EVIDENCE BASED MEDICINE

A classic from BMJ 2003, for those who haven’t had the pleasure of reading it. Smith and Pell are giving it to fanatical supporters of evidence based medicine. Evidence based medicine is important, and has given us a lot of useful answers. BUT this piece helps to remind us that evidence based medicine has its limitations and things can be true even in the absence of large RCT’s. Read, laugh and learn.

Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
Design Systematic review of randomised controlled trials.
Data sources Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.
Study selection Studies showing the effects of using a parachute during free fall.
Main outcome measure Death or major trauma, defined as an injury severity score > 15.
Results We were unable to identify any randomised controlled trials of parachute intervention.
Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. 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.

Read the full article here:

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

This post was originally published in Norwegian, 13. sept 2011:
http://www.scancrit.com/2011/09/13/evidensbasert-medisin/

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