Gordon Ramsey's message...

[853]

For those of you short of time, the above link is to an article from May 2013 from thebmj (a medical journal wholly owned by the British Medical Association). The article is based on the findings of this paper ...

No it's not. It's based on decades of experience of the cycle helmet debate in general, taking the paper mentioned as a starting point to say that the body of literature on helmets isn't conclusive because it isn't consistent and goes on to give some of the reasons that is so and problems that have yet to be overcome in the field.

Yes it is.

The paper you linked to is called

Thebmj01.jpg (7.19 KiB) Viewed 8460 times

On line 7 it contains a link to the paper I mentioned. It is the only link in the paper

Thebmj02-line7.jpg (5.55 KiB) Viewed 8460 times

On lines 9-11 it says the following:

Other ecological studies have come to different conclusions, but the current study has somewhat superior methodology—controlling for background trends and modelling head injuries as a proportion of all cycling injuries

And at the bottom it is stated as research - the only research for the paper.

Thebmj03-bottom.jpg (4.74 KiB) Viewed 8460 times

The editorial says how the research to date doesn't seem to have solved anything, and you then take the single paper taken as a start point and treat it as though it's conclusive.

That's not true, either. This is what I actually said

As we haven't been discussing legislation, (from either perspective), it's not exactly comparing apples with apples - but it does offer some data. Below are the results and conclusions from the abstract (there's a lot more info if you've got the time to read it)

[pjclinch]

For those of you short of time, the above link is to an article from May 2013 from thebmj (a medical journal wholly owned by the British Medical Association). The article is based on the findings of this paper ...

No it's not. It's based on decades of experience of the cycle helmet debate in general, taking the paper mentioned as a starting point to say that the body of literature on helmets isn't conclusive because it isn't consistent and goes on to give some of the reasons that is so and problems that have yet to be overcome in the field.

Yes it is.

No, it very briefly uses the named paper as a start point and then is about the complex contradictory mess of evidence on the impact of bicycle helmets.

The paper you linked to is called

Canadian legislation had minimal effect on serious head injuries

It's called "Bicycle Helmets and the Law".

On line 7 it contains a link to the paper I mentioned. It is the only link in the paper

It links to that because, as explained, that's the start point to initiate a general discussion.

On lines 9-11 it says the following:

Other ecological studies have come to different conclusions, but the current study has somewhat superior methodology—controlling for background trends and modelling head injuries as a proportion of all cycling injuries

And at the bottom it is stated as research - the only research for the paper.

The short paragraph you highlight is the only mention or discussion of that particular paper in a nine paragraph editorial.

Actually there are other research papers referenced, as you'll see in the References (12 citations in all, not many for a paper, but this isn't a paper, it's s brief editorial comment dealing in the generalities of the field and not much about specific papers, because there are hundreds).

The editorial says how the research to date doesn't seem to have solved anything, and you then take the single paper taken as a start point and treat it as though it's conclusive.

That's not true, either. This is what I actually said

As we haven't been discussing legislation, (from either perspective), it's not exactly comparing apples with apples - but it does offer some data. Below are the results and conclusions from the abstract (there's a lot more info if you've got the time to read it)

It's fair to criticise my use of "treat it as though it's conclusive", but the point remains that you concentrated on a paper briefly mentioned in the editorial rather than the editorial I actually highlighted itself. The editorial mentions the paper you concentrated on briefly in one paragraph before leaving it completely, with no mention of it at all in its concluding paragraph.

That concluding paragraph again, actually very important:

In any case, the current uncertainty about any benefit from helmet wearing or promotion is unlikely to be substantially reduced by further research. Equally, we can be certain that helmets will continue to be debated, and at length. The enduring popularity of helmets as a proposed major intervention for increased road safety may therefore lie not with their direct benefits—which seem too modest to capture compared with other strategies—but more with the cultural, psychological, and political aspects of popular debate around risk.

Pete.

[853]

Pete

The more you try to twist the facts to support your opinion, the more you look like someone who tries to twist the facts

[cycle tramp]

Pete

The more you try to twist the facts to support your opinion, the more you look like someone who tries to twist the facts

At this point, I'd like to point out that no one is actually anti helmet on this forum, we're pro-choice, based on our own experiences.
Unless Pete has failed to accurately quote those segments of the report to which he refers, then there's no facts to twist.

..yes helmets may be affective at reducing incidents of head injury, within certain parameters... however they don't reduce the chances of collision, nor do they assist with your balance...

It's a polystyrene bowl, not a force field generator

[853]

Pete

The more you try to twist the facts to support your opinion, the more you look like someone who tries to twist the facts

At this point, I'd like to point out that no one is actually anti helmet on this forum, we're pro-choice, based on our own experiences.
Unless Pete has failed to accurately quote those segments of the report to which he refers, then there's no facts to twist.

Read the thread, and in particular read the two papers from thebmj that we have just been discussing

[pjclinch]

Pete

The more you try to twist the facts to support your opinion, the more you look like someone who tries to twist the facts

At this point, I'd like to point out that no one is actually anti helmet on this forum, we're pro-choice, based on our own experiences.
Unless Pete has failed to accurately quote those segments of the report to which he refers, then there's no facts to twist.

Read the thread, and in particular read the two papers from thebmj that we have just been discussing

The "two papers we have just been discussing"...
I quoted an editorial that takes a paper as a start point and quickly leaves it to talk about the general issues of the whole field. You have by and large ignored the contents of the editorial and started going on about the paper which it only gives a short paragraph about and I haven't been discussing. You did manage to get the editorial's title wrong and miss most of the references.

So, which facts have I twisted? Specifics please.

Pete.

[cycle tramp]

Pete

The more you try to twist the facts to support your opinion, the more you look like someone who tries to twist the facts

At this point, I'd like to point out that no one is actually anti helmet on this forum, we're pro-choice, based on our own experiences.
Unless Pete has failed to accurately quote those segments of the report to which he refers, then there's no facts to twist.

Read the thread, and in particular read the two papers from thebmj that we have just been discussing

Yeah, I have been.... but at this point you're gonna have to give us a clue where Pete's quotes are different from those in the papers, because I can't spot the differences...

[mattheus]

At this point, I'd like to point out that no one is actually anti helmet on this forum, we're pro-choice, based on our own experiences.
Unless Pete has failed to accurately quote those segments of the report to which he refers, then there's no facts to twist.

Read the thread, and in particular read the two papers from thebmj that we have just been discussing

Yeah, I have been.... but at this point you're gonna have to give us a clue where Pete's quotes are different from those in the papers, because I can't spot the differences...

Ditto.

[Mike Sales]

The New Zealand experience.

You will note that the figures are from the New Zealand Government Ministry of Transport

I should point out that this is the Helmets & helmet discussion section, and we have been discussing head injuries and ways of preventing them.

Your graph is from New Zealand, probably the furthest country you could select from the UK. It is for the period 1988-2011, and it is now 2024, and is for total injuries - Not head injuries. It has no relevance to the discussion

The graph that you have cherry-picked actually comes from https://www.cycle-helmets.com/zealand_helmets.html and says so at the bottom. If you had chosen to do so, you could have selected this one, which shows a reduction in deaths and injuries over a wider and more recent period of time.


New Zealand.jpg

Below the graph you will find also a reference to the NZ Transport Ministry
There are two parts to making a graph like this. First the data are gathered, then put into graphical form for readier comprehension.
The website gives the source of the figures as the government department and the University of Otago.
Do you think that the distance to the antipodean source means makes any real difference to the validity of the conclusions?

I provided a link to the cycle helmets.org site a couple of posts earler.

[853]

The "two papers we have just been discussing"...
I quoted an editorial that takes a paper as a start point and quickly leaves it to talk about the general issues of the whole field. You have by and large ignored the contents of the editorial and started going on about the paper which it only gives a short paragraph about and I haven't been discussing.

So, which facts have I twisted? Specifics please.

You have, repeatedly, steered this thread back to the first paper, which you have described as an editorial and has not been externally peer reviewed, and away from the paper it links to which it describes as having "somewhat superior methodology" and is the research. The editorial actually refers to it as "The linked paper".

The linked paper https://www.bmj.com/content/346/bmj.f2674 contains considerable research which is essential to any proper discussion on this thread and it is peer reviewed.

Short editorial or quality peer-reviewed research is the question. Why do you try to avoid discussion on the research?

[pjclinch]

The "two papers we have just been discussing"...
I quoted an editorial that takes a paper as a start point and quickly leaves it to talk about the general issues of the whole field. You have by and large ignored the contents of the editorial and started going on about the paper which it only gives a short paragraph about and I haven't been discussing.

So, which facts have I twisted? Specifics please.

You have, repeatedly, steered this thread back to the first paper, which you have described as an editorial and has not been externally peer reviewed, and away from the paper it links to which it describes as having "somewhat superior methodology" and is the research. The editorial actually refers to it as "The linked paper".

Of course I have repeatedly steered this thread to that because it underpins the point I am trying to make. That's why I brought it up in the first place. I didn't bring up the "linked paper" it uses as a start point for the very reasons outlined in the editorial: the peer reviewed literature is not conclusive, rather it is a complex contradictory mess of evidence, i.e., beware concluding too much from the peer reviewed literature because it has yet to overcome numerous confounders such as those highlighted in the editorial.

I describe it as an editorial because that's what it says it is (just above the actual title).
"Somewhat superior methodology" is not the same as "they've solved all the problems", I think more an indication that they're at least trying to fix some of them.
you persist in misunderstanding the link. The editorial simply uses it as a jumping off point for further discussion, i.e., "this has just been published, it uses some interesting methods but it probably won't settle much because of this list of things that continue to dog research in the area."
If it were a particular discussion of that particular paper the authors would more likely just use the response facility of the paper itself rather than write an editorial for separate publication that briefly mentions it in one paragraph of nine.

The linked paper https://www.bmj.com/content/346/bmj.f2674 contains considerable research which is essential to any proper discussion on this thread and it is peer reviewed.

Short editorial or quality peer-reviewed research is the question. Why do you try to avoid discussion on the research?

The editorial is exactly "discussion on the research". That's the whole point of it. That's why the authors wrote it. That they consider cycle helmet research problematical is why they "dread questions about bicycle helmets", which they wouldn't do if all they had to do was say, "read the linked paper, it tells you all you need" or "just do a systematic review of the literature, that'll sort it" rather than "here's a big list of problems the peer reviewed research hasn't really managed to deal with yet".

Considering the linked paper really needs to be done in light of the whole body of peer reviewed research, not just cherry picked on its own. The editorial considers the overall body of research. It is not peer reviewed because the nature of the beast means it's pretty much impossible to do with a sane word count on top of very busy day jobs. Given the backgrounds of the authors, if they thought that e.g. a systematic review of hospital case/control studies would solve it I'd think they'd say so, but instead they list a stack of reasons why hospital case/control is very poorly suited to measuring helmet and helmet policy efficacy.

If it were the case that "this isn't peer reviewed so it must be junk" had much credence here then a) the authors wouldn't have bothered writing it and b) the BMJ wouldn't have bothered to publish it. But with two eminent figures in the field saying they've been stumped by the nature of the beast and willing to say so they figured that's worth publishing in a field where "the enduring popularity of helmets as a proposed major intervention for increased road safety may therefore lie not with their direct benefits—which seem too modest to capture compared with other strategies—but more with the cultural, psychological, and political aspects of popular debate around risk" and where the answers appear to be "methodologically challenging and contentious".

That the authors are good in this field doesn't make them right, of course, but their track record means their opinion does at least demand respect beyond "oh, this isn't peer reviewed, it's clearly not worth the bother".

And still waiting to hear which facts I've twisted.

Pete.

[853]

And still waiting to hear which facts I've twisted.

Here's a few for a start

EN1078 is designed for falls with no other vehicle involved. As soon as a rider collides with a motor vehicle at speed you're totally beyond the spec and you cannot realistically assume it will make much difference. That's why motorcycle helmets are massively more protective (but still very fallible).

Not sure where you've got this from, I never mentioned a cyclist-motor vehicle collision

Let me remind you how you brought up the threat of them:
"then so can ordinary cyclists with lesser bike handling skills, inferior equipment, and motor vehicles passing them in both directions."
If these vehicles and colliding with them isn't an issue, why bring it up?

I was talking about passing vehicles restricting the available road and the best 'line' to avoid obstructions and potholes, but you managed to turn this into a cyclist-motor vehicle discussion

Your faith in EN1078 helmets to save lives is not backed up by reality. They're a couple of centimeters of expanded polystyrene that cover part of the head, they can't be expected to work miracles and their track record doesn't make it obvious that they do.
But also your apparent assumption that anyone falling off without a lid is almost asking for a serious head injury is, while quite common, not one that stands scrutiny.

I never mentioned EN1078.

You mentioned helmets. By far the most common spec for cyclehelmets is EN1078, so unless you qualify any mention with a higher spec like Snell B95 it's pretty much a given that "cycle helmet" is the same as "EN1078 cycle helmet".

As I'd never mentioned EN1078, I can't have expressed my faith in it to save lives.

I never said helmets, of any description, for any use, save lives.

You clearly implied, with your emphasis of death of a rider that wasn't wearing one as a reason for people to wear one, that you think there's a significant chance your tragic example would have been different with a helmet. If you didn't think it would have been different, why bring it up?

I didn't say that, another member did. Stating a fact does not mean something is clearly implied.

I never said, or implied, that "anyone falling off without a lid is almost asking for a serious head injury". I suggest that you read what I did say before making false assertions.

But you did imply it, saying all the things that can bring riders down and how important it is to wear helmets while not feeling any other protection worth mentioning.

Again, stating the facts does not imply anything.



And I'm still waiting to hear why you continue to avoid discussion on the research?

[cycle tramp]

And I'm still waiting to hear why you continue to avoid discussion on the research?

For a meaningful discussion to take place one or both parties engaging in the discussion should be prepared to change their point of view....otherwise what you have isn't a discussion but eventually an arguement and if enough people join in a war
..and both sides must enjoy the discussion - if one of the parties begins to accuse the other of something, then it is probable they will cease in their dialogue, and quite frankly who can blame them.

[pjclinch]

And I'm still waiting to hear why you continue to avoid discussion on the research?

For a meaningful discussion to take place one or both parties engaging in the discussion should be prepared to change their point of view....

For those unaware of my particular history on this, I bought my first helmet in the late 80s with my first Proper Touring Bike because it struck me as the sort of sensible thing a Proper Touring Cyclist (as I aspired to be) ought to do, and I wore a lid for practically every trip I took in the 90s. If anyone can be bothered to comb through the Usenet archives for uk.rec.cycling you can probably find me telling people it's daft not to wear a helmet and of course you'll be safer with more protection and all the things you generally hear.
Getting on towards the end of the century there was a helmet flamewar going on (if you can imagine such a thing) and one of the participants said if I read the primary research myself I'd change my mind. My first thoughts were I was dealing with some libertarian loon who wasn't worth listening to, but my second thoughts were here's me, a science professional with full access to a medical research library, I'll prove he's an idiot, with citations! So, armed with the cyclehelmets.org critiques pointed out by the person whose idiocy I was setting out to demonstrate, I went in to the library to pick them apart and show how the peer reviewed literature trumped it... But it didn't turn out like that. The more I read, the less clear everything became. Some of the howlers picked up by cyclehelmets.org really were howlers, and there was nothing like a consistent train of methodology or results.
So I downgraded my opinions of how important cycle helmets were, but I did keep on wearing one because, well, it still seemed daft not to, though I was much less keen to call anyone who didn't wear one daft and stopped trying to push them. And a bit after that I started going out with a Dutch lady, and we visited Amsterdam, flying out and hiring bikes. I figured I could probably manage Amsterdam without a helmet so to keep the luggage more manageable I left it behind. That long weekend I counted hardly any people in helmets, and all those that were were either tourists or sports riders. My rationalisations about how it was daft not to wear one pretty much evaporated that weekend and I stopped using one for utility and touring cycling.

So I can change my mind on this. I have, quite dramatically. And if it turns out that someone comes up with compelling evidence that I really am much safer with some New! Improved! lid on I'll be happy to be safer. Why wouldn't I?

Pete.

[pjclinch]

And still waiting to hear which facts I've twisted.

Here's a few for a start

Not sure where you've got this from, I never mentioned a cyclist-motor vehicle collision

Let me remind you how you brought up the threat of them:
"then so can ordinary cyclists with lesser bike handling skills, inferior equipment, and motor vehicles passing them in both directions."
If these vehicles and colliding with them isn't an issue, why bring it up?

I was talking about passing vehicles restricting the available road and the best 'line' to avoid obstructions and potholes, but you managed to turn this into a cyclist-motor vehicle discussion

My central point on being forced off line was that if you can't be sure you're going to be on a decent road then riding a bike that is significantly more likely to come a cropper if it's not a decent road isn't your best way to stay safe.
I brought up the way you mentioned a car hitting a rider from behind as sounding like a collision to me, you clarified that it would be a clip to provoke a subsequent crash rather than a full on collision and I conceded that point: fair enough this is a different aspect of "collision"

You mentioned helmets. By far the most common spec for cyclehelmets is EN1078, so unless you qualify any mention with a higher spec like Snell B95 it's pretty much a given that "cycle helmet" is the same as "EN1078 cycle helmet".

As I'd never mentioned EN1078, I can't have expressed my faith in it to save lives.

You even re-quoted the explanation I gave you that explains there is no effective difference between the plain old helmets you're talking about and an EN1078 helmet, so I can only suppose you didn't understand it.

But there's an easy way to see if I'm being devious here: take any mention you've made of "helmet" and replace it with "EN1078 helmet" and see if it alters the sense of what you're getting at.
Since it doesn't, suggesting this is me maliciously twisting facts looks a bit like clutching at straws to paint me as a bad actor.

You clearly implied, with your emphasis of death of a rider that wasn't wearing one as a reason for people to wear one, that you think there's a significant chance your tragic example would have been different with a helmet. If you didn't think it would have been different, why bring it up?

I didn't say that, another member did. Stating a fact does not mean something is clearly implied.

I see it as '853' that said, "The Tour de France went over the Col de Portet d'Aspet earlier today. That's the pass where the Olympic champion, Fabio Casartelli, received the head injuries that killed him after a crash - whilst not wearing a helmet"

But you did imply it, saying all the things that can bring riders down and how important it is to wear helmets while not feeling any other protection worth mentioning.

Again, stating the facts does not imply anything.

Since you manage to infer I'm "anti helmet" it's pretty clear that people pick up stuff by reading between the lines. This is natural and normal, and sadly not always accurate. In the case of you calling me "anti helmet" I simply corrected you with facts, but the other direction it's all about me deliberately twisting stuff.
I assume when you misrepresent my ideas that you've misunderstood and give you the benefit of the doubt, but if I get the wrong end of the stick it's because I'm a bad actor that twists things

And I'm still waiting to hear why you continue to avoid discussion on the research?

I'll drag you back yet again to the editorial where you don't seem to able to get past the linked paper it briefly mentions and suggest you read the subsequent paragraphs carefully where the eminent authors suggest not much will change. I stopped reading the literature in serious detail about the time that editorial came out because it had two people I respect enormously and are vastly more capable in this area than I am put a reasonably authoritative lid on things that fitted pretty much perfectly with what I'd seen over the previous decade (during which time I had letters printed in the BMJ and JRSM on the subject and was invited to peer review a helmet paper for an international road safety journal, so I guess I wasn't completely alone in thinking I had reasonable ideas about it all).

I don't go in to the peer reviewed literature very deeply any more because it has a track record of being pretty pointless and I've got other ways to fill my time, like riding bikes. There are other folk on these boards who keep up with detail better than I do (and in at least several cases are frankly much better at the stats side that you need a pretty serious grasp of to appreciate the detail and understand if the conclusions stack up) and I'm sure they'll be happy to point out the issues in whatever latest piece hasn't managed to account for confounders sufficiently to tell you much.

So that's why I avoid direct discussion on the research these days: not because I'm afraid it'll tell me something I don't want to hear (why would I not want to find out about something that had good, clear evidence it could make me much safer?) but because I agree with the eminent Profs. Goldacre and Spiegelhalter that it probably won't resolve anything.

Another piece of non-peer reviewed work I like to quote is childhood play and risk consultant Tim Gill's "Cycling and children and young people" (https://rethinkingchildhood.com/wp-cont ... ill-05.pdf) written for a children's welfare charity. Back in 2005 when he wrote it cycle helmets were perceived as similarly important to how they are now, so Gill took 15 pages adding an Annex on helmets where he waded though some of the more prominently cited stuff and came to the conclusion that... it was hard to come to a conclusion. After all that discussion it's "the annex to this paper argues that the case has not yet been convincingly made for the compulsory use or promotion of cycle helmets". It's been nearly 20 years, but actually nothing much has changed.
One thing that strikes me about this piece, aside from it coming to the same conclusion I had from looking at a lot of the same stuff, is that Gill is honest enough to separate his personal use (at the time of writing he wore a helmet and insisted his then teenage daughter did too, I've no idea if he wears always, sometimes or never these days) from a policy recommendation: they have very different levels of proof required, with simply wanting to wear one being a perfectly good reason at a personal level, but policy requiring clear and pretty unambiguous evidence of benefit before pushing them. So here's a consultant who has an excellent reputation for furthering child welfare and thinks it's worth wearing a helmet when he rides his bike finding himself unable to recommend them as policy because the hard evidence didn't stack up.

Pete.