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#21
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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
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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
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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
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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
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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
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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
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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
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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] |
#29
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published helmet research - not troll
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#30
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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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