published helmet research - not troll

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

JT

(Tom Kunich) writes:

(CowPunk) wrote in message . com...

The same thing holds true for this discussion. You're looking
at FATALITIES. What about the accidents where a helmet
prevented brain injury? It's not something that can be answered
or tested easily....

That's a fair question. But ask yourself - how many brain injuries
have occurred to cyclists over the intervening 30 years. The answer is
that there are so few that they aren't even recorded. It isn't that
they don't occur, but that your chances of having similar injuries as
a pedestrian are many times greater on a statistical basis.

The statistics also show that serious head injuries aren't helped by
helmets either since the ratio of serious head injuries to fatalities
hasn't changed in the least either. Although there are some medical
sources that claim that using complicated statistical methods they can
JUST detect some help.

This is turning into a repeat of the very same discussion held 10
years ago. Go back to the archives to look if you want.

Keep in mind that serious head injuries covers a wide range of
impacts. If you make a serious injury less serious, it still gets
classified as a serious injury, and you might find it hard to
detect the fraction that drop from "serious" to "not serious" or
"prevented."


It is my OPINION that helmets make minor injuries even more minor or
even non-existant. That is a reason for ME to wear a helmet. That is
not a reason for laws that force helmets on children since it
coincidentally causes children to to ride a great deal less, causing
parents to drive their children to school making it more dangerous for
all children in the vicinity of schools.

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.

Bill

--
My real name backwards: nemuaZ lliB

On Fri, 18 Jun 2004 22:41:36 GMT, "Shayne Wissler"
wrote:


"John Forrest Tomlinson" wrote in message
.. .
On Fri, 18 Jun 2004 22:16:19 GMT, "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.

That's your evidence? That's speculation.

Let me guess. You must be a follower of Hume.

On the contrary, the thought experiment I gave is perfectly valid evidence,
from which a reasonable person would infer that some fraction of real-life
accidents would result in a lesser injury if a helmet were worn.

You're making a a big assumption -- that hitting a brick is similar to
the impact people get when they hit their head on the ground (which I
would guess -- note I am acknowledging the degree of specutation I'm
making) or a tree branch (which is the object in question). I think
that assumption is wrong insofar as it relates to any sort of likely
accident on a bke. But yes, if someone is riding where they will be
hit by falling bricks, a helmet sounds helpful.

JT

Shayne Wissler wrote:
"John Forrest Tomlinson" wrote in message
...

On Fri, 18 Jun 2004 22:16:19 GMT, "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.

That's your evidence? That's speculation.


Let me guess. You must be a follower of Hume.

On the contrary, the thought experiment I gave is perfectly valid evidence,
from which a reasonable person would infer that some fraction of real-life
accidents would result in a lesser injury if a helmet were worn.


Shayne Wissler

There is a germ of truth in the assertion that helmets won't prevent
death. This general feeling among safety experts seems to revolve
arount the assertion that serious brain injury from bicycle accidents
usually are not due to straight-on impact, but from torsional stresses
that a helmet is unable to eliminate. 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.

Steve

"John Forrest Tomlinson" wrote in message
...
On Fri, 18 Jun 2004 22:41:36 GMT, "Shayne Wissler"
wrote:


"John Forrest Tomlinson" wrote in message
.. .
On Fri, 18 Jun 2004 22:16:19 GMT, "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.

That's your evidence? That's speculation.

Let me guess. You must be a follower of Hume.

On the contrary, the thought experiment I gave is perfectly valid
evidence,
from which a reasonable person would infer that some fraction of
real-life
accidents would result in a lesser injury if a helmet were worn.

You're making a a big assumption -- that hitting a brick is similar to
the impact people get when they hit their head on the ground (which I
would guess -- note I am acknowledging the degree of specutation I'm
making) or a tree branch (which is the object in question). I think
that assumption is wrong insofar as it relates to any sort of likely
accident on a bke. But yes, if someone is riding where they will be
hit by falling bricks, a helmet sounds helpful.

I hesitate to say this because it amounts to pointing your nose in a
direction you obviously do not wish to look, and you can always avert your
eyes, but: Shape your "brick" like a flat peice of pavement and it is hardly
different from falling down on the pavement with your head.

He who actively engages in finding differences but is is lazy about finding
similarity is a self-made idiot.


Shayne Wissler

DRS wrote:
"Steven Bornfeld" wrote in message


[...]


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.


The difference is empirically obvious. I live in the first state in the
world that made seatbelt use compulsory (Victoria, Australia). Not only did
the fatality rate immediately plummet but the rate of spinal injuries
dropped 75% in the first year. There is no such corresponding data for
bicycle helmets.

The safety improvement from seat belt use that I have seen is nowhere
near that dramatic. Nevertheless, I can tell you from first hand
experience that no one involved in a car accident that I saw the whole
year (that I asked--most of them) had been wearing seat belts.
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.
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.

Steve

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

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]

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]

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