Do parachutes prevent death?
Af Simon Tulloch, chefkonsulent, psykolog, Dansk Selskab for Patientsikkerhed
An unusual inclusion in this month’s BMJ is a paper which aims to determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft. In a randomized controlled trial, 92 aircraft passengers aged 18 and over were screened for participation. 23 agreed to be enrolled and were randomized to jump from an aircraft (airplane or helicopter) with a parachute versus an empty backpack (unblinded). The main outcome measures constituted death or major traumatic injury upon impact with the ground measured immediately after landing.
The surprising result indicated that parachute use did not significantly reduce death or major injury (0% for parachute v 0% for control; P>0.9). This finding was consistent across multiple subgroups. However, compared with individuals screened but not enrolled, participants included in the study were on aircraft at significantly lower altitude (mean of 0.6 m for participants v mean of 9146 m for non-participants; P<0.001) and lower velocity (mean of 0 km/h v mean of 800 km/h; P<0.001).
The authors conclude that parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention. However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials might selectively enroll individuals with a lower perceived likelihood of benefit, thus diminishing the applicability of the results to clinical practice.
This paper, along with other unusual or festive related research is available in the BMJ Christmas special https://www.bmj.com/
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