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Hazardous Journeys

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

BMJ 2003; 327 doi: (Published 18 December 2003) Cite this as: BMJ 2003;327:1459
  1. Gordon C S Smith (gcss2{at}, professor1,
  2. Jill P Pell, consultant2
  1. 1Department of Obstetrics and Gynaecology, Cambridge University, Cambridge CB2 2QQ,
  2. 2Department of Public Health, Greater Glasgow NHS Board, Glasgow G3 8YU
  1. 1Correspondence to: G C S Smith


    Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

    Design Systematic review of randomised controlled trials.

    Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.

    Study selection: Studies showing the effects of using a parachute during free fall.

    Main outcome measure Death or major trauma, defined as an injury severity score > 15.

    Results We were unable to identify any randomised controlled trials of parachute intervention.

    Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.


    • Contributors GCSS had the original idea. JPP tried to talk him out of it. JPP did the first literature search but GCSS lost it. GCSS drafted the manuscript but JPP deleted all the best jokes. GCSS is the guarantor, and JPP says it serves him right.

    • Funding None.

    • Competing interests None declared.

    • Ethical approval Not required

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