Joe Minton

TBI-related death statistics may not be reliable.

The problem is with how they are typically recorded, by whom they are recorded and what the immediate goal is with the documentation of the death.

Physicians fill out certificates of death. They are typically niether practicing scientists nor trained statisticians; they are practitioners whose paperwork job in this case is to assign a cause of death. I am not saying these folks aren’t smart, they certainly are. It’s just that, when filling in the cause of death on the certificate, they are not thinking about gathering possible information for some future statistical study.

Typically, they’ll pick a single obvious cause of death and give that the full weight of their conclusion. Nothing is a more obvious cause than an open head wound. A possible example: We all know that JFK died from a head wound. What we don’t know is whether it was the only fatal wound. He was first shot through his neck which did great damage to his throat. He might have died from that were there no fatal head wound. I’ve never been able to discover if that might have been so. We got the simple clear and correct conclusion that a bullet through his brain was fatal with no mention of the throat wound.

This is what happens most times when there is a fatal head injury; the other possible fatal injuries are ignored on the paperwork.

Part of the motivation for Prof. Hurt’s “Death Study” which I referred to a few entries back was to more thoroughly document causes of death in motorcycle crashes. He followed 139 crash fatalities from the crash scene through autopsy. This took almost three years and was a lot of work.

He found that the examining physicians were being lazy. If there was a fatal head injury, it was given the full weight as the cause of death even though there might be others. This laziness prejudiced conclusions about the effectiveness of helmets.
He found that for every fatal head injury of a rider who was wearing a helmet, that same rider had 3.1 other fatal injuries as well. On the other hand TBI fatalities for riders wearing no helmet seldom included other life threatening let alone fatal injuries.

The traditional cause of death declarations were being skewed against the efficacy of helmets. They probably still are and for the same reasons: folks are filling in blanks on paperwork and being somewhat simple minded about doing so. As soon as Prof. Hurt finished his study the MEs went back to the old practice.

So: --- I recommend that you not trust statistics about helmet effectiveness because they probably aren’t accurate or complete.

Joe

“There are three kinds of lies: Lies, Damned Lies and Statistics” – Mark Twain