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Helmets Work!

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Helmets Work!

Old 03-03-11, 09:33 AM
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Originally Posted by pallen
Of course a dummy doesnt have the curl up instincts and such that a human has, but I still think that would be the best way to know exactly how much impact a helmet can absorb.
The best ethical way, I guess.
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Old 03-03-11, 10:01 AM
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Originally Posted by Phantoj
The best ethical way, I guess.
You know, we have 435 House representatives and 100 in the Senate. Is that a high enough sample size to get good results?

Last edited by pallen; 03-03-11 at 11:20 AM.
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Old 03-03-11, 10:03 AM
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Originally Posted by RTDub
A well-stated point of view, but I have to ask why on this one point. Peril doesn't care how far you are from your house. My rabbit encounter (commute, low traffic, non-pack) was a mere 500 yards from my point of origin. I do not believe anymore that there is a thing called 'low-exposure.' To say that your risk is lowered, sure, I can go with that, but the unexpected can happen anywhere, and at any time. It's not like wearing a helmet is asking someone to endure excruciating torture while riding. It's a freaking helmet: A kind of hat for cycling.
This goes exactly to my earlier point about driving in cars, sure your risk is lowered, but it only takes 1 time for something bad to happen, so you should be wearing a "driving hat" all the time.
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Old 03-03-11, 10:46 AM
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Originally Posted by RTDub
A well-stated point of view, but I have to ask why on this one point. Peril doesn't care how far you are from your house. My rabbit encounter (commute, low traffic, non-pack) was a mere 500 yards from my point of origin. I do not believe anymore that there is a thing called 'low-exposure.' To say that your risk is lowered, sure, I can go with that, but the unexpected can happen anywhere, and at any time. It's not like wearing a helmet is asking someone to endure excruciating torture while riding. It's a freaking helmet: A kind of hat for cycling.
Surviving a crash isn't about "peril", it's a probability game. The shorter the ride, the less probability of a catastrophe; or put another way, the shorter the ride, the less need to ride aggressively. You aren't going to reduce the probability to zero... it's acceptable to increase your risk slightly to accommodate convenience. We do it all the time in every facet of life. You can say all you want that it's not "excruciating torture" or it's "kind of a hat for cycling", but the fact remains that if I am just going out for lunch, I don't want to wear special shoes, I don't want to wear special cloths, and I don't want to wear a hat.
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Old 03-03-11, 10:49 AM
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Originally Posted by yugo campione
The major issue with using studies like this is that the falls by cyclist in which their head hits the ground, then they stand up and shake their head and say "whoa, that hurt", then get right back up on their bike and ride away, all without ever going in to see a doctor, are not included. Now you may say, "those should not be included in the study because there was not significant head trauma" and I would respond, "well...that's the point, isn't it?".
This makes no sense.

Why wouldn't the same scenario apply to before the law and study? You can't just start making different exclusions and scenarios..you have to assume this applies before the law and afterwards also.
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Old 03-03-11, 12:17 PM
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Originally Posted by zigmeister
This makes no sense.

Why wouldn't the same scenario apply to before the law and study? You can't just start making different exclusions and scenarios..you have to assume this applies before the law and afterwards also.
? I am sorry, I have no idea what you are trying to say.
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Old 03-03-11, 01:37 PM
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What makes this argument pointless is that most people disagree based on their righteousness of choice rather than scientifically sound evidence. It is unfortunate that our educational system cannot do better and the simplest laws of physics and logic can be overwhelming, whether you sell bicycles or perform surgeries. Cathexis is a major part of our society and when faced with dissent, many immediately assume they are being subjugated and controlled. This discussion was not in any way meant to tell anyone what must and must not be done. It was rather an attempt at a scientific explanation for a phenomenon. As human being, we should all have a choice to wear or not to wear a helmet. That's irrelevant to this discussion. I would in fact advocate that as long as the society is not forced to pay the medical costs, every human being should have the right to do whatever he or she pleases with his body, including not wearing seatbelts, abortion, suicide, or drugs. Natural selection is the driving force of the world and it will make our world a better place.

As for helmets, just like every other device and medication in the world, no one can deny that there can be some protracted circumstances where helmets might cause harm. Even airbags and water have side effects. It is up to the individual to understand the evidence and decide whether a possible, likely negligible side-effect is not worth the overall outcome.

Currently there is enough evidence in this thread for the shrewd observer to come to his or her conclusion. It is a mathematical fact that no matter the cause, there will always be some percentage of the fringe that will dissent. But that does not detract from the larger purpose of this discussion the goal here already been achieved. Good luck and may the force be within you.
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Old 03-03-11, 05:43 PM
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Originally Posted by pallen
Some of it is good. A lot of it is not. The rotational injury stuff is pretty weak, based on "some doctors think". Sure, its worth looking into, but it pretty weak right now. The whole population stuff deals with helmet laws being introduced. Its very difficult to draw any solid conclusion from these - there are a lot of factors at work there. The less exercise and people being more risky with helmets is irrelevant. The answer to those is not to stop wearing helmets, but to get out and ride and don't be stupid just because you're wearing a helmet.

I would be curious if anyone has published any crash test data with and without helmets. The only way to really know if helmets are effective is to try to simulate typical bike crashes with a test dummy fitted with sensors. I realize this is pretty difficult to pull off, but I'm sure it can be done. Look at the same kind of crash 100 times and compare the sensor data from a helmeted head and a non helmeted head. Of course a dummy doesnt have the curl up instincts and such that a human has, but I still think that would be the best way to know exactly how much impact a helmet can absorb.
I agree the rotational injury stuff is weak. What is real is the fact that riders wearing helmets strike their head more often than non-helmeted riders. Many of the "Look, my helmet saved me" anecdotes would never have even made head contact without the helmet.
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Old 03-03-11, 05:54 PM
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Originally Posted by Brian Ratliff
The mechanical engineer in me says that a fall, regardless of horizontal speed, onto a horizontal surface (IOW, not a curb, lamppost, garbage bin, car bumper, etc), is a fall from 5-6 vertical feet.

In any case, I won't tell you to wear a helmet. You are convinced by population statistics. I don't trust them in determining the best course of action for me. Population statistics pertain to populations. Not individuals. I ride in pack situations. I know for a fact that the type of crashes that happen in pack situations are not controllable. When your front wheel gets swept out, there is no time for the body to react in the normal way to protect your head. I've fallen a fair amount in the course of the last 15 years or so I've been riding road bikes; it wasn't until I started racing three years ago that I started getting into situations where I couldn't protect my head in a fall.

Thus, for me, I wear a helmet (most of the time) because 1) I know the type of risks I expose myself to involve crashes where I cannot control my body position, and 2) my falls typically happen onto horizontal pavement, meaning a fall from 5-6 vertical feet, which is the type of crash the helmet is optimized to absorb. A helmet makes sense for me. If most of my riding were short, 5 mile, low exposure, non-pack riding, commuting, then I probably wouldn't wear a helmet . If my riding was solo training in low car traffic areas, I might not wear a helmet (I do, though it's just out of habit, not because I believe I actually need it). And I don't wear a helmet on my rollers (too hot) even though the risk of falling is similar to that of riding solo on a country road. But in a race or group training ride, a helmet is an essential piece of equipment for injury prevention.
And your points are well taken. Nevertheless many feel that it is the speed of cycling , 20+ mph , that mandates helmet use and I think it important to dispel this notion. The helmet is thus just as important going 5 mph around the neighborhood as 25 mph in a cluster of riders. One could argue, successfully, that the risks at 5 mph of being involved in a crash are less, still the possibility of bizarre accident still exists. Of note, in my 25 years work in surgery/trauma, I have had only one bicycling fatality. The cause- a seven year old boy was going maybe 2 mph, see sawing back and forth with friends after soccer practice. The bike toppled over and he fell on the upended handlebar, shearing off the lateral segment of his left lobe of the liver and exsanguinating from this injury. Go figure.
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Old 03-03-11, 09:51 PM
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Glad to hear you're okay.

With all the give and take between the helmet crowd and no-helmet crowd, this is starting to look like the A&S forum!
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Old 03-03-11, 10:33 PM
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Originally Posted by BentLink
I crashed yesterday, 30mph on a downhill S-curve. Knocked me unconscious, broke my collarbone, and got a good case of road-rash. My Bell Furio took the heap of crash energy for my head. I'm not concussed, X-rays and CT scan show all is OK.

Maybe even knocked some sense into me...

Hope this reinforces good safety for you.
Glad you are OK!

A helmet saved my life a long time ago, some one strung a cable across an off road trail, on public land, I hit it on my daily ride to work in the morning, never saw it. My helmet was cracked in two covered with blood but I was fine. I ALWAYS wear one since then.

If you broke your collar bone, you won't be on the bike till it is healed, that has to be one of the most painful bones to break, hurts to bloody breath, and they can't really cast it, all they can do is strap you into this harness thing, or at least that is all they could do when I broke mine 30 years ago on a dirtbike.

Heal fast!
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Old 03-03-11, 11:19 PM
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Originally Posted by surgeonstone
And for a more recent and contrary point of view.
https://www.cyclehelmets.org/1052.html
I love it, you play the anti-helmet stereotype perfectly.

He provided you with a study that was more recent then the one you claimed was the the only one used and your response was...to immediately search for a link to back up your anti-helmet opinion.

You remind me of smokers.
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Old 03-04-11, 06:20 AM
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Originally Posted by Excelsius
First, a few points:

1. As a general surgeon, you do not deal nor are qualified to deal with head trauma. Neurosurgeons and neurologists are for this purpose.

2. As a doctor, it is unlikely that you do any bench research and hence you have no personal expertise in head injuries. If you are doing research, you can correct me.

Nevertheless, as someone educated in the sciences, I expect that when you claim helmets 1.don't work and 2.cause injury that you have read sufficient data that has formed your well-informed position. As such, the only thing that matters here is research. I would like to ask you if you could kindly share all the papers written on the topic that support your two claims. I am very open-minded and would love to see any data that suggests helmets do not work, no matter what the application is.

I would also like to take the liberty and address a few point you made. When you are reading a study that says helmet legislation increased the number of fatalities, you must tread very carefully to interpret that data. I did see a few articles like that as well. However, there is a big difference between a helmet causing those increased fatalities and the number of people who wear helmets and think they are invincible, therefore start riding more aggressively. The latter has been shown to happen. That is more of a psychological effect than anything related to helmets. Furthermore, when you read that this or that legislation did not decrease helmet fatalities, you must also try to see whether the study actually looked into the rate of helmet use. Legislation means nothing if people are going to ignore the law and not wear helmets or if they are going to wear helmets and assume they can do all types of dangerous maneuvers.

Here are a few, quick citations for you:

https://www.ncbi.nlm.nih.gov/pubmed/18646128

https://www.ncbi.nlm.nih.gov/pubmed/8571008
Originally Posted by 18hockey
I love it, you play the anti-helmet stereotype perfectly.

He provided you with a study that was more recent then the one you claimed was the the only one used and your response was...to immediately search for a link to back up your anti-helmet opinion.

You remind me of smokers.
What exactly does this even mean??

And, as you can clearly see in the above quote, he specifically asked him to provide these studies.
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Old 03-05-11, 02:39 AM
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So guys should we wear helmets or not!
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Old 03-05-11, 02:43 AM
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Originally Posted by rufvelo
So guys should we wear helmets or not!
IMO, default answer is yes.

If you have lots of miles and a fair amount of bike handling skills under your belt and a well maintained bike I think you can take your choice of whether a helmet's required on a ride-to-ride basis. Some rides have a very low head impact probability, say on par with jogging, so helmet might be overkill for some riders. If you want to err on the side of caution, get the helmet on before you even think of swinging a leg over.

If your local, state or provincial government tries to pass some stupid law, go fight it if you have the time!

If you're taking a known noob out for a ride suggest a helmet. If you see a stranger on the road sans helmet don't admonish or even scowl, try waving instead!

Last edited by LesterOfPuppets; 03-05-11 at 02:46 AM.
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Old 03-05-11, 03:16 AM
  #191  
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Originally Posted by rufvelo
So guys should we wear helmets or not!
I dunno. Should you? I think the point is: we all have to take our risk assessment and make our own decisions.
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Old 03-05-11, 06:21 AM
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Originally Posted by LesterOfPuppets
IMO, default answer is yes.

If you have lots of miles and a fair amount of bike handling skills under your belt and a well maintained bike I think you can take your choice of whether a helmet's required on a ride-to-ride basis. Some rides have a very low head impact probability, say on par with jogging, so helmet might be overkill for some riders. If you want to err on the side of caution, get the helmet on before you even think of swinging a leg over.

If your local, state or provincial government tries to pass some stupid law, go fight it if you have the time!

If you're taking a known noob out for a ride suggest a helmet. If you see a stranger on the road sans helmet don't admonish or even scowl, try waving instead!
Originally Posted by Brian Ratliff
I dunno. Should you? I think the point is: we all have to take our risk assessment and make our own decisions.
See? This isn't A&S because we can actually come to some kind of concensus!
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Old 03-05-11, 06:48 AM
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Glad you are ok.
I have bought brand new helmet yesterday. The same as last to have old for a spare parts (Spec Propero).
In autumn I have spent 3 months (2 sleeping in the sitting position) in a comfortless plaster after one ride I had broken collarbone, two ribs and helmet. Old Propero broken on the front, right and a huge hit on the back (tarmac road).
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Old 03-05-11, 02:20 PM
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message to follow.
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Old 03-05-11, 02:22 PM
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Originally Posted by 18hockey
I love it, you play the anti-helmet stereotype perfectly.

He provided you with a study that was more recent then the one you claimed was the the only one used and your response was...to immediately search for a link to back up your anti-helmet opinion.

You remind me of smokers.
So you know me so well that you can dismiss me as an " anti-helmet stereotype " huh. Interesting.
And I remind you of pro smokers. Even more interesting
Couple of questions.
1) Which article or web site do smokers quote to justify their addictions safety?
2) What makes you think I did an immediate search for the link to this discussion? I did not by the way.

Really you and I are more alike than you think. I have been a pro-helmet "zealot" from 1985, when decent helmets arrived on the scene, until this year.
I have been an anti-smoking zealot since 1958. You were most likely an un united sperm and ova at this time.
I have been pro motorcycle helmet since 1971, the year I started riding motorcycles (Still do), and remain so.
I have been pro seat belt use since they were available and remain so.
Why? Because I love life and hate that which is opposed to it.
So why the difference now for me with regards to bicycle helmet use and why would I, as a physician, suggest something that some would regard as dangerous and foolhardy.
Well, in defending helmet use and quoting the oft quoted article in New England Journal of Medicine (Bicycle helmet safety, Thompson, 1989)
I stumbled across contrarian views in the Safety and Advocacy forum ( Helmets cramp my style ). Reading some obviously informed but opposing views made me wonder more about this topic. So I spent quite a few hours reading the entire thread, thinking about what I read, thinking about my own experience and chasing down the various articles, both pro and con. In doing this I tried to keep an open mind.
After reading and rereading I came to the conclusion that ....

1) No one is suggesting that children or new riders go without helmets. They should not.
2) In this area of science, anecdotes rule.
3) No well designed study shows bicycle helmets save lives.
4) Helmet manufacturers themselves note that helmets will NOT prevent concussions. How often do you read here that I was not "Concussed" because I had my helmet on.
5) Studies of populations where helmet legislation was enacted fail to show any difference in injury or death rate and do show a dramatic reduction in bicycle usage.
6) Every whole population study of motorcycle helmet use or seat belt use DOES show marked reduction of head injury and fatality rates. Why is this NOT the case with bicycle helmets. Could it be they are not very effective?

So do I still remind you of a smoker?

Really I am not at all a zealot about this. I don't go around while riding telling people that they are wearing the only cycling accessory that fails to do what it is advertised to do. I really don't care if you wear one or not. But I would prefer that you not make assumptions about me that are somewhat ignorant. Still, I assure you I will like you no less if you do. And I am sure that our common likes ( cycling) would more than likely allow us to enjoy each others company on a ride. Hey, I won't even tell you to loose the helmet.
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Old 03-05-11, 06:07 PM
  #196  
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surgeon: you remind me of one of my college friends. He was an enthusiastic evangelical Christian when I was roommates with him in my freshman year. Then, one day when I was a senior, we were on a bike ride and he admitted he was now an enthusiastic atheist. He was attracted to evangelicalism the same way he was attracted to atheism. He heard a convincing argument from someone and thought it a bright glowing bit of logic and ran with it.

Now, the following is not to start an argument or even a discussion, but is merely an exercise in harmless pitch and toss:

1) Most of the arguments given about the lack of efficacy of helmets apply equally to the whole population. If the goose, why not the gander?

2) Anecdotes rule internet debates. The "science" is cherry picked by one extreme or the other. Which science is cherry picked usually defines the extremes of the debate. An "open mind" arrives at a theory that attempts to cover all evidence present. It's the partisan that groups the science into piles of pro and con and chooses which pile to accept. It's the difference between solving a problem and supporting a position; the difference between science and ideology.

3) Helmets aren't made to save lives. This is a secondary effect. They are made to mitigate the effects of head impacts with the ground.

4) This is the perfectionist fallacy. You can't have it all, so why bother with part-way? Basic physics suggest the helmet mitigates damage from head impacts with the ground. You don't need population studies to solve a physics problem.

5 & 6) Not showing an effect is very different than showing the effect is not present. Just as correlation does not automatically suggest causation, non-correlation does not automatically suggest non-causation. The danger of population studies is there are a myriad of variables, none of which can be controlled, leaving it to the imagination and creativity of the study author to recognize the variables and take them into account when analyzing the data. Sussing out the exact effect of a single variable from the melee is difficult and usually requires some separate, supporting studies.

Again, just an exercise, don't get your hackles up. I'm sure the A&S thread has all these counterpoints counterpointed. The course I am really suggesting here is to take internet threads with a grain of salt, read all the applicable, first hand, information on your own, take into account that common sense is usually common for a reason and if you are suggesting common sense be wrong, you'd better be pretty grounded on why, and come to your own, independent point of view on the subject. If you find yourself responding to arguments by repeating the arguments of others, or appealing to the authority of "studies" instead of responding to points directly, you should probably examine your own point of view to ensure it is fully informed.

As for myself, notice I choose a helmet based on the probability of whether my head is going to hit the ground or not, balancing that probability with convenience. Has nothing to do with "believing in" the efficacy of helmets or not.
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Old 03-05-11, 06:41 PM
  #197  
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There is a thread over in A&S where some people(I am not one of them) have the stupidity to think that helmets are worthless.
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Old 03-05-11, 07:13 PM
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Originally Posted by rufvelo
So guys should we wear helmets or not!
We should wear helmets if we think it's worth it. We shouldn't try to force others to wear them.
Just my .02.
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Old 03-05-11, 09:32 PM
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Originally Posted by Brian Ratliff
surgeon: you remind me of one of my college friends. He was an enthusiastic evangelical Christian when I was roommates with him in my freshman year. Then, one day when I was a senior, we were on a bike ride and he admitted he was now an enthusiastic atheist. He was attracted to evangelicalism the same way he was attracted to atheism. He heard a convincing argument from someone and thought it a bright glowing bit of logic and ran with it.


Now, the following is not to start an argument or even a discussion, but is merely an exercise in harmless pitch and toss:

1) Most of the arguments given about the lack of efficacy of helmets apply equally to the whole population. If the goose, why not the gander?

2) Anecdotes rule internet debates. The "science" is cherry picked by one extreme or the other. Which science is cherry picked usually defines the extremes of the debate. An "open mind" arrives at a theory that attempts to cover all evidence present. It's the partisan that groups the science into piles of pro and con and chooses which pile to accept. It's the difference between solving a problem and supporting a position; the difference between science and ideology.

3) Helmets aren't made to save lives. This is a secondary effect. They are made to mitigate the effects of head impacts with the ground.

4) This is the perfectionist fallacy. You can't have it all, so why bother with part-way? Basic physics suggest the helmet mitigates damage from head impacts with the ground. You don't need population studies to solve a physics problem.

5 & 6) Not showing an effect is very different than showing the effect is not present. Just as correlation does not automatically suggest causation, non-correlation does not automatically suggest non-causation. The danger of population studies is there are a myriad of variables, none of which can be controlled, leaving it to the imagination and creativity of the study author to recognize the variables and take them into account when analyzing the data. Sussing out the exact effect of a single variable from the melee is difficult and usually requires some separate, supporting studies.

Again, just an exercise, don't get your hackles up. I'm sure the A&S thread has all these counterpoints counterpointed. The course I am really suggesting here is to take internet threads with a grain of salt, read all the applicable, first hand, information on your own, take into account that common sense is usually common for a reason and if you are suggesting common sense be wrong, you'd better be pretty grounded on why, and come to your own, independent point of view on the subject. If you find yourself responding to arguments by repeating the arguments of others, or appealing to the authority of "studies" instead of responding to points directly, you should probably examine your own point of view to ensure it is fully informed.

As for myself, notice I choose a helmet based on the probability of whether my head is going to hit the ground or not, balancing that probability with convenience. Has nothing to do with "believing in" the efficacy of helmets or not.
Which is what I have done. Certainly did not just "run" with it. Hackles aren't up BTW but thanks for your input. All's good

Last edited by surgeonstone; 03-05-11 at 09:49 PM.
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Old 03-05-11, 09:51 PM
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Originally Posted by Chris516
There is a thread over in A&S where some people(I am not one of them) have the stupidity to think that helmets are worthless.
Nicely said
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