Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial

Abstract

ObjectiveTo determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft.DesignRandomized controlled trial.SettingPrivate or commercial aircraft between September 2017 and August 2018.Participants92 aircraft passengers aged 18 and over were screened for participation. 23 agreed to be enrolled and were randomized.InterventionJumping from an aircraft (airplane or helicopter) with a parachute versus an empty backpack (unblinded).Main outcome measuresComposite of death or major traumatic injury (defined by an Injury Severity Score over 15) upon impact with the ground measured immediately after landing.ResultsParachute use did not significantly reduce death or major injury (0% for parachute v 0% for control; P>0.9). This finding was consistent across multiple subgroups. Compared with individuals screened but not enrolled, participants included in the study were on aircraft at significantly lower altitude (mean of 0.6 m for participants v mean of 9146 m for non-participants; P<0.001) and lower velocity (mean of 0 km/h v mean of 800 km/h; P<0.001).ConclusionsParachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention. However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials might selectively enroll individuals with a lower perceived likelihood of benefit, thus diminishing the applicability of the results to clinical practice.

Conducting Value for Money Analyses for Non-randomised Interventional Studies Including Service Evaluations: An Educational Review with Recommendations

“…There are practical examples as part of the debate for [142] (here focussed on the Cancer Drugs Fund) and against [143] using RCTs, the 'against' here being a comedic look at using RCTs to assess parachute use to prevent death and major trauma when jumping from aircraft. The use of RCTs is debated relative to other options including nonrandomised, real-world, and observational data either with or without a comparison group, and using historical controls [13].…”

The Folly of the R: A Case Study

“…This real‐time case study has informed my decision to pass on the funding announcement that arrived in my inbox today. After all, many landmark papers have been published without NIH funding …”

What do renal stents and parachutes have in common?

“…A recently published, tongue in cheek, RCT "proved" that parachutes, compared to empty backpacks, were not effective in preventing death and/or major trauma when jumping from aircraft. 4 The article humorously illustrates the limitations of RCTs. In this study, the authors were able to ethically randomize two treatments, parachutes versus empty backpacks when jumping from aircraft, because the study cohort only jumped from the wing of a parked aircraft, about 2 ft above the ground.…”

“…How did we get to a place where a potentially very effective treatment, renal stenting, is believed to be no better than medical therapy alone? A recently published, tongue in cheek, RCT “proved” that parachutes, compared to empty backpacks, were not effective in preventing death and/or major trauma when jumping from aircraft . The article humorously illustrates the limitations of RCTs.…”