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In a Parachute-Effectiveness Trial, Who Gets the Placebo?

How do we know that parachutes are really a good treatment for preventing serious injury in someone falling from an airplane?

That’s the subject of this tongue-in-cheek paper on the limits of evidence-based medicine, written by two physicians and published in the British Medical Journal.

After applying to parachutes the guidelines usually used to test new drugs, the authors find that, since nobody has ever conducted a placebo-controlled trial on parachutes, the only evidence we have of their effectiveness is “anecdotal” and worthy of healthy skepticism:

It might be argued that the pressure exerted on individuals to use parachutes is yet another example of a natural, life-enhancing experience being turned into a situation of fear and dependency. The widespread use of the parachute may just be another example of doctors’ obsession with disease prevention and their misplaced belief in unproved technology to provide effective protection against occasional adverse events.

Ian Ayres tackled evidence-based medicine on this blog back in March. What he found made him feel a little better about going to the dentist.