Parachutes and the Military Industrial Complex
May 2, 2007 6:38 AM Subscribe
Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials.
I wonder if I should present this article the next tiem I do journal club?
posted by TedW at 6:58 AM on May 2, 2007
posted by TedW at 6:58 AM on May 2, 2007
There's a story (possibly apocryphal) of Russian soldiers in WWII being dropped from low-flying planes without parachutes, the idea being that they could land safely in snowdrifts. Freefalltroopers, if you will. Maybe the researchers should have consulted the Russian military in the course of their literature review.
In seriousness, the paper is a lighthearted attack on research that's tried to test the effects of obviously effective medical treatments. I'm not sure I support the normative argument they're making, though. The location of the line between "obvious" and "non-obvious", in science, is itself non-obvious. That line shouldn't be policed arbitrarily, but through the standard channels of peer review and scientific consensus.
posted by shadow vector at 7:05 AM on May 2, 2007
In seriousness, the paper is a lighthearted attack on research that's tried to test the effects of obviously effective medical treatments. I'm not sure I support the normative argument they're making, though. The location of the line between "obvious" and "non-obvious", in science, is itself non-obvious. That line shouldn't be policed arbitrarily, but through the standard channels of peer review and scientific consensus.
posted by shadow vector at 7:05 AM on May 2, 2007
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.
Not true. Extensive animal studies were done in the Mojave Desert from the late 1940's to the mid-1960's.
posted by PlusDistance at 7:13 AM on May 2, 2007 [5 favorites]
Not true. Extensive animal studies were done in the Mojave Desert from the late 1940's to the mid-1960's.
posted by PlusDistance at 7:13 AM on May 2, 2007 [5 favorites]
This attack is obviously fronted by the very influential personal jetpack lobby. Nothing incenses me more than seeing science manipulated by politics and corporate greed. Damn you Big Jetpack!
posted by Terminal Verbosity at 7:13 AM on May 2, 2007 [2 favorites]
posted by Terminal Verbosity at 7:13 AM on May 2, 2007 [2 favorites]
Main outcome measure Death or major trauma, defined as an injury severity score > 15.
I though death from massive damage was 50 hit points.
posted by Bugg at 7:58 AM on May 2, 2007
I though death from massive damage was 50 hit points.
posted by Bugg at 7:58 AM on May 2, 2007
Oh, that zany BMJ! First motivational deficiency disorder, now this.
posted by Mister_A at 8:31 AM on May 2, 2007
posted by Mister_A at 8:31 AM on May 2, 2007
Not true. Extensive animal studies were done in the Mojave Desert from the late 1940's to the mid-1960's.
You honestly had me thinking the government was pushing pigs out of planes for years until I mouse-overed the link. Question: Why hasn't the government been dropping animals out of planes? They've already nuked animals, and I would much rather my military-industrial complex waste money on animal cruelty than Iraq.
posted by TheOnlyCoolTim at 8:32 AM on May 2, 2007
This seems like a straw man attack on evidence based medicine.
posted by bhnyc at 9:23 AM on May 2, 2007
posted by bhnyc at 9:23 AM on May 2, 2007
Question: Why hasn't the government been dropping animals out of planes?
No need for them. Private industry already ran the experiment for their own purposes. The work was done in the Cincinatti area in the late 1970s, under the supervision of Arthur Carlson.
posted by ROU_Xenophobe at 9:25 AM on May 2, 2007 [4 favorites]
No need for them. Private industry already ran the experiment for their own purposes. The work was done in the Cincinatti area in the late 1970s, under the supervision of Arthur Carlson.
posted by ROU_Xenophobe at 9:25 AM on May 2, 2007 [4 favorites]
I liked the citation to the Guinness Book of World Records.
posted by facetious at 9:58 AM on May 2, 2007
posted by facetious at 9:58 AM on May 2, 2007
Man, it's gotta suck to be the guy who gets the placebo in that test...
posted by yeloson at 10:04 AM on May 2, 2007
posted by yeloson at 10:04 AM on May 2, 2007
Edward Tufte attributes this counterpoint to a Dr. E. E. Peacock:
"One day when I was a junior medical student, a very important Boston surgeon visited the school and delivered a great treatise on a large number of patients who had undergone successful operations for vascular reconstruction. At the end of the lecture, a young student at the back of the room timidly asked, “Do you have any controls?” Well, the great surgeon drew himself up to his full height, hit the desk, and said, “Do you mean did I not operate on half the patients?” The hall grew very quiet then. The voice at the back of the room very hesitantly replied, “Yes, that’s what I had in mind.” Then the visitor’s fist really came down as he thundered, “Of course not. That would have doomed half of them to their death.” God, it was quiet then, and one could scarcely hear the small voice ask, “Which half?”"
posted by Killick at 10:46 AM on May 2, 2007 [1 favorite]
"One day when I was a junior medical student, a very important Boston surgeon visited the school and delivered a great treatise on a large number of patients who had undergone successful operations for vascular reconstruction. At the end of the lecture, a young student at the back of the room timidly asked, “Do you have any controls?” Well, the great surgeon drew himself up to his full height, hit the desk, and said, “Do you mean did I not operate on half the patients?” The hall grew very quiet then. The voice at the back of the room very hesitantly replied, “Yes, that’s what I had in mind.” Then the visitor’s fist really came down as he thundered, “Of course not. That would have doomed half of them to their death.” God, it was quiet then, and one could scarcely hear the small voice ask, “Which half?”"
posted by Killick at 10:46 AM on May 2, 2007 [1 favorite]
Jean Pierre "Blanchard gave the first successful demonstration of the use of a parachute when a basket containing a small animal was dropped from a balloon and parachuted to earth."
posted by designbot at 10:51 AM on May 2, 2007
posted by designbot at 10:51 AM on May 2, 2007
This seems like a straw man attack on evidence based medicine.
That it is. But it is also hilarious.
posted by deanc at 12:44 PM on May 2, 2007
That it is. But it is also hilarious.
posted by deanc at 12:44 PM on May 2, 2007
A possible controlled experiment to determine the efficacy of parachutes that would still be ethical would be to take two groups, and specify that one group must at all times wear a parachute and the other group must at all times never wear a parachute.
You'd still have to control for behavior -- clearly the no-parachute-wearing group would never engage in high-risk behaviors like sky-diving -- but in the case of accidental freefall, one could measure the health benefit of a prophylactic parachute protocol and compare it to the consequences of not having a parachute.
posted by deanc at 1:11 PM on May 2, 2007
You'd still have to control for behavior -- clearly the no-parachute-wearing group would never engage in high-risk behaviors like sky-diving -- but in the case of accidental freefall, one could measure the health benefit of a prophylactic parachute protocol and compare it to the consequences of not having a parachute.
posted by deanc at 1:11 PM on May 2, 2007
This is fun. Well, maybe not, because a lot of people have died based on physicians' arrogance about their ability to judge the efficacy of a treatment based on theory.
Several high profile medical procedures that were "obviously" effective have been shown by randomized trials to be (oops) killing people when compared to placebo. For starters to a long list of such failed therapies, look at flecanide, encanide and moricizine for post-MI arrhythmias, sulfa prophylaxis for T. gondii in HIV infection, and endarterectomy for carotid stenosis; all were proven to be harmful rather than helpful that way, yet it had to be done in the face of widespread opposition to even testing them against placebo. In theory they "had to work."
But what the hell, let's play along. Suppose we had never seen a parachute before. Someone proposes one and we agree it's a good idea, but how to test it out? Human trials sound good. But what's the question? It is not, as the author would have you believe, whether to jump out of the plane without a parachute or with one, but rather stay in the plane or jump with a parachute. No one was voluntarily jumping out of planes prior to the invention of the parachute, so it wasn't to prevent a health threat, but rather to facilitate a rapid exit from a nonviable plane. deanc comes close, but a little too broad a target population. I'd say just randomized airplane travelers to parachute/no parachute.
The author also doesn't offer an alternative to evidence-based methods. It's usually the "trust me, I'm a doctor" method, which has worked out so well (see above, plus note the recent finding that expensive, profitable angioplasty and coronary artery by-pass grafts are no better than simple medical treatment of arteriosclerosis). Thanks, but I'll stick with scientifically proven remedies.
posted by Mental Wimp at 3:13 PM on May 2, 2007 [1 favorite]
Several high profile medical procedures that were "obviously" effective have been shown by randomized trials to be (oops) killing people when compared to placebo. For starters to a long list of such failed therapies, look at flecanide, encanide and moricizine for post-MI arrhythmias, sulfa prophylaxis for T. gondii in HIV infection, and endarterectomy for carotid stenosis; all were proven to be harmful rather than helpful that way, yet it had to be done in the face of widespread opposition to even testing them against placebo. In theory they "had to work."
But what the hell, let's play along. Suppose we had never seen a parachute before. Someone proposes one and we agree it's a good idea, but how to test it out? Human trials sound good. But what's the question? It is not, as the author would have you believe, whether to jump out of the plane without a parachute or with one, but rather stay in the plane or jump with a parachute. No one was voluntarily jumping out of planes prior to the invention of the parachute, so it wasn't to prevent a health threat, but rather to facilitate a rapid exit from a nonviable plane. deanc comes close, but a little too broad a target population. I'd say just randomized airplane travelers to parachute/no parachute.
The author also doesn't offer an alternative to evidence-based methods. It's usually the "trust me, I'm a doctor" method, which has worked out so well (see above, plus note the recent finding that expensive, profitable angioplasty and coronary artery by-pass grafts are no better than simple medical treatment of arteriosclerosis). Thanks, but I'll stick with scientifically proven remedies.
posted by Mental Wimp at 3:13 PM on May 2, 2007 [1 favorite]
Jumping out of perfectly good airplanes is dumb in the first place.
posted by tkchrist at 3:16 PM on May 2, 2007
posted by tkchrist at 3:16 PM on May 2, 2007
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[Oh, this is good.]
posted by Blazecock Pileon at 6:41 AM on May 2, 2007