Look Before You Leap
December 14, 2018 8:33 PM Subscribe
Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention. [British Medical Journal Christmas edition]
I am going to make a note of this paper, so that next time I review a paper that uses the same methodological approach, I can insist that they reference this paper as a prior demonstration of the soundness of the methodology. Next time.
posted by brambleboy at 8:52 PM on December 14, 2018 [3 favorites]
posted by brambleboy at 8:52 PM on December 14, 2018 [3 favorites]
I did this experiment once, many years ago.
An acquaintance and I both jumped from a plane. I went first, with no parachute. He directly followed, with a chute (well, technically two, but let's ignore the reserve since it was not deployed).
We both fell for quite a long time. This was at the Marina, CA municipal airport, near Monterey. It was really beautiful falling through the air, seeing the beach and ocean. But my main memory is how goddamn cold my ears got. It was the one and only time in my life I wished I was wearing an old-timey leather pilot's cap.
As the ground got closer and closer, the other guy decided it was time to chicken out and he deployed his chute. I did not, obviously, since I didn't have one.
We both hit the ground in a large field near the airport. Neither of us were hurt.
Lesson learned: parachutes are cool and all, but you can get by without one in the right circumstances.
posted by ryanrs at 9:35 PM on December 14, 2018 [21 favorites]
An acquaintance and I both jumped from a plane. I went first, with no parachute. He directly followed, with a chute (well, technically two, but let's ignore the reserve since it was not deployed).
We both fell for quite a long time. This was at the Marina, CA municipal airport, near Monterey. It was really beautiful falling through the air, seeing the beach and ocean. But my main memory is how goddamn cold my ears got. It was the one and only time in my life I wished I was wearing an old-timey leather pilot's cap.
As the ground got closer and closer, the other guy decided it was time to chicken out and he deployed his chute. I did not, obviously, since I didn't have one.
We both hit the ground in a large field near the airport. Neither of us were hurt.
Lesson learned: parachutes are cool and all, but you can get by without one in the right circumstances.
posted by ryanrs at 9:35 PM on December 14, 2018 [21 favorites]
(it was a tandem jump)
posted by ryanrs at 9:35 PM on December 14, 2018 [48 favorites]
posted by ryanrs at 9:35 PM on December 14, 2018 [48 favorites]
This is a little inside baseball for people outside of medicine. See, evidence based medicine is A Thing and over the last decade or so it has created a revolution where we have questioned every medical practice that isn’t supported by high quality randomized controlled trials proving a particular intervention’s effectiveness. On balance, this is a good thing that has led to discoveries like:
“There is no evidence that arthroscopic knee surgeries are effective for torn meniscus.”
“There is no evidence that prescribing opiates for back pain improves recovery from acute back pain.”
“There is no evidence that surgery is more effective than antibiotics for uncomplicated appendicitis.”
But it has led to some ridiculous assertions like “There is no evidence that stopping the bleeding when your leg gets cut off improves survival” (which is true) and the classic “There is no evidence that parachutes save lives when jumping out of airplanes” (also true).
So this study is methodolically sound and they are upfront about the limitations of the study and it is therefore not much different than hundreds of actual studies that get funded and published every year.
Now do you get it?
posted by Slarty Bartfast at 9:49 PM on December 14, 2018 [20 favorites]
“There is no evidence that arthroscopic knee surgeries are effective for torn meniscus.”
“There is no evidence that prescribing opiates for back pain improves recovery from acute back pain.”
“There is no evidence that surgery is more effective than antibiotics for uncomplicated appendicitis.”
But it has led to some ridiculous assertions like “There is no evidence that stopping the bleeding when your leg gets cut off improves survival” (which is true) and the classic “There is no evidence that parachutes save lives when jumping out of airplanes” (also true).
So this study is methodolically sound and they are upfront about the limitations of the study and it is therefore not much different than hundreds of actual studies that get funded and published every year.
Now do you get it?
posted by Slarty Bartfast at 9:49 PM on December 14, 2018 [20 favorites]
The author contributions from the 2003 paper:
Contributors GCSS had the original idea. JPP tried to talk him out of it. JPP did the first literature search but GCSS lost it. GCSS drafted the manuscript but JPP deleted all the best jokes. GCSS is the guarantor, and JPP says it serves him right.
posted by medusa at 10:13 PM on December 14, 2018 [6 favorites]
Contributors GCSS had the original idea. JPP tried to talk him out of it. JPP did the first literature search but GCSS lost it. GCSS drafted the manuscript but JPP deleted all the best jokes. GCSS is the guarantor, and JPP says it serves him right.
posted by medusa at 10:13 PM on December 14, 2018 [6 favorites]
Did anybody not get it?
posted by bleep at 11:34 PM on December 14, 2018 [5 favorites]
posted by bleep at 11:34 PM on December 14, 2018 [5 favorites]
How journal articles work isn’t really that obscure. Some people who aren’t doctors also have heard things & learned things over time. It happens.
posted by bleep at 11:45 PM on December 14, 2018 [4 favorites]
posted by bleep at 11:45 PM on December 14, 2018 [4 favorites]
just in case someone doesn't get it, the Christmas edition of the BMJ is for brilliantly witty spoof papers, my favorite was the disappearing teaspoons
posted by Wilder at 2:47 AM on December 15, 2018 [3 favorites]
posted by Wilder at 2:47 AM on December 15, 2018 [3 favorites]
Also check out the accompanying BMJ blog post by the authors that outlines some of the context for this paper. It makes an important point about the limitations of our ability to do randomized controlled trials in a context where everyone 'knows' the right thing to do (i.e., of course you don't jump out of a plane without a parachute, of course you do X treatment for Y condition), and highlights some issues with actual medical studies as Slarty Bartfast explained. Honestly, I'd be assigning this paper to my Experimental Design class ASAP if the semester hadn't just ended.
posted by pemberkins at 3:11 AM on December 15, 2018 [3 favorites]
posted by pemberkins at 3:11 AM on December 15, 2018 [3 favorites]
This is the same sort of methodologically important parody paper as the fMRI that showed brain activity in a dead salmon.
posted by pemberkins at 3:13 AM on December 15, 2018 [5 favorites]
posted by pemberkins at 3:13 AM on December 15, 2018 [5 favorites]
Now do you get it?
I do and must say that the British Medical Journal has very low standards for spoofery. This is barely witty enough for a letter to the editor.
posted by tirutiru at 4:49 AM on December 15, 2018
I do and must say that the British Medical Journal has very low standards for spoofery. This is barely witty enough for a letter to the editor.
posted by tirutiru at 4:49 AM on December 15, 2018
Funny is not the opposite of serious.
posted by hawthorne at 5:37 AM on December 15, 2018 [1 favorite]
posted by hawthorne at 5:37 AM on December 15, 2018 [1 favorite]
According to my dental hygienist, apparently there is also very little to no evidence for the dental health benefits of flossing, just because no-one has ever done the relevant controlled study. She and I both found this distressing.
posted by heatherlogan at 7:03 AM on December 15, 2018
posted by heatherlogan at 7:03 AM on December 15, 2018
Sorry, I should have been more clear. “There’s no evidence that parachutes save lives” is an oft repeated rejoinder on hospital rounds when someone is told there is no evidence to support something they are about to do anyway. I think even House might have used it. The line is meant to point out the limitations of evidence based medicine.
And now there is a study proving that parachutes don’t save lives.
It’s funny.
See?
posted by Slarty Bartfast at 7:39 AM on December 15, 2018 [13 favorites]
And now there is a study proving that parachutes don’t save lives.
It’s funny.
See?
posted by Slarty Bartfast at 7:39 AM on December 15, 2018 [13 favorites]
If anything it tells us that priors matter. The conclusions of this study shouldn’t move the needle on our beliefs that much.
posted by MisantropicPainforest at 8:35 AM on December 15, 2018 [2 favorites]
posted by MisantropicPainforest at 8:35 AM on December 15, 2018 [2 favorites]
I just think it’s weird to be so sure that nobody got the very obvious joke.
posted by bleep at 10:23 AM on December 15, 2018 [6 favorites]
posted by bleep at 10:23 AM on December 15, 2018 [6 favorites]
May or may not be a topical comic about a philosopher.
posted by sammyo at 11:46 AM on December 15, 2018
posted by sammyo at 11:46 AM on December 15, 2018
We really need a randomised trial comparing those who read the article and then Slarty Bartfast's comment with those who read the comment without the benefit of having RTFA...
posted by GeckoDundee at 4:04 PM on December 15, 2018
posted by GeckoDundee at 4:04 PM on December 15, 2018
There’s really no evidence to show anything I say is insightful or funny.
Further study is warranted.
posted by Slarty Bartfast at 6:14 PM on December 15, 2018 [3 favorites]
Further study is warranted.
posted by Slarty Bartfast at 6:14 PM on December 15, 2018 [3 favorites]
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posted by Halloween Jack at 8:40 PM on December 14, 2018 [7 favorites]