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published helmet research - not troll



 
 
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  #21  
Old June 19th 04, 12:38 AM
Steven Bornfeld
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Default published helmet research - not troll



John Forrest Tomlinson wrote:
On Fri, 18 Jun 2004 18:28:05 -0400, Steven Bornfeld
wrote:



Why someone would even try to suggest that helmets don't save lives
because there are no controlled studies to prove they do says more about
these people than it does about helmets.


I haven't suggest anything. I've asked questions of assumptions. It's
fine to say "I hope my helmet will protect me from brain injuries from
hitting branches when mountain biking?" Or "Id' speculate that
helmets will protect me from falling rocks and bricks that hit my
head, or accidents on a bike that approximate that."

But to go from that to "Wear a helmet because it'll save you from a
brain injury" is a big leap. If you're going to advocate that people
do something like wear helmets, at least you could be honest about the
degree of speculation involved. And when you consider that riding a
bike w/o a helmet is probably better for your health than not riding
at all,



Pure speculation, JT, pure speculation.

Steve


honesty and recognition of uncertainty is even more important.
To do otherwise is either intellectually lazy or unethical.

JT


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  #22  
Old June 19th 04, 01:08 AM
Frank Krygowski
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Default published helmet research - not troll

Jay Beattie wrote:


And the New York Times wrote on May 1, 2001 that:

"A report last summer on "The Future of Children" noted that 35
states lacked bicycle helmet laws, even though "research has
shown that bicycle helmets are 85 percent effective at reducing
head injuries."


They should have at least hedged by saying "up to 85%." This number
came from the Thompson & Rivara case-control study of 1989. In order to
get that high number, T&R had to count even scratches on ears as "head
injuries," and had to compare wildly different groups. Yes, if you
compare helmeted middle class white kids with excellent insurance
coverage (i.e. free ER) riding on bike paths, versus unhelmeted
low-income kids who only go to the ER if it's really serious, and who
ride on streets, you'll get good results for helmets!

That's only a slight exaggeration. If you want a more serious
discussion of the shortcomings of that study, see
http://www.cyclehelmets.org/mf.html#1001


A study in Queensland, Australia, of bicycle
accidents among children showed that wearing a helmet reduced the
risk of loss of consciousness from a head injury by 86 percent.


Did they give a source for that?

Other pro-helmet studies from Australia have done things like ignore the
drop in cycling, ignore the concurrent installation of speed cameras and
stiff drunk driving enforcement, etc. to maximize the supposed helmet
benefit. Still, this is the first time I recall any study but T&R's
coming anywhere close to 85%. Despite the fudging, other pro-helmet
studies come out much lower. I'd like to check the original paper.




Even preschoolers who do not ride in traffic and toddlers on
tricycles need head protection "whenever and wherever they are
cycling," insists Dr. Elizabeth C. Powell of Children's Memorial
Hospital in Chicago. Dr. Powell, a specialist in pediatric
emergency medicine, notes that helmets can also reduce the risk
of facial injuries when a child falls off a tricycle or bicycle."


Why of course they can! Also while playing hopscotch, of course.


I guess it all depends on whether you live in New Zeland or
Australia. Or whether you are Rivera or Scuffham. For every
scientific study you come up with, I can find one or two that go
the other way.


I take a different view. In fact, most scientists take a different view
in such situations.

When cold fusion was trumpeted about 15 years ago, there was one team
(similar to Thompson & Rivara) that published a miracle of success.
There were others who disagreed.

The scientific community didn't say "Oh well, it can go either way."
They kept testing.

In the long run, cold fusion seems to be a dud - at least, by the method
proposed.

This seems to be what's happening with bike helmet research. T&R have
gained fame by saying "85%!!!" but results of mandatory helmet laws
(passed as a result) are pretty dismal. Some other self-selected
case-control studies still give optimistic results, but large population
data doesn't.

It may be that helmets help only if you're lucky enough to be part of a
case-control study, I don't know. But it's worth remembering that
self-selected case-control studies are never accepted for the usual
questions, like "Does this drug prevent cancer" and the like. It's far
to easy to bias the results.



And in the final analysis, it really does not
matter, because we all just do what we do -- and, with minor
exception, we are all too old for the MHLs in most states. MLHs
are mostly a kid thing, and my kid wears a helmet when he is
riding or skiing -- but not when he is walking, showering, or
playing with his Legos or YuGiOh cards. Yes, I know that is
inconsistent when we look at injury patterns, but we have learned
to live with that inconsistency. -- Jay Beattie.


Perhaps it really does not matter to you. But it really does matter to
me.

I'm bothered by the portrayal of all cycling as an extreme activity.
I'm bothered that there have already been attempts to blame cyclists for
injuries caused by negligent drivers, because the cyclist didn't wear a
helmet. I'm bothered by the drop in cycling caused by enforced MHLs,
and I'm bothered by the mixed message given to kids by America's
unenforced MHLs. And I'm bothered by pro-helmet prejudice and the
resulting lack of rigor when examining supposed pro-helmet data.

You'll decide for your kid, of course. But I kind of hope you'll
somehow stay away from statements like "Omigod, NEVER ride without a
helmet!!!" If you want to scare him, it's better to just tell him about
the boogeyman.


--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

  #23  
Old June 19th 04, 01:23 AM
Frank Krygowski
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Default published helmet research - not troll

Steven Bornfeld wrote:



Well, that's the problem, isn't it? Tough to run a controlled study
of this type in real-life conditions.


It would be tough if there weren't such things as mandatory helmet laws
(MHLs). Or even better, _enforced_ MHLs. When you've got a step
increase in the percentage of cyclists in helmets for a whole country,
it's not a bad test of "real-life conditions." All you have to do is
remember to account for the decrease in cycling those laws have caused.
(Pro-helmet papers have been known to ignore a 35% cycling drop, and
count the 30% HI drop as a good sign!)

Why someone would even try to suggest that helmets don't save lives
because there are no controlled studies to prove they do says more about
these people than it does about helmets.


Your statements are too vague to be of use.

The people I know who say helmets don't save lives are the people who
have spent the largest amount of time examining the actual data. The
people who claim they must are typically people who have read a few
helmet promotion blurbs.

Is that what you meant, exactly?


I've heard the same arguments from people who don't wear seatbelts
in cars. I thought they made what could be valid points--until I spent
a year covering head/neck trauma during my residency.


Let's stick to the issue. Seatbelts are a side point. They're not
really comparable - largely because seat belts are tested and certified
for serious collisions, the ones that cause most serious accidents.
Bike helmets are definitely not.

So tell us about your head trauma experience. Since we're talking about
saving lives, what percentage of the head trauma fatalities you saw were
cyclists?

You probably realize that nationally, cyclists are less than 1% of that
problem, right?

Was your experience different from the national average? I'm quite curious.

--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

  #24  
Old June 19th 04, 01:25 AM
John Forrest Tomlinson
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Default published helmet research - not troll

On Fri, 18 Jun 2004 19:24:50 -0400, Steven Bornfeld
wrote:


But this is like saying that a
seat belt shouldn't be worn because it won't save you from crushing
injury of the thorax in a head-on 60 mph crash.
Safety measures shouldn't be discarded because they are not 100% effective.


I haven't said anyone should wear a seatbelt and I haven't said anyone
shouldn't wear a bicycle helmet. I've asked, repeatedly in this
thread, for some evidence of speculation about overstated dangers. If
helmet proponents want to push for wider helmet use, I think it's only
fair that they be honest about what is known and identify their
speculation as such. That's not a lot to ask -- for honesty.

JT
  #25  
Old June 19th 04, 01:29 AM
Keith Willoughby
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Default published helmet research - not troll

Shayne Wissler wrote:

"John Forrest Tomlinson" wrote in message
...

Now what evidence do you have about helmets protecting against dented
skulls or brain injuries?


I have an idea for an experiment. Go outside and have someone hold a brick
about 2 feet over your bare head and have him drop it. Observe the pain and
damage (assuming you're still conscious). Then try the same experiment on
your friend, but have him wear a cycling helmet. If he laughs at you, you
may be able to infer from this, experimentally, that he thought it was not
necessary to run the experiment to know that you would end up with a damaged
head and he wouldn't.


Here's another experiment.

Get someone to swing a baseball bat so that it misses the top of your
skull by an inch.

Now wear a cycle helmet, and repeat the experiment.

Report back which hurts the most.

--
Keith Willoughby http://flat222.org/keith/
I have seen the enemy, and he is quite short.
  #26  
Old June 19th 04, 01:29 AM
Frank Krygowski
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Default published helmet research - not troll

Steven Bornfeld wrote:


There are many studies out there--some designed better, some worse.
There is poor compliance with helmet regulations in the US where they
exist. But certainly Kunich can show studies which cast doubt on the
efficacy of helmets in preventing head injuries. There is also this:

http://www.cochrane.org/cochrane/revabstr/ab001855.htm

which reaches exactly the opposite conclusion.


It's scary to me that a person can get serious medical training, yet
come away with your attitude. "Some go one way, some go another way.
Oh well, no point examining the methodology. We'll just go by gut
feeling."

Seriously, is that how they select chemotherapy drugs??


In the end, people are going to believe what they want.
Unfortunately, my tax dollars are going to pay the medical expenses of
those who ignore common sense.


Good grief. Sounds like more gut feeling to me!

Why not compute what percentage of your tax dollars to to auto accidents
(40,000 fatalities per year), to pedestrian fatalities (6500 per year),
to drownings (over 4000 per year). Then start thinking about obesity,
smoking, and all the other causes of preventable death.

Given the numbers, the 700 or so bike fatalities per year in the US are
NOT going to keep you from buying your next Mercedes! (As if the others
did...)


--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

  #27  
Old June 19th 04, 01:32 AM
Frank Krygowski
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Default published helmet research - not troll

Steven Bornfeld wrote:



John Forrest Tomlinson wrote:

And when you consider that riding a
bike w/o a helmet is probably better for your health than not riding
at all,


Pure speculation, JT, pure speculation.


Meyer Hillman, a rather famous researcher for the British Medical
Association, has computed that the years of life gained due to cycling
outnumber the years of life lost by a 20 to 1 ratio.

From what I've seen, the speculation in this discussion has come from
you! "Common sense" indeed!



--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

  #28  
Old June 19th 04, 01:46 AM
Frank Krygowski
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Default published helmet research - not troll

Steven Bornfeld wrote:


Safety measures shouldn't be discarded because they are not 100%
effective.


Perhaps that's true.

But safety measures shouldn't be strongly promoted unless their benefits
are proven in large populations.

They shouldn't even be considered for mandating unless it's proven that
the resulting benefits outweigh the detriments - including the important
benefit of personal freedom, for one's self and one's family.

And they shouldn't receive the lion's share of promotion unless other
measures are much less effective.


Unfortunately, bike helmets seem to look relatively useless in large
population studies (as opposed to limited case-control studies with
self-selected subjects).

Mandating, and perhaps even strong promotion, of bike helmets tends to
drive people away from cycling, by making it seem extraordinarily
dangerous. And promoters have successfully convinced the public that
cycling is, indeed, dangerous - despite data to the contrary.

And it's still true that often, the ONLY thing people hear about bike
safety is "Always wear a helmet!!!!" Nothing about rules of the road,
lights at night, maintaining the machine, etc.

I've seen enough helmeted families riding facing traffic, or riding at
night without lights, to know that the emphasis needs to be changed.


Recently, a member of my extended family was in for some minor medical
care - interestingly, related to being hit by a car while walking. The
physician heard mention of bicycling, and asked "Do you always wear a
helmet?" When the answer was "No," there was some scolding.

Think about that. Nothing about "Do you follow the rules of the road?
do you ride on the right? Do you use lights at night? Is your bike
mechanically sound?" And of course, nothing about "Do you wear a helmet
when crossing the street?" _despite_ the recent car impact!

Clearly, the emphasis is mistaken.


--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

  #30  
Old June 19th 04, 02:54 AM
Erik Freitag
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Default published helmet research - not troll

On Sat, 19 Jun 2004 00:21:50 +0000, Bill Z. wrote:

This is not true. Children do not ride less due to helmet laws,
particularly in California, where the helmet laws are not enforced (or
rarely enforced.) If you tell a young teen to start using a helmet when
he previously didn't want to, you can expect a negative reaction (natural
rebelliousness.) Kids who started using helmets when they started riding
bicycles don't have that reaction.


I think this is another evidence-free (in the statistical sense)
assertion. I offer a counter-anecdote - my kids, 11 & 13 won't ride to
school because they don't want to wear their helmets because helmets make
them look like geeks, like their dad. Dad won't let them ride without one
because there's a law ...

 




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