Cycle mag, CTC finally caved in re helmets & sold us out?

For all discussions about this "lively" subject. All topics that are substantially about helmet usage will be moved here.
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pjclinch
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by pjclinch »

mjr wrote:
pjclinch wrote:With smoking we're on pretty safe ground saying no good will ever come of it to someone pulling on a cigarette, but that's not a fair conclusion for a random person wearing a cycle helmet.

Not a fair conclusion from current evidence. We might simply still be at the same primitive stage with helmets as with cigarettes in the early 1900s, with experts regarding them as possibly useful for some people, with some experts still promoting them as good for most people. I think there are many more aspects worth studying before we know the full picture because the current data doesn't seem to explain even my negative experiences. Time will tell, hopefully before it's too late either way.


That's fair, although I'd think you'd need to know rather more about the "random person" than simply if they were wearing a lid or not (where do they ride, how do they ride, is either affected by the helmet, etc. etc.)

Though also worth noting S&G's thinking that, "In any case, the current uncertainty about any benefit from helmet wearing or promotion is unlikely to be substantially reduced by further research".

My main hope is TPTB coming to the realistaion that an effect against serious injury of "about zero, plus or minus error bars (and we're not really sure how big the error bars might be)" is not a rational basis for promoting something as a major health must-have.

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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by Steady rider »

Here’s an editorial I wrote in the British Medical Journal with David Spiegelhalter, about the complex contradictory mess of evidence on the impact of bicycle helmets.


OK they think the evidence is contradictory but the evidence may be viewed in various ways. I am proposing just focusing on the accident rate part, the rest - health, enforcement, fines, individuals reports, bike share, safety aspects (part includes the accident rate) are all important and can be considered as extra detail. The individual and society at large needs to know if the accident rate increases with helmet use. A one day conference may be worthwhile to focus on this one aspect. If York could provide a suitable venue this may be a good location for travel purposes. A suitable venue may at http://www.priorystreetcentre.org.uk/

If the accident rate aspect is better understood then the whole topic may become a little clearer.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by pjclinch »

Steady rider wrote:
Here’s an editorial I wrote in the British Medical Journal with David Spiegelhalter, about the complex contradictory mess of evidence on the impact of bicycle helmets.


OK they think the evidence is contradictory but the evidence may be viewed in various ways. I am proposing just focusing on the accident rate part, the rest - health, enforcement, fines, individuals reports, bike share, safety aspects are all important and can be considered as extra detail. The individual and society at large needs to know if the accident rate increases with helmet use. A one day conference may be worthwhile to focus on this one aspect. If York could provide a suitable venue this may be a good location for travel purposes. A suitable venue may at http://www.priorystreetcentre.org.uk/

If the accident rate aspect is better understood then the whole topic may become a little clearer.


As well as thinking what has been published is contradictory, there is the further point that “what is the effect of wearing a helmet?” and the question is "methodologically challenging and contentious".

One reason it's so damn hard to pull out hard numbers is there are so many inter-related factors. Case control famously produces mince here, and that's because if you're doing it properly there are (at least notionally) no differences bar your intervention between the case and control groups. But as Thompson, Rivara and Thompson have so well demonstrated (if only they realised themselves!) factoring out all of the other differences is "non-trivial". Another reason hard numbers are hard to come by are the effects mainly appear to be quite small and subtle, which makes the data produced by their sum very tricky to untangle. Trying to pull a single strand out and quantifying it is, as they said, "methodologically challenging and contentious".

If you've got a scheme that isolates effects on crash frequency purely to terms relating to helmet wearing then I'd be interested to hear it, and if it would work I'd be very pleased, but TBH I'm not holding my breath. Considerable stats-fu has been applied to these issues and where it's produced good (ish ??) results they're pretty broad brush: stuff like the conclusion that mandatory helmet laws have not clearly been a Big Health Win is a very useful thing to know, but in terms of granularity it is a very long way from saying whether I'm more or less likley to crash on my trundle home if I put a lid on or not.

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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by Steady rider »

Pete, I think your are about right. A change in behaviour due to wearing one could easily affect the accident rate. I think people change their behaviour to take account of risk/benefits and is part of human nature or animal nature. There are other aspects of wearing a helmet that may be possible to measure/detect and some progress may be possible.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by TonyR »

Steady rider wrote:OK they think the evidence is contradictory but the evidence may be viewed in various ways. I am proposing just focusing on the accident rate part, the rest - health, enforcement, fines, individuals reports, bike share, safety aspects (part includes the accident rate) are all important and can be considered as extra detail. The individual and society at large needs to know if the accident rate increases with helmet use. A one day conference may be worthwhile to focus on this one aspect. If York could provide a suitable venue this may be a good location for travel purposes. A suitable venue may at http://www.priorystreetcentre.org.uk/

If the accident rate aspect is better understood then the whole topic may become a little clearer.


So what are you going to do at this conference? Sit and speculate about what the relationship might be? That will get us no further forward as its all speculation. Examine the data that is available on the relationship? Well, you can do that in a few minutes there is so little data on the topic and what there is is not going to help you much because the methodology is so poor. Design new experiments? Well Goldacre and Spiegelhalter have concluded that is unlikely to reduce the uncertainty. So I'm not sure what you are actually going to do that will take a day nor how it will help.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by Tonyf33 »

here you go ctc, I'm sure the photographer would let you have this pic for nowt for the next edition of cycle.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by Steady rider »

So what are you going to do at this conference?

We know its a difficult topic, so examining one aspect in detail may lead to recommending more research or recommending warnings be included in some publications. The accident rate could be assessed by;
A) comparing wearers to non-wearers in some form
B) comparing injury stats following a higher proportion wearing helmets
C) considering the physics and applied science to wearing a helmet
D) risk compensation considerations by cyclists or drivers or guardians
E) The issue of extra impacts plus any effects on head rotation and linear accelerations could be considered.

From this approach, fine tuned research may seem possible to try and quantify or establish effects and if suitable input came from a one day conference, recommendations may be possible. Universities may be able to build on this basis. If on the other hand the issue was still unresolved and the potential higher accident rate not fully explained, then there would be a weak basis for insisting on wearing helmets from a safety point of view. Some people may gain in having a better understanding of the pros and cons of helmets, depending on the information provided and input from those attending.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by pjclinch »

Steady rider wrote:
So what are you going to do at this conference?

We know its a difficult topic, so examining one aspect in detail may lead to recommending more research or recommending warnings be included in some publications.


That it's difficult should be enough for the warning. But if you've got lots of inter-related factors then the whole point is you can't "examine one aspect in detail". That way lies 85% cuts in head injuries...

Steady rider wrote:The accident rate could be assessed by;
A) comparing wearers to non-wearers in some form
B) comparing injury stats following a higher proportion wearing helmets
C) considering the physics and applied science to wearing a helmet
D) risk compensation considerations by cyclists or drivers or guardians
E) The issue of extra impacts plus any effects on head rotation and linear accelerations could be considered.


A) suffers as already noted. To do it right you need to be sure that the wearers are identical in all respects to the non-wearers except for their helmets, and even if you could do that impossible thing you can't have a properly randomised sample. If you're testing a drug you won't alter your behaviour much according to if you might have a placebo, but if you knew you might be wearing a fake helmet you'd be rather likely to do things as if you were sure you were. And so on. Read the critiques of You-Know-Who... it's just as hard proving they're a problem as proving they're a benefit.

B) is better, but we've been there already and it's pretty broad brush. We get to find out mass effects but we can't detect ecological fallacies (those who benefit as individuals even though the overall population is worse off, or vice versa), so we can't say if a random subject is better or worse off. We also have quite a lot of noise (reporting standards vary, for example), and because only serious injuries are reported to any degree of usefulness they're the only things we learn about (shame really, since helmets aren't designed for these but for minor stuff, and minor stuff's the most likely outcome of the loss of balance you want to look at).

C) loses the psychological aspects. Go and read up on seatbelts.

D) devilishly hard to pin down, like a lot of psychological things. At least in part because it doesn't work predictably on a given subject. Take, for example, two archetypal helmet wearing groups, the risk averse, wearing because they're particularly worried, and the risk seekers, wearing so they can do riskier things. If you just identify someone by "is wearing a helmet" they could be in either.

E) They could be, though at the end of the day you''ll have to decide how many (probably relatively common) abrasions and headaches are worth a (probably relatively rare) twisted neck, and even if you can do that then the lack of decent data about how many abrasions and headaches you're actually getting rather throws a blanket over that one. And so on.

Steady rider wrote:From this approach, fine tuned research may seem possible to try and quantify or establish effects and if suitable input came from a one day conference, recommendations may be possible. Universities may be able to build on this basis. If on the other hand the issue was still unresolved and the potential higher accident rate not fully explained, then there would be a weak basis for insisting on wearing helmets from a safety point of view. Some people may gain in having a better understanding of the pros and cons of helmets, depending on the information provided and input from those attending.


There already is a weak basis for helmets from a safety point of view. The problem is not the (lack of) evidence, it's that it's a political matter decided by people with no idea but who think they have a very good one underpinned by their "common sense", with wide support of a "common sense" empowered public. From an evidential point of view all you should need is what you already have: for serious injuries around zero plus or minus error bars across populations. That the effects are so small are why they are, to quote that editorial again, "too modest to capture".

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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by horizon »

pjclinch wrote:Helmet wearing is normal.


Helmet wearing in our view (yours and mine) isn't normal. What you meant was that people normally wear helmets.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by pjclinch »

I take that as being the same thing. There is no need for it to be normal, but it is.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by horizon »

I think it's what has created this discussion. Is this a normal picture of a normally attired person? The huge irony is that a single picture of an unhelmeted rider is completely banned in most media (e.g. the BBC). They at least know the power of a single image even if the CTC doesn't. As does the entire UK advertising and photographic image industry. So at least in that sense Tonyf33 has some pretty impressive backing - a huge swathe of media and communication professionals. This photo, for the helmet manufacturers, was a winner. And not only didn't they have to pay a penny for it, the CTC paid for it themselves. You couldn't make it up. It's the CTC's bacon sandwich moment and a triumph for the pro-helmet lobby IMV.

It might have been a small pond but it was a pretty big fish.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by bovlomov »

horizon wrote:The huge irony is that a single picture of an unhelmeted rider is completely banned in most media (e.g. the BBC). They at least know the power of a single image even if the CTC doesn't. As does the entire UK advertising and photographic image industry.
Yes.

It seems unreasonable to ban images of helmeted riders from the cover of Cycle, but that tiny act of unreason would pale into nothing against the backdrop of censorship of bareheaded riders. If it was about race or gender, then many would be arguing for positive discrimination.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by beardy »

and many would not. I would not begrudge Steven Abraham appearing on the front page if the only picture available was him in a helmet if he had broken the record for annual mileage. Though plenty of pictures are available of him riding without one.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by bovlomov »

beardy wrote:and many would not.

I'm only making the point that it's hard to stand your ground when the crowd is shoving you in a direction you don't want to go. It's tempting to shove back.

A cover picture chosen to illustrate an endurance feat would be one thing, but the picture in question hardly had any relevance even to cycling. Was it there to draw attention to the Bike to Work feature? It hardly looks like someone riding to work. A helmet may appear because an image relevant to an article happens to show a helmeted rider, but that rider is a model and the picture has only a tenuous link to the content. That's what makes it especially annoying.
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Re: Cycle mag, CTC finally caved in re helmets & sold us out

Post by mjr »

horizon wrote:
pjclinch wrote:Helmet wearing is normal.


Helmet wearing in our view (yours and mine) isn't normal. What you meant was that people normally wear helmets.

Huh? It's still a minority of riders, isn't it? Not that you'd know it from magazine photos...
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