Every Christmas issue of the British Medical Journal, now known simply as the BMJ, has some really fun articles. I haven’t opened this year’s issue yet but when I picked it up from behind my door just now a study from old BMJ Christmas issue came to mind. It was a systematic review of the evidence base for the use of parachutes. In the introduction they say –
The perception that parachutes are a successful intervention is based largely on anecdotal evidence. Observational data have shown that their use is associated with morbidity and mortality, due to both failure of the intervention1 2 and iatrogenic complications.3 In addition, “natural history” studies of free fall indicate that failure to take or deploy a parachute does not inevitably result in an adverse outcome.4 We therefore undertook a systematic review of randomised controlled trials of parachutes.
The authors completely failed to find a single randomised controlled trial of parachute use! This article is typical of the BMJ Christmas editions. It’s funny, tongue in cheek, but thought-provoking and makes serious points through the use of humour. I love their conclusion –
Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.
Any volunteers? (and, no, you’re not allowed to volunteer anybody else!)
Heroes Not Zombies 
Think I will sit this trial out, ha! Fun post.
When it comes to parachuting, an old saying does not apply:
“If at first you do not succeed, try, try again.”
drtombibey.wordpress.com
. . . . if only the closed minds associated with evidence based practice (EBP) could open like a parachute, feel the wind beneath their thoughts moving them on to greater possibilities unencumbered and free. Currently the EBP clan just hurtle to the ground and their peril, unfortunately with many trusting individuals caught in the iatrogenic slip stream. Personally I prefer having the choice to jump or not jump.
Bob, thank you for the work you put into this Blog I have found many pearls of wisdom within these electronic pages and look forward to finding many more. Have a Happy Christmas and all the very best for 2008.
Bob,
I do hope your homeopathic readers will understand the nature of the parachute parody and not come to any silly interpretation that common sense is better than proper studies.
My criticisms of homeopathy are that it thrives off such fallacies. I do hope you are not adding to them. We shall see if the parachute analogy crops up in discussions elsewhere.
Perhaps you might like to explain to your less scientifically literate readers why this is a parody and has no applicability in the case of homeopathy.
But anyway, merry xmas. off for a while…
Tongue-in-cheek indeed! Thanks for the wonderful laugh!