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Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

bmj.com

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Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#51
post #9

They solved aircraft safety back in the 50s, but big parachute is keeping the research suppressed so they can sell more parachutes.

I always wear a parachute during paragliding :)

Found DB Cooper!

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#52
post #12

What point is this article trying to make?

Studies, including RCTs, are often affected by selection biases introduced (intentionally or unintentionally) by how participants are selected and/or self-select. Even the gold standard RCTs are thus not guaranteed to produce valid (or rather, useful/non-misleading) results. They thoroughly researched the effectiveness of parachutes on a pool of candidates at various speeds and altitudes. While the initial pool of ca…

Note that you missed the actual catch, which sibling comment `eastern` managed to spot.

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#53

How do we really know whether double blind randomized controlled trials actually work? Is there any RCT done on evaluating the efficacy of RCT?

At first I was confused about how this would work, but thinking a little about it, it should be fairly easy. Give some researchers (randomly selected!) results from studies that are not RCTs ("control") and others RCT-based results ("treatment") to replicate. See which group manages to replicate more results.

Expensive, yes. Would I like to see it? Heck yes, if nothing else as a way to trick the establishment into doing more replication studies.

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#55

Putting common sense aside. And pretend the height of jump thing is some super abstract and nuanced thing you didn’t spot. Does this result simply mean you just can’t reject the null hypothesis (parachute makes no difference)? Rather than a proof of it?

All this means is that statistical significance is not enough to reject anything. All statistical significance means is that the effect did not come from sampling error. It can come from any number of other confounders still.

Statistical significance is a hint that it could be worth running more replication studies, and vary the conditions in other studies. Significance alone does not indicate the effect as real.

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#56

I came to leave a snarky joke comment about "in mice?", and then I remembered that mice don't actually need parachutes because their terminal velocity is roughly the same as a human using a parachute [1]. If someone actually ran the study with mice, they'd find that parachutes aren't necessary! 1: https://johnmjennings.com/can-a-mouse-survive-a-fall-from-a-...

That introduction Haldane quote: > You can drop a mouse down a thousand-yard mine shaft; and, on arriving at the bottom, it gets a slight shock and walks away, provided that the ground is fairly soft. A rat is killed, a man is broken, a horse splashes. "A horse splashes". That's some mental imagery right there.

[deleted]

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#58
> Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial.

Both options may be true for different cases. It may be simple to decide on parachutes. But think of bureaucrats who were patting themselves on the head for being “flexible enough and humble enough” to issue new guidance on masks instead of saying “We don’t know” in the first place.

“The sovereign is he who selects the null hypothesis.”

Re: Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]

#59

Is it typical for clinical trials to completely miss the point like this? I’d like to read a followup meta-analysis that focuses on the actual physiology — “Parachute use to prevent death … when hitting the ground ”. [shurely some mistake?]

I don't think it's missing the point, but you do want to be aware of the context a little bit. Randomized controlled trials are often held up as the gold standard of evidence, and they are good when it is possible to carry them out, but the point of the linked study is that the kinds of treatments it is possible and ethical to perform RCTs for limit their applicability. In this case, it would be unethical and crimina…

I had Hodgkins Lymphoma when I was younger. Because we've been successfully treating Hodgkins for so long we don't have RCTs for the basic idea of the treatment. We can observe that people who choose not to be treated tend to die (but that might be for some other reason, they weren't randomised) and we have modern studies comparing one therapy to another as it has advanced, e.g. I got ABVD, I'm not sure what the current gold standard is - but it would be unethical to run the basic RCT now. "We're going to randomly kill some people just to prove that we were right".
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