I want to note I actually laughed out loud when I read their science-y way of saying that only people on the ground agreed to participate.
They wrote: “participants in the study were similar to those screened but not enrolled with regard to most demographic and clinical characteristics.
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OBJECTIVES To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
DESIGN Systematic review of randomised controlled trials.Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. joined with skydivers to publish “Parachute Use to Prevent Death and Major Trauma When Jumping from Aircraft: Randomized Controlled Trial.” The team enlisted and randomized 23 volunteers.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.” Which brings us to the Christmas issue of the , always stocked with unconventional scholarship. Twelve participants wore parachutes while the other 11 donned backpacks that contained no parachutes. The jumpers were assessed shortly after hitting the ground for death or major trauma, and most were reevaluated 30 days later.Th article has received a far share of media attention, both mainstream and social.In case you haven’t seen any of the coverage, the study tested “if using a parachute prevents death or major traumatic injury when jumping from an aircraft.” The study compared “(j)umping from an aircraft (airplane or helicopter) with a parachute versus an empty backpack.” Setup as a rigorous, methodologically unassailable RCT, the researchers concluded “(p)arachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention.”What!?!? Well, as they report, they were “only able to enroll participants on small stationary aircraft on the ground.” Although they tried to recruit participants both during commercial flights and on the ground, saying they would be randomized to either a parachute or an empty backpack before they jumped from the plane, they were only able to recruit subjects when on the ground.Skip ahead a quarter of a millennium to 2003, when the (and informally to some as the Limey Medical Journal), published an article entitled, “Parachute Use to Prevent Death and Major Trauma Related to Gravitational Challenge: Systematic Review of Randomised Controlled Trials.” The write-up was a response to a long-held criticism of RCTs, namely, that you don't need them to make reasonable conclusions about certain effects of certain actions—such as jumping out of a plane without a parachute.Indeed, the 2003 paper's objective, “To determine whether parachutes are effective in preventing major trauma related to gravitational challenge,” met with a hard landing.Increasingly, insurance company algorithms and controversial treatment guidelines require their presence as a condition for determining the medical necessity of a treatment.But depending on how they're used RCTs can be incredibly dumb, as well as being the most important tool in a clinical researcher’s toolkit.Plus, the absence of a smart, good RCT does not mean a treatment is not well-grounded.It just might mean no one is willing to pay for the study to be done properly.