Can I say that I've tried hard all my life to follow reports of research and to make decisions on my own helmet wearing that are based on evidence? I've got a science degree, so some ability to follow papers, but I'm only a physicist
But I'm finding it hard to take anything that I can use from this discussion. It's difficult to see a summary view. There are plainly two sides here, but they aren't clearly engaging with each other or going anywhere. So I'm going nowhere.
As things stand, I've been reluctant to wear a helmet. I've been very aware of the deficiencies of Thompson and Rivara, and therefore surprised that they were invited to prepare the Cochrane Review, and even more so that the review so much emphasised their own work and derivatives. There have definitely been some studies that were more impressive, especially hospital studies that used other injuries to control for the kind of error that T&R evidently made, and that found positive results. But strongly positive results are difficult to accept, precisely because there doesn't seem to be much corresponding real-world population-level evidence, except where the effect was probably to reduce levels of exposure. So, in a way, the more positive the results, the less likely they are to be true.
From the physics point of view, I'm really aware that most of the massive difference between falling off at 12mph and being hit by a heavy car at even 20mph, which on the face of it makes it nearly impossible for a device designed for the former consistently to make a substantial difference to the latter. Again, therefore, the bigger the claims, the less likely they are.
I've just looked at Olivier et al cited here but, in a world where so many studies are criticised on methodological grounds, I didn't see an effort to establish what were reliable methodologies and to filter accordingly. Nor is there any obvious accounting for later critiques. It feels a bit like quantity over quality (without of course having read any of the primary research, so not really an attempt to make what would anyway be unqualified comment!)
I'm impressed by Goldacre (who appears to be more truly disinterested, and yet better qualified, a commentator than anyone), as well as what Chris Boardman says about making cycling look dangerous - and that almost any other measure would have more effect. So I've tended to follow Cycling UK's statement as a broad position. But it has not escaped me, for example, that that refers to neck injuries, which Olivier et al describe as rare, which would if true mean that at least some update were needed to that statement.
I'm very much in agreement with mattheus here, as well:
mattheus wrote: ↑7 Dec 2021, 4:14pmI'm not worried about a few bumps, cuts and scrapes.On my head, or my knees, elbows, hips etc etc ... I've had worse driving my car! If I thought a lid would make my brain *significantly* safer, I might well be persuaded to wear one.
The critical point here being that it is perfectly possible for helmets to reduce scalp injuries and yet increase brain ones so, whilst I'm not asserting that to be the case, it's pretty important to be clear what we're measuring! So any study worth including in a review is going to be explicit about that.
So where from here? Do we invite both sides to state cases in clearer ways? Is there any way to reach a new assessment? Should I be rethinking? (More convincing answers please than "Of course (not)!"