full text]
Excellent Article for Citation and Debate
Stephen J Véronneau MD
bmj.com, 19 Dec 2003 [Full text]
Isn’t that unethical?
Carlos Cuello
bmj.com, 20 Dec 2003 [Full text]
Dr
Zachary T Bloomgarden
bmj.com, 20 Dec 2003 [Full text]
Qualitative Data Collection?
Ashley P Simons-Rudolph
bmj.com, 20 Dec 2003 [Full text]
alternative parachutes
David Brookman
bmj.com, 20 Dec 2003 [Full text]
Social costs need to be considered
Mike Thomas
bmj.com, 20 Dec 2003 [Full text]
Social costs need to be considered
Mike Thomas
bmj.com, 20 Dec 2003 [Full text]
Evidence and practice
Martin J Dumskyj
bmj.com, 22 Dec 2003 [Full text]
Publication bias may explain the (lack of) review's findings
Victor M. Montori
bmj.com, 23 Dec 2003 [Full text]
Anecdotal support for short course of parachute therapy
Robert N C Pfeifer
bmj.com, 24 Dec 2003 [Full text]
Blinding and class effect?
Barry J Lyons
bmj.com, 29 Dec 2003 [Full text]
What is EBM
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bmj.com, 31 Dec 2003 [Full text]
Evidence-based medicine (EBM) or prejudiced based medicine (PBM)?
Sean Lynch, et al.
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Do straw men need parachutes?
Lee A. Green
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On the Value of Evidence for Parachutes
Scott D Ramsey
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Secondary Gain
Terence Silverton
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On the other hand....Type I travails
Jack E. Rosenblatt, M.D.
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Poppycock and rubbish
Richard A. Davidson, MD,MPH
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RCTs
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Evidence-based medicine is not THAT funny
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Dedication and rhetoric through chemical imbalance and sleep deprivation
Jason D. Carroll
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Parachutes and medical interventions: An unfair comparison
Rajiv Sarin
bmj.com, 4 Feb 2004 [Full text]
Evidence-base for using insulin to treat diabetics: can it ever be complete?.
Richard G Fiddian-Green
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EBM: A Postmodern Phenomenon
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Noah's Parachute?
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Evidence Base for EBM ?
Howard McNulty
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Flaw in analysis
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Parachutes and male circumcision: any similarity?
Julius Atashili
bmj.com, 15 Oct 2004 [Full text]
Re: Evidence-based medicine is not THAT funny
Larry M. Weisenthal
bmj.com, 24 Nov 2005 [Full text]
Hang Glider Pilot Response
C Williams
bmj.com, 19 Sep 2006 [Full text]
Time to Ponder Over What We Consider Evidence
GS Umamaheswara Rao
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Non-medical response
Peter A Dulimov
bmj.com, 12 Jan 2007 [Full text]
Re: Non-medical response
Sharon R Bridgeman
bmj.com, 21 Feb 2007 [Full text]
Fun, but perhaps not so much
Timothy R. Church
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Comment on: Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials
Nibu .A . George
bmj.com, 8 Dec 2007 [Full text]



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