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"Helmet use reduces head injuries by up to 60%"

 Poster: A snowHead
Poster: A snowHead
Martin Bell, oranges and apples are both spherical fruit, however they are not the same.

Comparing skiing to motorcycling is one of the logical fallacies that I alluded to in one of my earlier posts. As is the "well it saved me from a head injury" argument.

There is a lot of evidence and research that shows the wearing of motorcycle helmets prevents deaths and injuries, there isn't for ski helmets, or cycle helmets for that matter.
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Martin Bell, don;t worry about a face guard. He didn't punch you at the time, I doubt he'll do it now... Laughing
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lbt's is most likely still at the dentist Laughing
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Kramer,
Quote:

or cycle helmets for that matter

As it happens, a cycle helmet saved me from more injury than anything else has (had to throw the damn thing away though)
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Caspar wrote:
As it happens, a cycle helmet saved me from more injury than anything else has (had to throw the damn thing away though)


Unfortunately you cannot know this for sure. You may feel that it is the case, but you cannot know for sure what would have happened in the same circumstances if you hadn't been wearing a helmet, it is impossible.
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Kramer wrote:
...one of the logical fallacies that I alluded to in one of my earlier posts. As is the "well it saved me from a head injury" argument.

Is there any research which says that wearing a helmet is completely unnecessary as it won't save you from any kind of injury?
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Kramer, helmets definitely reduce the level of injury. There is plenty of anecdotal, as well as my own personal evidence out there to persuade me. I don't need a scientific study. Where they didn't prevent death, death was probably inevitable anyway.


Last edited by Then you can post your own questions or snow reports... on Fri 24-02-06 17:38; edited 1 time in total
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Tim Brown wrote:
PP, helmet are very light, so the increase in mass is small unlike with motor racing helmets. Your helmet might help if your head connects with a rock during a tumble.


I'm not sure it is a mass problem but the fact that more of the shock gets transferred to the neck rather than absorbed by the head. This is a problem with climbing helmets which are not dissimilar to ski helmets these days.

If we extrapolate from other safety aids we can assume that helmet wearers will also, on average, tend to ski faster and take more risks so you may not be able to realise a benefit just by saying "everyone must now wear a helmet".

The other problem is that most ski helmets conform to the CE norm which, it can be argued, is unsuitable for high speed recreational type use on relatively crowded pistes as seen in 2006.

Personally I would like to see a study of what has happened in Italy where helmet use has been mandated for children. Hopefully a study by people who don't have some kind of vested interest (it seems helmet use studies all start out with the premise that mandating helmet use is a good thing.)
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Tim Brown, anecdotal evidence is worthless in assessing the effectiveness of a health intervention as it is frequently wrong. If you want to have an objective discussion of the best way of assessing these things with someone who knows something about how health interventions are best assessed then I'm happy to carry on with you. If you want to try and bait me by presenting your ill-informed opinion as fact then I'm not interested.
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davidof, the problem with looking at Italy is that you cannot extrapolate from children to adults. To the best of my knowledge it has been proven that it is beneficial for children to wear helmets.
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davidof, I thought modern helmets were designed to deform on impact?
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Kramer,
Quote:

Unfortunately you cannot know this for sure. You may feel that it is the case, but you cannot know for sure what would have happened in the same circumstances if you hadn't been wearing a helmet, it is impossible

I tend to disagree. My head was in the helmet but it was the helmet that ended up splitting. I think I can be fairly certain that if my uncovered head had hit a surface like concrete from a height of about 6 feet that I probably would have had at least a headache Skullie . As it happens, my (unprotected) shoulder suffered a nasty injury requiring an operation to fix it.
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Kramer wrote:
anecdotal evidence is worthless in assessing the effectiveness of a health intervention as it is frequently wrong.

Is the analysis for an intervention across a whole population (eg making helmets compulsory), different to decision making at an indivudual level (eg, I'm skiing GS gates and don't want to be bashed in the head by a spring-loaded pole)?
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 You know it makes sense.
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Kramer, calm down, lets not start a fight. Helmetts help to reduce injury, don't they? If not, then lets have your evidence for them being unnecessary.


Last edited by You know it makes sense. on Fri 24-02-06 17:56; edited 1 time in total
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rob@rar.org.uk wrote:
(eg, I'm skiing GS gates and don't want to be bashed in the head by a spring-loaded pole)?


Rob, this one is easy - don't wear a helmet, take a wider line! rolling eyes Laughing
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 Poster: A snowHead
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rob@rar.org.uk, that is an excellent example of a helmet reducing harm.
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Wear The Fox Hat wrote:
rob@rar.org.uk wrote:
(eg, I'm skiing GS gates and don't want to be bashed in the head by a spring-loaded pole)?


Rob, this one is easy - don't wear a helmet, take a wider line! rolling eyes Laughing


Laughing

Sometimes it's not the choice of line but an inability to stay on my feet that leads to a getting too close to the gate!.
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Martin Bell, Tim Brown, Caspar, I have not had a chance to review the literature re cycle helmets. However, an interesting observation is that one of the most prominent neurosurgeons in the UK who cycles to work on daily basis does not use a helmet.

The government probably had more accurate factual evidence for going to war with Iraq then for its cycle helmet policy. This policy was probably introduced when the opinion of 'experts' was more important then scientific evidence in support of such policy. Twisted Evil
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Kramer, "If you want to try and bait me by presenting your ill-informed opinion as fact then I'm not interested."

I've been careful not to do that.
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PP, how does wearing a cycle helmet cause more harm than good?
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Caspar, sorry, but scientifically speaking it is impossible to say what would have happened if you hadn't been wearing a helmet, there are too many variables in the biomechanics of trauma to make predictions of outcome possible on an individual basis. Speaking as a scientist, and a medic who has been involved in many trauma cases, you cannot tell what the outcome of a particular accident will be. I would ask you, how do you know for sure what the outcome would have been

One of the first things that we have understand when assessing these things is that results are often counterintuitive to what our instincts tell us.

rob@rar.org.uk, the analysis over a whole population should give you an idea of what course of action gives the greatest chance of the preferred outcome, so it tells you what the safest course of action to take is, however it will not predict the outcome on an individual basis, so it cannot guarantee that it will work.


Last edited by You'll need to Register first of course. on Fri 24-02-06 18:23; edited 1 time in total
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Kramer wrote:
rob@rar.org.uk, the analysis over a whole population should give you an idea of what course of action gives the greatest chance of the preferred outcome, so it tells you what the safest course of action to take is, however it will not predict the outcome on an individual basis, so it cannot guarantee that it will work.

OK, I understand that. So does that mean that my choice to wear a helmet (but not to insist that anyone else does) is a reasonable resonse to my circumstances, rather than a logical fallacy because so far rthe scientific community has failed to find a conclusive answer to the question of helmet wearing?
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rob@rar.org.uk, that is not what is being argued here. What Kramer (correct if I am wrong) and I are saying is that the risk benefit ratio has not been conclusively proven.



Tim Brown, would you feel safe if airlines or doctors applied your logic? 'Trust me Tim, I don’t need scientific proof, this pill in my experience is probably going to help you, although I cant be certain what if any side effects it may have' or ' I have taken off plenty of times in similar conditions and I have never had any trouble'. It is fine to make these types of decisions for yourself, but your reasoning cannot be applied to persuade others to do the same.
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Tim Brown, ok, maybe I took it in the wrong way. Very Happy
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Kramer, do you have access to the full report (ie are you a subscriber?)
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Tim Brown, dont know if it causes any harm but what i was trying to eluding to is that i am not sure if it’s of any benefit.

rob@rar.org.uk, oops i am a few posts too late.
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To my knowledge there have been three major studies looking at this, one found that helmets decreased your risk of having a severe head injury, perhaps at the cost of increasing your risk of a neck injury, the second found that it seemed to increase your risk of a head injury if you wore a helmet, and this one which AFAIK shows that wearing a helmet decreases your risk of a head injury, but didn't comment on the other types of injuries.
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Kramer wrote:
davidof, the problem with looking at Italy is that you cannot extrapolate from children to adults. To the best of my knowledge it has been proven that it is beneficial for children to wear helmets.


No but at least someone should do the study or even better just collate ski related injuries before and after helmet use was mandated for children then we can argue the toss over them here in our usual sH fashion. At least that would give us a clearer picture for the benefits (or not) for kids.

Personally I'm against mandating helmet use for adults but I would like to see a lot more information available so people could make informed decisions.

I"m not that interested in whether my doctor wears a helmet. 6/10 doctors I know smoke but that isn't going to make me take up the addiction.
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PG, I'm not a subscriber to JAMA. It is a well respected peer reviewed journal, on a par with the BMJ and the lancet, so papers accepted will be of a higher standard than in a lesser known journal, however given the quality of a lot of medical research unfortunately that doesn't always mean a lot.
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PP wrote:
rob@rar.org.uk, that is not what is being argued here. What Kramer (correct if I am wrong) and I are saying is that the risk benefit ratio has not been conclusively proven.

I'm not doubting that, and when there is a wide body of agreement I'll no doubt pay great attention to it. But I'm going skiing next week, so what should I do while we're all waiting for the scietific and medical community to reach a provable conclusion? My thinking so far has been descibed as a logical fallacy, but the answer from those possessing unflawed logic seems to be "we don't know whether it's a good thing or not".
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 Poster: A snowHead
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PP, I know the limitations of my helmet. I know I feel just as vulnerable in situations of high exposure. I don't expect it to save me from death in a 20mph impact with a tree. If my head does have a low speed impact with something, I fully expect my helmet to get dented and absorb some of the impact. In wearing a helmet, I'm not subjecting myself to medical experiments.
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davidof, I'm pretty sure that it is more clearcut in children, and in favour of helmets.
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rob@rar.org.uk wrote:
My thinking so far has been descibed as a logical fallacy, but the answer from those possessing unflawed logic seems to be "we don't know whether it's a good thing or not".


So it comes down to personal choice. Either go with the feeling that it has saved you in the past, or go with the feeling that you've skied for many years prior to that without needing one, but just be aware that you're basing your decision on a feeling and not facts. Very Happy
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Kramer, you could say the same thing about a seat belt, couldn't you?
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Kramer wrote:
but just be aware that you're basing your decision on a feeling and not facts. Very Happy

Not really. I'm basing my decision on facts from a study of n=1 rather than n=many. I well aware of the dangers of studies with n=1, but in the absence of any provable conclusions from studies of n=many it's the best that I have to go on. I don't think that's flawed logic, just me waiting until the scientific community gets its act together.
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Tim Brown, but you are taking a preventative measure without being certain that it will work or that it want expose you to unnecessary risk.
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OK, its Friday evening and i have a life. I am done. Very Happy
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Ye Gods I cannot BELIEVE we are still having these arguments rumbling on!! This week there is a set of statistics in favour of helmets; next week there will be another set against, and so on, and so on....... Cue another 10 page thread!

If you are anti-helmet becoz:

- they're heavy;
- they're hot;
- they're expensive;
- you prefer the wind whistling through your ears;
- you can't be bothered packing another piece of kit;
- you prefer your old wooly hat ya mum knitted;

then fine, I used to be anti-helmet too for (some of) those reasons. But don't tell me wearing a modern lightweight helmet doesn't make you less prone to MOST head injuries coz that is simply codswallop.
Before you ask: NO I am not going to produce any statistics or articles from the Lancet to back that up coz I cannot be bothered to spend hours trawling the internet for yet more statistics for us snowHead snowHead to argue about.

And can we PLEASE not have any more self-righteous "I SHOULDN'T BE FORCED TO WEAR A HELMET!!" rants. I don't know of a single resort that makes it compulsory for adults, nor do I know of any considering such a rule. So stop it.

Have a good weekend! Very Happy
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the ice perv wrote:
This week there is a set of statistics in favour of helmets; next week there will be another set against, and so on, and so on.......


and as a doctor part of my job is reading and making sense of those statistics, so forgive me if I try and claim a little expert knowledge on the subject.

the ice perv wrote:
If you are anti-helmet becoz:

- they're heavy;
- they're hot;
- they're expensive;
- you prefer the wind whistling through your ears;
- you can't be bothered packing another piece of kit;
- you prefer your old wooly hat ya mum knitted;

then fine, I used to be anti-helmet too for (some of) those reasons.


I'm not anti-helmet, I own and wear one, I also wear one when cycling, however I am aware that I'm making these decisions because I feel that it is the right thing to do rather than knowing it to be so. I don't think that enforced public health measures should be brought in on the back of rather flimsy evidence, which is what the FIS seem to be calling for.

the ice perv wrote:
But don't tell me wearing a modern lightweight helmet doesn't make you less prone to MOST head injuries coz that is simply codswallop.


Firstly it's not just head injuries that injure people, so to take it to extremes there's no point in a helmet saving your head if it breaks your neck in the process. The overall injury rate needs to be assessed rather than just specific areas.

Secondly, it's only clinically significant headinjuries that really matter, as they're what people expect to be protected from by wearing a helmet, and that case just isn't proven. We're not talking about the low energy bumps here, as they're not likely to cause any permanent damage, we're talking about the high energy impacts, where it certainly isn't proven that a lightweight helmet makes any difference.

the ice perv wrote:
Before you ask: NO I am not going to produce any statistics or articles from the Lancet to back that up coz I cannot be bothered to spend hours trawling the internet for yet more statistics for us snowHead snowHead to argue about.


Fine, then please don't refer to my evidence as "codswallop"!

the ice perv wrote:
And can we PLEASE not have any more self-righteous "I SHOULDN'T BE FORCED TO WEAR A HELMET!!" rants. I don't know of a single resort that makes it compulsory for adults, nor do I know of any considering such a rule.


Apart from the FIS who are reported as asking for such a rule in the article at the beginning of this thread.

the ice perv wrote:
Have a good weekend! Very Happy


And you too. Very Happy
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PS it's friday evening and I'm on duty at the out of hours service so I guess that I don't have a life tonight. rolling eyes
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