24 ms·
Parachute use to prevent death, trauma when jumping from aircraft (2018) [pdf]
- napier 3y agoThere’s no evidence parachutes work.
- xpil 3y agoOh come on, my uncle touched a parachute once and survived so they clearly do work.
- cmcaleer 3y agoMy grandfather was wearing one and died. This is clear and thorough proof they don't work (he was hit with flak as a paratrooper).
- nroets 3y agoThat's why I'm working on an invisible parachute. So that flak gunners can't see the paratroopers.
- cseleborg 3y agoThat doesn't prove anything. What it does clearly prove, though, is that the Earth is flat. Think about it: have you ever successfully landed with a parachute on a spherical object like a soccer ball or large marble? See?
- deleted 3y ago[deleted]
- Scarblac 3y agoAnd with this paper, we now have evidence that they don't work.
- arrowsmith 3y agoHey, I wear a parachute to work every day and it's kept me alive this far! Granted, I work in a ground-floor office, but you can't prove that the parachute isn't what saved me.
- praptak 3y agoPrework for people wanting to dispute this statement: https://plato.stanford.edu/entries/evidence/ https://plato.stanford.edu/entries/evidence/
- deleted 3y ago[deleted]
- casefields 3y agoSerious Problems With RCTs And EBTs Exposed By The Satirical 'Parachute Study': https://www.forbes.com/sites/toddessig/2018/12/30/serious-problems-with-rcts-and-ebts-exposed-by-the-satirical-parachute-study/?sh=32fec84e53f2 https://www.forbes.com/sites/toddessig/2018/12/30/serious-pr...
- Zemtomo 3y agoAs usual the group size is way to small! I hope they don't make it mandatory...
- Edd314159 3y agoThe “correlation is not causation” people were right all along!
- psychphysic 3y agoLove it.
- earthbee 3y agoThey solved aircraft safety back in the 50s, but big parachute is keeping the research suppressed so they can sell more parachutes.
- kenniskrag 3y agoI always wear a parachute during paragliding :)
- arghwhat 3y agoAs a paraplegic paramedic studying the paranormal in parallel
- wkat4242 3y agoFound DB Cooper!
- kenniskrag 3y agoI'm younger than the years he is hiding :)
- _yb2s 3y agoYou expect us to believe that?
- kenniskrag 3y agoIs there an algorithm to convince you?
- LorenPechtel 3y agoNah, it's Big Atmosphere. You can survive the landing. On Titan or Venus. (Surviving the environment is another matter...)
- hcks 3y agoWhat point is this article trying to make?
- Vecr 3y agoThey do a Randomized Controlled Trial on parachutes, but due to ethical reasons the plane is only a few feet off the ground and there's no effect (the parachutes don't have time to deploy).
- eastern 3y agoThis para, buried deep in the paper, is the point: A minor caveat to our findings is that the rate of the primary outcome was substantially lower in this study than was anticipated at the time of its conception and design, which potentially underpowered our ability to detect clinically meaningful differences, as well as important interactions. Although randomized participants had similar characteristics compared with those who were screened but did not enroll, they could have been at lower risk of death or major trauma because they jumped from an average altitude of 0.6 m (SD 0.1) on aircraft moving at an average of 0 km/h (SD 0). Clinicians will need to consider this information when extrapolating to their own settings of parachute use Real studies have an equivalent para far too often.
- seszett 3y agoIt's right in the abstract and conclusions though, not really buried.
- gorgoiler 3y agoIs it typical for clinical trials to completely miss the point like this? I’d like to read a followup meta-analysis that focuses on the actual physiology — “Parachute use to prevent death … when hitting the ground”. [shurely some mistake?]
- vasco 3y agoIt is you that missed the point, read the conclusions again and realise this is a statement about medical papers and randomized participants.
- sebstefan 3y agoWhat do you mean? The point is identifying if parachutes prevent death when jumping from air aircraft, it's in the title!
- gorgoiler 3y agoPerhaps it was intended as part of the satire. A whole new set of trials will be needed, from scratch, to investigate deaths caused by base jumping from cliff tops!
- karatinversion 3y agoI don't think it's missing the point, but you do want to be aware of the context a little bit. Randomized controlled trials are often held up as the gold standard of evidence, and they are good when it is possible to carry them out, but the point of the linked study is that the kinds of treatments it is possible and ethical to perform RCTs for limit their applicability. In this case, it would be unethical and criminal to get volunteers to jump off airplanes at 10,000ft with placebo parachutes, and the kind of RCT it is possible to carry out (this study) does not show parachutes to be effective. Thus no RCT showing that parachutes are effective is possible.
- tialaramex 3y agoI had Hodgkins Lymphoma when I was younger. Because we've been successfully treating Hodgkins for so long we don't have RCTs for the basic idea of the treatment. We can observe that people who choose not to be treated tend to die (but that might be for some other reason, they weren't randomised) and we have modern studies comparing one therapy to another as it has advanced, e.g. I got ABVD, I'm not sure what the current gold standard is - but it would be unethical to run the basic RCT now. "We're going to randomly kill some people just to prove that we were right".
- deleted 3y ago[deleted]
- arrowsmith 3y ago> individuals were screened for inclusion in the PArticipation in RAndomized trials Compromised by widely Held beliefs aboUt lack of Treatment Equipoise (PARACHUTE) trial. Brilliant.
- HPsquared 3y agoI learned a new word, "equipoise". That is, there an ethical dilemma when conducting a controlled trial: it's not ethical to withhold treatment from the control group, if the treatment is already known to work. You'd be basically sacrificing peoples' health for the sake of trial results - to get data that's not worth much (since the treatment is already known to work). This seems to be a big issue in medical trials. https://en.wikipedia.org/wiki/Clinical_equipoise https://en.wikipedia.org/wiki/Clinical_equipoise
- mysecretaccount 3y agoReminds me of Taleb's metaphor about academia working backward from real progress as "teaching birds how to fly". Both related to flight, too.
- gnicholas 3y agoI came to leave a snarky joke comment about "in mice?", and then I remembered that mice don't actually need parachutes because their terminal velocity is roughly the same as a human using a parachute [1]. If someone actually ran the study with mice, they'd find that parachutes aren't necessary! 1: https://johnmjennings.com/can-a-mouse-survive-a-fall-from-a-high-rise/ https://johnmjennings.com/can-a-mouse-survive-a-fall-from-a-...
- King-Aaron 3y agoThat introduction Haldane quote: > You can drop a mouse down a thousand-yard mine shaft; and, on arriving at the bottom, it gets a slight shock and walks away, provided that the ground is fairly soft. A rat is killed, a man is broken, a horse splashes. "A horse splashes". That's some mental imagery right there.
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- deleted 3y ago[deleted]
- ricksunny 3y agoMakes me wonder if a bunch of the world's smallest flightless mammal (a fraction of the house mouse's mass) were released at altitude, would they survive? (Not proposing that this be done but thought experiments and/or simulations): https://en.m.wikipedia.org/wiki/Etruscan_shrew https://en.m.wikipedia.org/wiki/Etruscan_shrew
- tialaramex 3y agoAt altitude it's very cold, the shrews don't work well in the cold due to the same thing that makes them suitable for this experiment - they are very small, thus they lose heat to the environment easily. So, it's possible they freeze to death first. But yes, I imagine that if they survive the cold and aren't falling onto a hard surface (e.g. they land in grass, not a car park) they would survive. For them other than the cold a drop from 1000 metres is the same as a drop from 10 metres.
- nhkcode 3y agoFinally someone is filling the knowledge gap identified by https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/
- jodrellblank 3y ago> “Indeed, in seminal work published in the BMJ in 2003, a systematic search by Smith and Pell for randomized clinical trials evaluating the efficacy of parachutes during gravitational challenge yielded no published studies.1 In part, our study was designed as a response to their call to (broken) arms in order to address this critical knowledge gap.”
- lelandfe 3y ago> Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. 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 “Oh yeah, tough guy? Jump out of this airplane.”
- quickthrower2 3y agoPutting common sense aside. And pretend the height of jump thing is some super abstract and nuanced thing you didn’t spot. Does this result simply mean you just can’t reject the null hypothesis (parachute makes no difference)? Rather than a proof of it?
- kqr 3y agoAll this means is that statistical significance is not enough to reject anything. All statistical significance means is that the effect did not come from sampling error. It can come from any number of other confounders still. Statistical significance is a hint that it could be worth running more replication studies, and vary the conditions in other studies. Significance alone does not indicate the effect as real.
- LanceH 3y agoI think this result actually shows that a parachute doesn't increase death/trauma when exiting a non-moving plane from 2 feet up. So, worst case for parachute wearers is that they are no worse off than without one. Parachutes are safe for use with regards to de-planing.
- 666_howitzer 3y agoHow do we really know whether double blind randomized controlled trials actually work? Is there any RCT done on evaluating the efficacy of RCT?
- eimrine 3y ago> Is there any RCT done on evaluating the efficacy of RCT? What is the set of possible results from the experiment you propose? What function are you going to test: randomness in general, some special RCT event, maybe some doctor who loves to break some double blind experiments?
- kqr 3y agoAt first I was confused about how this would work, but thinking a little about it, it should be fairly easy. Give some researchers (randomly selected!) results from studies that are not RCTs ("control") and others RCT-based results ("treatment") to replicate. See which group manages to replicate more results. Expensive, yes. Would I like to see it? Heck yes, if nothing else as a way to trick the establishment into doing more replication studies.
- proto-n 3y agoA good post on the subject: https://slatestarcodex.com/2014/04/28/the-control-group-is-out-of-control/ https://slatestarcodex.com/2014/04/28/the-control-group-is-o...
- mabbo 3y agoReminds me of: https://m.xkcd.com/1526/ https://m.xkcd.com/1526/
- somebody78978 3y agoIf the meta-RCT shows that RCTs are efficacious, then RCT's are effective. But, if the meta-RCT shows that RCTs are not efficacious, that means the meta-RCT, which is also an RCT, cannot be trusted, which means that RCTs are still effective.
- wodenokoto 3y agoThat headline reminds me of the most recent XKCD [1] where an astronomy research group realize how they can churn out findings. The joke is they’re ruling out the obvious. The headline makes you believe they are stating the obvious (but actually the study is a comment on randomized trials and what kind of research is possible) [1] https://xkcd.com/2783 https://xkcd.com/2783
- deleted 3y ago[deleted]
- xattt 3y agoThere is no discussion regarding REB approval. That would really sell the article. /s
- amelius 3y agoDid anyone try to use a large airbag suit/chamber to survive a plane crash while still in the plane?
- snitty 3y agoTo the best of my knowledge that hasn't been tried. Among other things, fatal crashes typically occur at speeds over 2x those of car crashes. There's no meaningful ability to emergency brake before a crash, and many small airplanes don't have the weight budget to get the things that help you survive a crash, like crumple zones. An airbag won't do much if you're still going to be squeezed between the engine and tail of the plane at 180 mph.
- amelius 3y agoWell, if you are in the middle of a 737 you have quite some crumple zone. And you can probably see the crash coming in advance, so plenty of time to inflate your airbag suit/chamber.
- LudwigNagasena 3y ago> 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. Both options may be true for different cases. It may be simple to decide on parachutes. But think of bureaucrats who were patting themselves on the head for being “flexible enough and humble enough” to issue new guidance on masks instead of saying “We don’t know” in the first place. “The sovereign is he who selects the null hypothesis.”
- maxerickson 3y agoBoth options may be true for different cases. That's option one. Or do you insist on some particular definition of exceptional circumstances?
- LudwigNagasena 3y agoIt’s like the difference between civil law and criminal law. In civil law the balance of probabilities is used. In criminal law the accusation should be proved beyond reasonable doubt. Option one means treating something like civil law cases. Option two means treating it like criminal law cases.
- maxerickson 3y agoThe use of common sense does not preclude the use of evidence. In fact, when good evidence is available, it suggests it. You are arguing a distinction that does not exist.
- LudwigNagasena 3y ago> The use of common sense does not preclude the use of evidence. In fact, when good evidence is available, it suggests it. Nothing I said implies the opposite. > You are arguing a distinction that does not exist. No, the paper framed the issue as if such distinction exists. I didn’t agree with that and I don’t see why you would accuse me of that.
- d--b 3y agoHonest question: is this satire or gpt?
- PapstJL4U 3y agodeep deep down: >The PARACHUTE trial satirically highlights some of the limitations of randomized controlled trials. Nevertheless, we believe that such trials remain the gold standard for the evaluation of most new treatments. The PARACHUTE trial does suggest, however, that their accurate interpretation requires more than a cursory reading of the abstract.
- ksala_ 3y agoSatire. Also calling out studies that don't reproduce using real life, realistic parameters. It was written in 2018 so definitely no AI.
- fransje26 3y agoAccepted: 22 November 2018.
- mannykannot 3y agoIt is clear that it is satire, but it does not really work because it asks the wrong question. When you ask the right question (about travelling in an airplane, not jumping out of one) the fact that commercial aviation is conducted without parachutes (though with seat restraints) makes sense.
- tialaramex 3y agoSurely this work's result is indicative for commercial air travel. The vast, vast majority of passengers will leave the aeroplane when it is stationary and they will drop far less than half a meter when disembarking, circumstances in which the parachute was ineffective. So that's not the wrong question at all. The ideal satire ought to bring up what we should do, ridiculing it. For example, the famous "A Modest Proposal" says that we shouldn't consider taxing the wealthy, particularly the people who make most money from Ireland while not even living there. It insists you couldn't even begin to tackle the problem with taxation or other measures, whereas eating babies would solve the problem entirely.
- TowerTall 3y ago"Annals of Improbable Research" [1] is a treasure throve of other research projects that will make you laugh. [1] https://improbable.com/ https://improbable.com/
- phkahler 3y agoI see this all the time when researching various non-pharmasutical treatments. Vitamin D supplementation has no benefit for people without a deficiency for example. It's annoying how much of this is out there.
- LorenPechtel 3y agoYup, this sort of factor can make it hard to find the answer. Do some patients benefit from D supplements? Certainly. Yet you can find a group that gains no benefit. In this case we obviously can divide them up but in many cases the division is unknown.
- TheOtherHobbes 3y agoSurprised and disappointed there wasn't a more thorough investigation of a potential placebo effect.
- moioci 3y agoStudy was unblinded, though.
- incone123 3y agoUnclear why this is in the bmj. Might be of use to students learning how to structure a paper?
- jpambrun 3y agoProbably for readers to learn about critical thinking.
- thomasjudge 3y agoThe BMJ "Christmas Issue" often posts satire
- jpeanuts 3y agoI think the paper is a satire on "evidence-based medicine" - a framework which insists upon randomized controlled trials as the primary basis for medical decisions. Notably this is exactly such a trial, while also absolutely irrelevant to the question of needing a parachute or not (the trial planes were all on the ground at the time of the jumps).
- bratgpttamer 3y agoIt's a follow-up to a previous satire, which questioned whether or not we need RCTs for time-tested, common-sense interventions. The original paper suggested that the most die-hard EBM fans organize and participate in a RCT of the parachute. Several years later, tongue planted firmly in cheek, they did. https://healthjournalism.org/blog/2019/02/breakthrough-research-reveals-parachutes-dont-prevent-death-when-jumping-from-a-plane/ https://healthjournalism.org/blog/2019/02/breakthrough-resea...
- avs733 3y agofunny enough I actually use this article and others in a project when I teach stats. This article is part of what is known as the 'BMJ Christmas Edition' which gone on for quite a while[0]. it is meant to be at the same time scientifically serious and practically silly [1]. Its...basically satire, but satire as specific scientific commentary. In this case, about the details and clarity of scientific reporting and the claims made from data. There have been a couple notable problems...One is that satire and human don't always generalize culturally. The second problem though became much more insidious with the electronic shift in publishing. If you access a Christmas edition article electronically, nothing clearly indicates that anything is different about these articles. Nothing indicates 'Christmas edition'. Nothing indicates that they are meant to be light hearted scientific commentary. So they get cited...both as satire and as not satire. Either for cultural reasons or because people aren't being rigorous. [0] https://www.bmj.com/about-bmj/resources-authors/article-types/christmas-issue https://www.bmj.com/about-bmj/resources-authors/article-type... [1] https://www.statnews.com/2017/12/13/bmj-christmas-issue-studies/ https://www.statnews.com/2017/12/13/bmj-christmas-issue-stud...
- jwilk 3y agoNon-PDF version: https://www.bmj.com/content/363/bmj.k5094 https://www.bmj.com/content/363/bmj.k5094
- bratgpttamer 3y agoBackground (2003): A systematic review of the literature found no evidence to support the routine use of parachutes to prevent death from gravitational challenge and concludes with "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." [https://www.bmj.com/content/327/7429/1459 https://www.bmj.com/content/327/7429/1459] 2018: Protagonists of EBM both organized and participated in such a study and found that parachutes don't make any difference in survival when jumping from a plane. Also in 2018, https://www.cmajopen.ca/content/6/1/E31.full https://www.cmajopen.ca/content/6/1/E31.full looked at the use of the parachute metaphor in medicine and confirmed most people didn't quite get the joke
- haldujai 3y agoI think people misunderstand what evidence based medicine is[0]. There are many types of evidence ranging from lab studies and expert opinion at the bottom to systematic reviews/meta-analyses at the top. The point being that we should strive for RCTs when possible, and that RCTs carry more weight than expert opinion or case-control. Many (I don’t have an exact number) clinical practice guidelines are based on expert opinion or observational studies, and are completely valid/evidence-based (it’s just weak evidence). The point of EBM is not “RCT or bust” it’s really more about the hierarchy, that medicine should not practice in defiance of quality evidence and that we should strive to obtain the highest quality evidence possible. [0] https://en.wikipedia.org/wiki/Hierarchy_of_evidence https://en.wikipedia.org/wiki/Hierarchy_of_evidence
- maxbond 3y ago(Saved you a search: Randomized Controlled Trial) (Corrected)
- psychphysic 3y agoRandomised controlled trial. Controlled means there is a control arm that get no treatment, or treatment as usual (depending on what's needed). Ideally a Db-rct a doubly blinded randomised controlled trial.
- haldujai 3y agoApologies, bad medicine habit to use ambiguous acronyms. I meant "randomized controlled trial" in this case (as the post). "Randomized clinical trial" is often used interchangeably but does not necessarily require a control group (e.g. a non-inferiority study comparing two different treatments).
- psychphysic 3y ago> Many (I don’t have an exact number) clinical practice guidelines are based on expert opinion or observational studies, and are completely valid/evidence-based (it’s just weak evidence). A big problem is that humans have a preference for action, and a dislike of waiting for information. Many flawed guidelines are based on a desire to act even in the absence of evidence of benefit. "Primum non nocere" is probably the most accepted but least respected tenant of good medical practice.
- swader999 3y agoDid they even consider the speed of the plane? I suspect this is multi factorial and not just a simple case of using a parachute. More funding is needed. And please, don't call me an altitude denier, I firmly believe height has a role to play in this.
- lakis 3y agoYes. All participants (parachute and control) jumped from vehicles with 0 speed and 0.6 meters altitude ;-) I'm not joking. This is the actual study. It shows how studies can be valid statistically and shows nothing usefull for the real world.
- PeterStuer 3y ago.3 seconds after jumping from a high altitude plane there was no colleration to parachute usage wrt injuries, ramdomized trial confirms. (Double blind study awaiting approval)
- dang 3y agoRelated: Parachute use to prevent death, major trauma when jumping from aircraft (2018) - https://news.ycombinator.com/item?id=30795522 https://news.ycombinator.com/item?id=30795522 - March 2022 (8 comments) Parachute use to prevent death and major trauma: systematic review (2003) - https://news.ycombinator.com/item?id=28508084 https://news.ycombinator.com/item?id=28508084 - Sept 2021 (24 comments) Parachute use to prevent death and major trauma when jumping from aircraft (2018) - https://news.ycombinator.com/item?id=27676727 https://news.ycombinator.com/item?id=27676727 - June 2021 (6 comments) Parachute use to prevent death and major trauma related to gravity challenge (2003) - https://news.ycombinator.com/item?id=22788043 https://news.ycombinator.com/item?id=22788043 - April 2020 (9 comments) Parachute use to prevent death jumping from aircraft: random controlled trial (2018) - https://news.ycombinator.com/item?id=22778832 https://news.ycombinator.com/item?id=22778832 - April 2020 (36 comments) Parachute use to prevent death and major trauma when jumping from aircraft - https://news.ycombinator.com/item?id=18677508 https://news.ycombinator.com/item?id=18677508 - Dec 2018 (110 comments) Parachute use to prevent death and major trauma due to gravitational challenge - https://news.ycombinator.com/item?id=4644463 https://news.ycombinator.com/item?id=4644463 - Oct 2012 (57 comments)