Read 'em and weep, boys: Bicycle helmets "protective role for intra-cranial hemorrhage is questionable."

From Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries. - PubMed - NCBI

So, yeah, helmets are good for lacerations and bumps and bruises. So is a baseball cap.

???

What medical school teaches that a fracture is a "laceration" or a "bump and bruise"?

You really have no idea what the stuff you link to says. Bizarre.

(People should read the link instead of being mislead about what it is supposed to have said.)

OTOH, just like lacerations, bumps and bruises, skull fractures are usually not clinically significant. The phrase "skull fracture" does sound serious, and while they can be serious and while they also can be indicative for more serious injuries, skull fractures themselves usually don't even require medical treatment.

Whether or not this is true is beside the point I was making.

Anyway, I doubt that people are advised to treat skull fractures as if nothing happened.

Unsurprisingly, another blatantly dishonest summary of a research paper.

The fair summary is correctly quoting "Further studies accessing the protective role of helmets for intra-cranial hemorrhage are warranted."

The authors were careful to express the statistically significant results of the study comparing helmeted and non-helmeted patients.

In their entirety, the statistically significant results showed differences in:
Age - non-helmeted younger
Sex - non-helmeted more male
Intoxication - non-helmeted more likely to be intoxicated
Scalp lacerations- non-helmeted more likely to have scalp lacerations
Skull fracture - non-helmeted more likely to have skull fractures
Facial fractures - non-helmeted more likely to have facial fractures
Hospital admission - non-helmeted more likely to be hospitalized
ICU admission - non-helmeted more likely to be admitted to the ICU


The reason that further studies are warranted is that they were not able to answer the question the study asked. (FWIW, in their study, helmeted patients were *LESS* *LIKELY* to have intra-cranial hemorrhage than non-helmeted patients (13.9% versus 17.6%), but the results were not statistically significant. Also FWIW, *helmeted* had a higher mortality rate (1.3% versus 0.2%), but again, only a dishonest, ignorant, or both person would conclude that this means anything since the result was not statistically significant.)

And that's before we get to the fundamental limitation of a study that only studied patients who directly presented to a single level 1 trauma center (the only such center in the study city) and excluded transfer patients from other centers.


Finally, there are many studies that show the complete lack of efficacy of baseball caps with skull and facial fractures - which is why baseball HELMETS are required for batters and base runners.

You've been caught - again. Will you ever learn not to do this?

-mr. bill

The point you were making is that a skull fracture is a serious injury. It is not in most cases. Which brings us back to the fact that bicycle helmets are especially good at preventing minor injuries.

The point you're making here is called a Strawman Argument.

A sprained ankle is also typically clinically insignificant and also doesn't require medical treatment in most cases. This doesn't mean you should ignore a sprained ankle.

:rolleyes: No, I said nothing like that. You are imagining it.

Err, no.

Read what I wrote carefully. I am clearly saying that people would not get advice to treat fractures as nothing happened.

There is really no excuse to omit "head fractures" over mentioning "lacerations" and "bumps and bruises".

Unless one thinks that fractures are more trivial than "lacerations" and "bumps and bruises" (which doesn't seem likely).

Why did Skye omit fractures?

This is a misleading and false characterization of the abstract linked to.

It's not really clear what you were saying, because of the awkward phrasing. You doubt that "people are advised to treat fractures as nothing" is something that happened? Or you you doubt that people are "advised to treat fractures" as (meaning because) "nothing happened"? Or as made the most sense to me, are you omitting "if": you doubt that people are "advised to treat fractures as if nothing happened"?

I was tempted to ask you to clarify what exactly you meant, but didn't because I don't see why it is relevant to evaluating skye's conclusion or the study he linked. Another study that fails to show that helmets are very effective in treating TBI, but does demonstrate the obvious effectiveness with minor head injuries. They need more data samples to say anything about the inconclusive part. What is so controversial about it? What IS your point ultimately?

Any head hit that is hard enough to cause a skull fracture is probably hard enough to cause brain damage. Therefore a helmet that will mitigate energy is a good thing.

But is it too much of a good thing?

But when a helmet prevents the skull from cracking, it doesn't necessarily mean that it will also prevent brain damage. Especially since TBIs are usually the result of different forces than skull fractures

You are being *far* too generous, imo.

And for what it's worth, wonder why somebody didn't link to something more than an abstract?
Such as this link to the first two pages of the four page article (click "look inside").

To be clear, this is a "misleading and false characterization" of the ENTIRE SHORT RESEARCH PAPER. The more of the paper one reads the clearer that this is a matter of a lack of characterization.

-mr. bill

Yes, I suppose I missed the "if". It wasn't that unclear. You figured it out.

And, the alternative meaning you arrived at really isn't saying any thing different.

Whether or not they are allowed to heal on its own, I doubt that "people are advised to treat skull fractures as nothing" happened as well. (You might also question the use of "treat" here.)

To be clear, I don't doubt that, often, skull fractures are allowed to heal on their own (it's easy enough to find out about that). This being true doesn't excuse not mentioning it (and making-up "bumps and bruises"). As I said, this being true is beside the point I was making.

I wasn't talking about the abstract.

My point is in the my first comment about this abstract. But I'll repeat it here.

Skye omitted "skull fractures" and mentioned "lacerations" and he invented "bumps and bruises". That's a problem.

Skye's characterization of the abstract is incorrect. It's not like it should be hard to summarize the abstract accurately.

Skye too-often mischaracterizes stuff he links to. People should be sure to look at the link over trusting whatever Skye says about it.

Bicycle helmets are highly protective against traumatic brain injury within a dense urban setting.

Going from past experience I have no doubt that *every* anti-helmet nut will focus on only three letters from this study, so I'll quote the final paragraph of the Discussion in its entirety.

(And thirdly, Vision Zero is more what what you'd call "wishful" than actual goals. In the year twenty fifty-(fifty?)-five....)

-mr. bill

I told you a while back that I would check in from time to time. Here's a helmet study you should actually read, front to back.

https://www.researchgate.net/profile...9d47c2428b.pdf

Mr. bill, you should check out the Vision Zero concept from the originators.

Vision Zero Initiative

John

See the thread that says Australia just passed a law that fines a cyclist $319 for riding without a helmet. Apparently Aussies think that wearing a helmet is a good thing.

There's the problem then. You don't understand the ambiguity of what you wrote, nor even why it was ambiguous, and then you write condescendingly to the guy that was apparently responding to one of the possible meanings. It was your misunderstanding, not his, and you should rein that in a bit.

I don't agree with Skye very much, but omitting "skull fractures" does not change the gist of the conclusions.

I've been following the reports of opinions and consequences of their helmet law for years, and it seems to me that most Australian cyclists don't, but their government does. They believe that it has seriously curtailed the amount of cycling in Australia, a net negative in health consequences.

No, "the guy" imagined what what I said (it wasn't a "possible meaning" either). Then accused me of making a straw man argument. The condescendion was deserved.

I wrote exactly what I wanted to write (including the "if" might have been better but the meaning doesn't really change). It was deliberate.

People should have done what I said they should have done (read the article). They should have noticed the "odd" replacement of "skull fracture" with "bumps and bruises" and realized that they are not equivalent. "The guy" failed to do that.

If he thought what I wrote was "ambiguous", the proper response would have been to ask me to clarify it. (Not putting word in my mouth.)
He misrepresents stuff much too frequently. The "omission" is yet another example of that. And he added stuff he just made-up. There isn't really any way to reasonably excuse that. It appears you are trying to excuse it.

http://blog.simplejustice.us/2016/02...of-ideologies/

So much for the "YOU MUST REPLACE YOUR HELMET EVERY TWO YEARS OR YOU'RE GOING TO DIE!!!!" BS.

Age does not affect the material properties of bicycle helmet foam liners. - PubMed - NCBI

"Based on these data, the impact attenuation properties of bicycle helmet foam do not degrade with the age."

Not that bicycle helmets do anything useful in the first place.

Also, quit claiming I misrepresent studies. If all you have read is the abstract, shut your pie hole until you read the entire article, as I have. Just because a study doesn't meet your preconceived notions doesn't mean I misquoted it.

You guys have a hella problem with facts.

Old news (not surprising it's been confirmed).

You misrepresented it, regardless.

:lol::lol::lol: Ironic.

Says Bell on replacing helmets:
"This helmet has a limited life span in use and should be replaced when it shows obvious signs of wear."
"YOU SHOULD NEVER: 1. Wear a helmet that’s been in an accident, even if no damage is visible."

What Bell doesn't say about replacing helmets:
"YOU MUST REPLACE YOUR HELMET EVERY TWO YEARS OR YOU'RE GOING TO DIE!!!!"

Not only do you misrepresent studies, you misrepresent lots of things. All the time. It's the voodoo that you do so well.

-mr. bill

What Bell also says about helmet replacement that is closer to skye's comment (exaggeration about death aside):

http://www.bellhelmets.com/product-faq




This "YOU SHOULD NEVER: 1. Wear a helmet that’s been in an accident, even if no damage is visible" always cracks me up, though. How do you know that ANY helmet is damage free then? Pick it up right off the assembly line and never let it out of your sight?

You don't. That things in life are never certain shouldn't "crack you up".

Would you drive across a bridge in the dark you know is out?

I don't often agree with CarinusMalmari either, but he is correct in this case. The unsurprising conclusion is that helmets are not particularly effective in preventing traumatic brain injury, but are more effective with the relatively minor injuries. Whether or not you specifically list skull fractures among the injuries doesn't really impact that conclusion.

A baseball cap doesn't really provide much protection against bumps and bruises, lacerations, or facial contusions in addition to doing little for skull fractures. If you have to attack someone's hyperbole, that would have been a logical point of attack.