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

updated

Tags: scientific medicine, bad science, fun

One article on PainSci cites Smith 2003: Why “Science”-Based Instead of “Evidence”-Based?

PainSci notes on Smith 2003:

A classic satire of evidence-based medicine, particularly the hyperbolic (straw man!) notion that you have to have an RCT to say anything about the safety or efficacy of a treatment. That, of course, is utter bollocks.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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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Specifically regarding Smith 2003:

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