All those helmets posts in one place

Last year I went into some detail about why existing research into the efficacy and safety of helmets for cycling does not come close to the standard of evidence that is normally required and which we would usually demand for a medical intervention (which is what they are). Basically an application to helmets of all those things that Ben Goldacre bangs on about. But I never added an easy to link to contents page when it was complete. So here it is.

Killer Cures: a very brief introduction to why it is so important to do proper thorough research on medical interventions.

So what’s the best evidence we have on bicycle helmets?: a brief review of the research that has been performed on helmet efficacy — how it was done, what it found, and what the limitations of the methods were.

Headline figures: putting the relative risk figures reported by research papers into context of absolute risk.

What is a bicyclist?: looking at one of the major flaws in existing research on helmet efficacy — ignoring the differences between transport, leisure and sport cycling.

Would a helmet help if hit by a car?: a brief diversion into one of the side-arguments, but an important one given that most transport and leisure cycling deaths and serious injuries involve a motor vehicle.

Risk compensation and bicycle helmets: why it’s important to test for potential side-effects of interventions, some of the proposed side-effects, and why the research in this area also has too many limitations.

The BMA, the BMJ, and bicycle helmet policy: introducing the BMA’s position on helmets. Just one of several organisations with a dodgy position, but one that I think is particularly important/interesting.

How did the BMA get bicycle helmets so wrong?: a sort of conclusion piece, reiterating the importance of doing proper research on both the efficacy and the side-effects of medical interventions, and how an organisation which should know better managed to abandon this principle in favour of anecdotes for helmets.

Followed by some frivolous posts:

8 thoughts on “All those helmets posts in one place”

  1. I can’t imagine what prompted you to post this? :-)
    I’ve had a couple of conversations today where I have voiced my displeasure at the comments attributed to Mr. Wiggins – people look at me like I have fallen out of a tree, before asking “why shouldn’t helmets be compulsory?”. These people aren’t informed on the subject, nor are they particularly interested enough to listen for more than a few seconds as to why helmet laws are a bad idea. Has anyone come up with a “one-liner” that would answer this question, or at least provide the foundation for a reasoned discussion of the subject?

  2. Well done for posting these again, with a very nice introductory paragraph.
    I do think you should refer to http://www.cyclehelmets.org where the Bicycle Hemet Research Foundation gives additional evidence base to what you have been saying.
    I had to struggle against the usual prejudice when being interviewed on Sky News today on the subject (including reference to the now infamous fiction from Mayor Johnson that “63% of cyclist casualties are the legal fault of
    cyclists”.
    For Marchie’s one-liners:
    1. “There is no population based evidence because of the inefficacy of helmets and the behavioural adaptation/risk compensation of the helmeted cyclists and maybe other road users”.
    2.”You are unlikely to need one more than you do in a car, and they aren’t much good if you do”.
    3. “if Brad Wiggins wants to deliberately engage in road racing where competitiors have dozens (if not hundreds) times more of a chance of serious injury than a normal cyclist, that’s fine. But it doesn’t make them qualified to pontificate on cyclist safety”

  3. “Has anyone come up with a “one-liner” that would answer this question, or at least provide the foundation for a reasoned discussion of the subject?”

    How about: “I used to agree with you – would you like to hear how I came to change my mind?”

  4. Here’s my response: “Thank-you for your interest in cyclist safety! Everyone has all heard, many times, how important helmet usage is. If you really would like to make cycling safer, let’s campaign for safer streets which prevent collisions.”

    Another way to put it, “Why is it that places which have no culture of wearing helmets have less serious injuries and fatalities on bicycles? Perhaps there are other things, besides helmets, which we can also look into?”

  5. My one liner is “A helmet’s not going to stop a dangerous driver from driving dangerously.” Also “The one time I came off my bike, the thing I wish I’d worn more than anything else was bigger knickers.”

  6. One of the quicker methods I use occasionally is to cheerfully state something like, “oh no dear, I don’t ride competitively, I just use my bike for getting around”

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