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

Angsuman Chakraborty

January 31st, 2004

Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

A very interesting article providing reality check on blind dependence of the medical community today on double blind, randomized, placebo controlled, crossover trials. Often you see them getting religious over evidence based therapy disregarding observation based therapy completely.

They concluded:
"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. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial."

Dr. Mike Thomas aptly commented:

" Editor

Smith et al (1) are right to highlight the inadequate evidence-base to the use of parachutes, but their calls for the greater use of the ill-defined and unquantifiable property 'common-sense' in research is unscientific and needs to be challenged. Have the authors considered the social and economic consequences of their recommendations? Are they unaware of the comfortable and profitable industry that has arisen around 'evidence- based' systematic reviews of controlled trials? The measures they suggest may lead to widespread economic and intellectual redundancy, and force large numbers of academics to leave behind old certainties and start thinking for themselves. This could have dangerous consequences such as forcing original thought and research, and these need careful monitoring. "

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