Re: Helmets +/- Safety
- From: Mike Clark <mrc7@xxxxxxxxxxxxxxxx>
- Date: Fri, 29 Aug 2008 18:56:32 +0100
In message <9s5gb4ple81eibbkbgtq2d8fejghi3djh8@xxxxxxx>
judith <judithsmith@xxxxxxxxxx> wrote:
[snip]
Thanks for the links.
But you have said take in to account the latest literature.
I apologise if I am missing something here - but:
the DfT report was produced in 2002
Strangely though in Section 5 it fails to make use of Robinson 2001 as a
reference source and instead merely looks at the earlier publication
Robinson 1996. Section 5 makes use of Povey 1999 which Robinson 2001
calls into question.
Why were the DfT selective in their use of the pre 2002 references? What
were they trying to achieve by this apparent bias? The DfT report makes
out that it is a comprehensive review of the available evidence. If so
why omit key research from that comprehensive overview?
The D L Robinson report was produced in 2006 - but it is really a
rehash of stuff that he/she has produced over the years. The second
"report" is comment on comments on first
There are 14 references prior to 2002 going back to 1987 and then
only 5 post the DfT report. Of these 5 - I would say that only 2 are
relevant (8, 12) new information
I think that reference 4 is of major significance although you may have
overlooked its consequences because it is not about "helmets" but rather
about the validity of trusting controlled observational trials.
Also Robinson 2001 is important (see comments above).
I am not convinced that this report is based on more up to date
experience.
Reference 4 calls into question the way that scientists and doctors had
previously placed too much emphasis on the reliability of case
controlled studies that had not been properly randomised and blinded.
Also - the object of his paper was to review the benefits of helmet
laws - not review the efficacy of cycle helmets / head injuries.
Health, safety and medicine are often about a cost benefit analysis.
That's why there is so much press and media attention surrounding NICE
and whether it approves new therapies under the Health Service. It is
not simply enough to show a slight benefit, that benefit has to be
weighed against the costs.
Given that the evidence for the effectiveness of helmets at a population
level is weak, that the freqency of serious injuries is relatively
small, yet the costs of every cyclist buying a new helmet every few
years is relatively large, it doesn't seem to be reasonable to advocate
their use as an effective safety measure. The same amount of money
invested in other ways could easily reduce more injuries.
Mike
--
M.R. Clark PhD, Reader in Therapeutic and Molecular Immunology
Cambridge University, Department of Pathology
Tennis Court Road, Cambridge CB2 1QP
Tel +44 (0)1223 333705 Web http://www.path.cam.ac.uk/~mrc7/
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