Parachutes. They are almost ubiquitous among those who jump out of planes. But have we ever done research on them to see precisely how safe they are?
Sure, we’ve seen people jump out of planes with parachutes in the past. But how many studies have there been about the safety and effectiveness of parachutes? And how many of those were sponsored by Big Parachute?!
In a new study published yesterday in The BMJ, researchers addressed this very issue.
They set out with this goal: “To determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft.”
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The team interviewed 92 people, of which 23 agreed to participate in the study. Then, they had the participants jump out of a helicopter or airplane. Some of them had parachutes in their backpacks, while others did not.
Their results were shocking:
Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention.
So there you have it. We don’t need to waste anymore money on parachutes!
Not so fast
Staying inside a plane is generally a preferred course of action, but if you do decide to exit the plane while it’s in air, obviously you need something to slow you down a bit before you hit the ground. So what’s going on here?
In an opinion piece linked to the article, the authors explain the point a bit more in depth:
That no one would ever jump out of an aeroplane without a parachute has often been used to argue that randomising people to either a potentially life saving medical intervention or a control would be inappropriate, and that the efficacy of such an intervention should be discerned from clinical judgment alone. We disagree, for the most part. We believe that randomisation is critical to evaluating the benefits and harms of the vast majority of modern therapies, most of which are unlikely to be nearly as effective at achieving their end goal as parachutes are at preventing injury among people jumping from aircraft.
Let me summarize:
Say you have ten people who have a rare illness. You give the drug to five of the people, and give a placebo to the other five (a control group), while telling all ten that you’re administering the drug. Many people would say that it’s appropriate to give the drug to everybody instead of collecting data on who did/didn’t receive the drug and monitor the success/failure/side effects of the drug.
So in their case, even though common knowledge is that parachutes are beneficial, they are sarcastically suggesting that it would be appropriate to only give a certain segment of their test subjects parachutes, and those without parachutes would be their test group. They explained further:
However, [randomized controlled trials] are vulnerable to pre-existing beliefs about standard of care, whether or not these beliefs are justified. Our attempts to recruit in-flight passengers to our ambitious trial were first met with quizzical looks and incredulity, predictably followed by a firm, “No, I would not jump without a parachute.” For the majority of the screened population of the PARACHUTE trial, there was no equipoise—parachutes are the prevailing standard of care. And we concur.
Yes, parachutes are good.
But what if we provided assurances that the planes were stationary and on the ground, and that the jump would be just a couple of feet? It was at this point that our study took off. We set out in two groups, one at Katama Airfield on Martha’s Vineyard and the other at the Yankee Air Museum in Ann Arbor. One by one, our study subjects jumped from either a small biplane or a helicopter, randomised to either a backpack equipped with a parachute or a look-a-like control. As promised, both aircraft were parked safely on terra firma.
Kind of boring, but… I guess it’s more ethical than the alternative.
The matchup was, unsurprisingly, a draw, with no injuries in either group. In the first ever [randomized control trial] of parachutes, the topline conclusion was clear: parachutes did not reduce death or major traumatic injury among people jumping from aircraft.
And here is the main takeaway from the entire study:
But topline results from RCTs often fail to reveal the full story. We conducted the PARACHUTE trial to illustrate the perils of interpreting trials outside of context. When strong beliefs about the standard of care exist in the community, often only low risk patients are enrolled in a trial, which can unsalvageably bias the results, akin to jumping from an aircraft without a parachute. Assuming that the findings of such a trial are generalisable to the broader population may produce disastrous consequences.
Just because you read a headline on the internet like ‘a glass of red wine is the same as exercising 30 minutes’ doesn’t make it true. Yes, we would love for that to be the case, but thanks to reality, it’s not.
The authors closed with this thought:
Without careful attention to context, extrapolating findings from such an [randomized controlled trial] to the patient in front of us may be, well, a leap too far.
Special thanks to Michael for reaching out with this story idea. If you have an idea for a story that you think would be a good fit on A Science Enthusiast, reach out to us at tips@aScienceEnthusiast.com!