Helmets and Autopsy

"Coyoteboy" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based
(presumably) on facts - surely well regarded since he is a fellow of the
royal medical gods etc?

If you've been listening at all, you'll know the stock answer to that one.
It's a stock answer for good reason too...

(hint - look at where he got that number from)

cheers,
clive

Clive George said:

"Coyoteboy" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based
(presumably) on facts - surely well regarded since he is a fellow of
the royal medical gods etc?

If you've been listening at all, you'll know the stock answer to that
one. It's a stock answer for good reason too...

(hint - look at where he got that number from)

cheers,
clive

Dont think ive seen that number in my readings, maybe ive missed it?

He certainly didnt mention where in the program?

Coyoteboy said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based
(presumably) on facts - surely well regarded since he is a fellow of the
royal medical gods etc?

Interesting.

The question occurs to me; how many A&E staff, and/or
surgeons are knowledgeable in statistics (which one might
presume is NOT their speciality).

The "I've seen head injuries so I know what I'm talking
about" approach to statistics is NO more valid when the speaker
is medically trained.

BugBear

Coyoteboy said:

I suspect he has significant reading and experience in the field, not
just "ive read a paper and regurgitated it" :

Areas of Expertise:
All aspects of Accident & Emergency medicine
Medical competence, accidents and negligence
Emergency pre-hospital care
Emergency hospital care
Resuscitation (hospital care)
Multiply-injured (trauma) patients (hospital care)
Foot and ankle injuries and surgery
Hand, wrist and upper limb injuries and surgery
Whiplash injuries
Soft tissue injuries
Head injury (initial care)
Road traffic accidents (personal injury)
Falling, tripping and slipping accidents
Sports and leisure injuries
Criminal assault/CICA claims

None of that necessarily translates to "has stopped and thought a bit
further than the obvious 'of course helmets will help against head
injuries', and having stopped and thought about it researched it
thoroughly".

Especially when the medical environment has a pervasive "helmets are
good" vibe echoing around the surgeries and hospitals, not least thanks
to the BMA and RCNs' uncritical endorsement of helmet mandation. People
only tend to research stuff that isn't already blindingly obvious, or at
least seemingly so. It was blindingly obvious to me (a clinical
scientist, btw) that a helmet was clearly a Good Thing before I was
pushed and prodded into reading the research myself, so I know how it works.

Pete.
--
Peter Clinch Medical Physics IT Officer
Tel 44 1382 660111 ext. 33637 Univ. of Dundee, Ninewells Hospital
Fax 44 1382 640177 Dundee DD1 9SY Scotland UK
net [email hidden] http://www.dundee.ac.uk/~pjclinch/

In article said:

Clive George said:

"Coyoteboy" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries

(hint - look at where he got that number from)

Dont think ive seen that number in my readings, maybe ive missed it?

You've done a good job of staying clear of helmet threads till now then.
http://www.cyclehelmets.org/1068.html

Alan Braggins said:

In article said:

Clive George said:

"Coyoteboy" <[email hidden]> wrote in message
news:[email hidden]...
> Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
> claiming 85% reduction in cycle related serious head injuries
(hint - look at where he got that number from)

Dont think ive seen that number in my readings, maybe ive missed it?

You've done a good job of staying clear of helmet threads till now then.
http://www.cyclehelmets.org/1068.html

I got involved in one and was basically told my opinion wasn't worth
listening to. Since I don't really care what other people do and since I
generally wear a helmet myself I decided to try to avoid contributing.

Indeed the quoted text does seem flawed. Also it is rather old and
barely relates to modern riding or safety equipment.

Peter Clinch said:

Coyoteboy wrote:

Quoted message said:

None of that necessarily translates to "has stopped and thought a bit
further than the obvious 'of course helmets will help against head
injuries', and having stopped and thought about it researched it
thoroughly".

Especially when the medical environment has a pervasive "helmets are
good" vibe echoing around the surgeries and hospitals, not least thanks
to the BMA and RCNs' uncritical endorsement of helmet mandation. People
only tend to research stuff that isn't already blindingly obvious, or at
least seemingly so. It was blindingly obvious to me (a clinical
scientist, btw) that a helmet was clearly a Good Thing before I was
pushed and prodded into reading the research myself, so I know how it works.

Pete.

True, you cannot assume it. One would hope it seeing as his work will be
peer reviewed. I'm not so sure about the "people only research not
obvious stuff" presumption. Plenty of the papers I have read have been
based on "we can get a paper out of this obvious result", certainly a
lot of the papers I have seen are borne out of "we know we can prove
this so lets do it and get published". I have a slight waryness of the
peer review process, as well as research funding in general which seems
to be fueled by "we want to prove this, heres some cash to make it so".

Coyoteboy said:

I got involved in one and was basically told my opinion wasn't worth
listening to.

perhaps because your information wasn't particularly up to speed?

Quoted message said:

Indeed the quoted text does seem flawed. Also it is rather old and
barely relates to modern riding or safety equipment.

Yet it is /still/ the most widely quoted study, and as you noticed it's
been quoted again by a man of influence who seems to have taken it with
something of a lack of questioning. 85% (or 88%) is immediately
suspicious as a quoted figure because this is the *only* piece of work
that has ever come up with those numbers. Anyone quoting them as gospel
either hasn't looked into the source carefully, can't understand it's
problems or is being basically dishonest.

(One note about the quality of the equipment, it was actually made to
higher specifications those days than it is now).

Pete.
--
Peter Clinch Medical Physics IT Officer
Tel 44 1382 660111 ext. 33637 Univ. of Dundee, Ninewells Hospital
Fax 44 1382 640177 Dundee DD1 9SY Scotland UK
net [email hidden] http://www.dundee.ac.uk/~pjclinch/

Coyoteboy said:

True, you cannot assume it. One would hope it seeing as his work will be
peer reviewed.

Not much comfort in itself. Plenty of terrible papers have got through
peer review, and if you're a medic who isn't actually that good at
epidemiological experiments then of course your peers can't be
necessarily expected to be any better.

Quoted message said:

I'm not so sure about the "people only research not
obvious stuff" presumption. Plenty of the papers I have read have been
based on "we can get a paper out of this obvious result", certainly a
lot of the papers I have seen are borne out of "we know we can prove
this so lets do it and get published".

That's the production of papers, not the reading of them. If you're
pretty happy that the earth is flat then you'll only look further into
theories of the earth being a ball if you haven't got anything better to
do. I certainly don't spend my time reading up on /everything/ that can
possibly affect my work, as I'd never have time to do anything if I tried.

Quoted message said:

I have a slight waryness of the
peer review process, as well as research funding in general which seems
to be fueled by "we want to prove this, heres some cash to make it so".

"Policy based evidence making". The DfT's "independent" Road Safety
Research report 30 is a fine example...

Pete.
--
Peter Clinch Medical Physics IT Officer
Tel 44 1382 660111 ext. 33637 Univ. of Dundee, Ninewells Hospital
Fax 44 1382 640177 Dundee DD1 9SY Scotland UK
net [email hidden] http://www.dundee.ac.uk/~pjclinch/

Peter Clinch said:

(One note about the quality of the equipment, it was actually made to
higher specifications those days than it is now).

You've got to be carefull here: the important specifications (weight,
ventilation, design, comfort, pricelevels) have much improved 😉
--
/Marten

info(apestaartje)m-gineering(punt)nl

bugbear bugbear@trim_papermule.co.uk_trim said:

Coyoteboy said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based
(presumably) on facts - surely well regarded since he is a fellow of the
royal medical gods etc?

Interesting.

The question occurs to me; how many A&E staff, and/or
surgeons are knowledgeable in statistics (which one might
presume is NOT their speciality).

The "I've seen head injuries so I know what I'm talking
about" approach to statistics is NO more valid when the speaker
is medically trained.

Indeed. It's about as valid as assuming your local garage's
panel-beater will be an expert on advanced driving and worth
consulting about accident investigation. I'm sure all the police
accident investigators are highly successful panel-beaters sharing
their expertise for the good of society.

regards, Ian SMith
--
|\ /| no .sig
|o o|
|/ \|

Peter Clinch said:

Coyoteboy said:

I got involved in one and was basically told my opinion wasn't worth
listening to.

perhaps because your information wasn't particularly up to speed?

My points were simply that the references given, suggesting helmets were
bad, were as flawed as the opposition. It didn't go down well and I'm a
busy man, I don't have time for too much petty online arguing, although
it does get the better of me at times!

Quoted message said:

Quoted message said:

Indeed the quoted text does seem flawed. Also it is rather old and
barely relates to modern riding or safety equipment.

Yet it is /still/ the most widely quoted study, and as you noticed it's
been quoted again by a man of influence who seems to have taken it with
something of a lack of questioning. 85% (or 88%) is immediately
suspicious as a quoted figure because this is the *only* piece of work
that has ever come up with those numbers. Anyone quoting them as gospel
either hasn't looked into the source carefully, can't understand it's
problems or is being basically dishonest.

(One note about the quality of the equipment, it was actually made to
higher specifications those days than it is now).

Pete.

One would hope that more research were done into this area and the
opponents on both sides of the argument would be consulted on the test
procedure in order to settle the argument once and for all. It seems to
me that both sides quote flawed material and no-one actually sets about
doing a good study, so the usenet arguments are futile.

Maybe someone like the CTC or suchlike should commission a proper study?

M-gineering said:

You've got to be carefull here: the important specifications (weight,
ventilation, design, comfort, pricelevels) have much improved 😉

The primary spec for safety probably is how much punishment a helmet can
take. IIRC the EN1078 spec used now is lower in that regard than the
Snell specs in use back in the 80s. Also the outers tended to be hard
shells.

Pete.
--
Peter Clinch Medical Physics IT Officer
Tel 44 1382 660111 ext. 33637 Univ. of Dundee, Ninewells Hospital
Fax 44 1382 640177 Dundee DD1 9SY Scotland UK
net [email hidden] http://www.dundee.ac.uk/~pjclinch/

In article <[email hidden]>,
bugbear@trim_papermule.co.uk_trim says...

Quoted message said:

Coyoteboy said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based
(presumably) on facts - surely well regarded since he is a fellow of the
royal medical gods etc?

Interesting.

The question occurs to me; how many A&E staff, and/or
surgeons are knowledgeable in statistics (which one might
presume is NOT their speciality).

The "I've seen head injuries so I know what I'm talking
about" approach to statistics is NO more valid when the speaker
is medically trained.

I suspect their logic is similar to a car repairer who reckoned Fords
are the most dangerous cars because they see lots of them in for repair
but exotic supercars are very safe because he's never had one to repair.
Most of the cyclists they see will not have been wearing a helmet
because most cyclists don't wear one, not because the ones not wearing
helmets are disproportionately represented in hospitalisations.

--
Tony

"The single biggest problem in communication is the illusion that it has
taken place"
George Bernard Shaw

Quoted message said:

Quoted message said:

Quoted message said:

Just been on Ch4 with Dr John Heyworth (emergency medicine specialist)
claiming 85% reduction in cycle related serious head injuries with
helmets, stressing the vitality of helmets? His opinion, based

I thought the case had 'fallen' from a 6th floor onto concrete.
Her chest was full of blood amongst other things.I did not stay with
the program, so unfortunately missed his assertion that a cycle helmet
would have helped.
I look forward to a live demonstration with him as the subject.
If her skull was in such a state I wonder what her brain must have
looked like.

TerryJ

Coyoteboy said:

...both sides quote flawed material and no-one actually sets about
doing a good study, so the usenet arguments are futile.

Maybe someone like the CTC or suchlike should commission a proper study

That's tricky to arrange, given that it involves destructive testing
of a statistically significant number of heads...

On the other hand, we can have a look at the experience of those
countries which have mandated helmet use and confirm that they have
observed a significant reduction in serious injuries and deaths: After
all, you would expect to see some sort of reduction if helmets are
effective.

Curiously, we don't. I won't try and paraphrase the findings here
(the studies are listed at the cyclehelmets.org site), but Australia,
New Zealand and other countries that have tried it don't seem to have
benefited from cumpulsory helmet wearing.
It therefore seems unlikely that we would, or at the bare minimum,
that there's no compelling evidence to suggest it...

It seems to me that one of the reasons that the old, flawed studies
keep being cited is that more recent, rigorous work doesn't support
the opinions of those who'd like to see helmets used more widely.

It's a difficult situation- Intuitively, helmets seem as if they
ought to work. People want to be seen to "do something" to improve
safety and the more people get swept up in the illusion the more
commonplace the assumption that they must be useful becomes. Added to
this is the fact that many people feel safer wearing a helmet, and
that makes them more comfortable. It's hard to convince somone that
something which makes them feel safer actually puts them at higher
risk... Especially if they don't understand why you'd want to convince
them of this in the first place!

Cheers,
W.

Quoted message said:

Coyoteboy said:

...both sides quote flawed material and no-one actually sets about
doing a good study, so the usenet arguments are futile.

Maybe someone like the CTC or suchlike should commission a proper study

That's tricky to arrange, given that it involves destructive testing
of a statistically significant number of heads...

On the other hand, we can have a look at the experience of those
countries which have mandated helmet use and confirm that they have
observed a significant reduction in serious injuries and deaths: After
all, you would expect to see some sort of reduction if helmets are
effective.

Curiously, we don't. I won't try and paraphrase the findings here
(the studies are listed at the cyclehelmets.org site), but Australia,
New Zealand and other countries that have tried it don't seem to have
benefited from cumpulsory helmet wearing.

<snip>

The problem is that, as I said, all the studies done so far have equally
large flaws as the ones we have FOR helmets - so they are pointless. For
a start NZ and Aus have such a small population and vehicle density that
it isnt even remotely comparable. Even in cities we are talking of
cities of 400K people (Capital of NZ) and overall population of 4
million. Theres more people living (driving and cycling) in some of our
larger cities than in the entirety of NZ. They have been brought up
under different cultures, with different road rules. They simply arent
applicable in much the same way as the anti-85% arguments that say
"helmeted were mostly white upper class in parks" and "unhelmeted were
mostly black, riding on the streets". The arguments dont work one way.
You need a statistically and scientifically fair test in the country in
questions and across a range of locations. No point comparing city
riding in NZ to city riding in the UK.

Unfortunately, as you say, this would involve purposefully destroying
heads. Not likely to go down well with a funding body.

Tony Raven said:

I suspect their logic is similar to a car repairer who reckoned Fords
are the most dangerous cars because they see lots of them in for repair
but exotic supercars are very safe because he's never had one to repair.

Hmm not sure about that one, dont thnk ive seen car safety so poorly
compared since the mid 80s, these days they are given standardised
tests. Dont think I've seen supercars entered for the NCAP testing
procedure though.

TerryJ said:

I thought the case had 'fallen' from a 6th floor onto concrete.
Her chest was full of blood amongst other things.I did not stay with
the program, so unfortunately missed his assertion that a cycle helmet
would have helped.
I look forward to a live demonstration with him as the subject.
If her skull was in such a state I wonder what her brain must have
looked like.

TerryJ

He never asserted that a cycle helmet would have helped in this case.
That would be yet another case of anti-helmet knee jerk assumptions
disease. His point followed a discussion of general head impact, how
frontal and rear impacts are fairly well protected against but side
impacts are less well protected due to the sides of the skull being
thinner. I was in and out of the room so i didnt see the exact link to
cycling. Its probably on youtube if you want to see it.