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
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bmj.com, 19 Dec 2003
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- Excellent Article for Citation and Debate
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- Mike Thomas
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- Publication bias may explain the (lack of) review's findings
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