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Trends in serious head injuries among English cyclists and pedestrians
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  • Published on:
    Authors' second reply

    Dear Editor

    Franklin and Robinson are correct to question the complexity of the evidence on helmet wearing among children.[1] As a brief report our paper was unable to explore this in detail but we are grateful for the opportunity to do so here. The helmet wearing surveys suggested that helmet wearing fell among children between 1994 and 1996.[2] Analysing accident data for the years 1995/96 alone shows a corresp...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: Authors' reply

    Dear Editor

    Cook and Sheikh have accepted the fundamental error in their paper pointed out by Annan.[1-3]

    When the arithmetic error is corrected there are only two conclusions that can be reached. One, pointed out by Annan,[2] is that for every helmet worn, two people are saved. This is clearly untenable and so the only other conclusion, also pointed out by Annan,[2] is that there are other factors invo...

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    Conflict of Interest:
    None declared.
  • Published on:
    Another serious error in Cook & Sheikh's analysis
    • John Franklin, Cycling Safety & Skills Consultant
    • Other Contributors:
      • Dorothy L Robinson

    Dear Editor

    There is another serious problem with Cook and Sheikh's paper.[1] The authors cite a TRL report [2] stating that, on major roads, helmet wearing (%HW) increased from 16.0%, in 1994, to 17.6% in 1996 then 21.8% in 1999. The TRL report continues: "this was due to an increase among adult cyclists wearing helmets: there was no change amongst child cyclists."[2]

    In fact, Table 3 shows %HW o...

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    Conflict of Interest:
    None declared.
  • Published on:
    Authors' reply
    Dear Editor

    We are grateful to Annan for spotting the arithmetic error in the discussion section of our paper of trends in cyclist head injuries.[1] It would be a mistake, however, to allow a minor mistake in the discussion to divert attention from the main finding of the paper, which was that cyclist head injuries fell during a time of increased helmet wearing. Population level time trend studies are limited in the am...

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    Conflict of Interest:
    None declared.
  • Published on:
    Cycle helmets: time for a reality check

    Dear Editor

    To focus on injury mitigation in cyclists to the exclusion of addressing the causes of crashes, as is the trend in public debate at present,[1] risks fundamental errors - not least the post hoc fallacy of assuming that cycling head injuries are the result of failure to wear helmets, rather than of the types of crashes cyclists experience.

    As a result of this obsession we have arrived at the ab...

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    Conflict of Interest:
    None declared.
  • Published on:
    IP is lacking objectivity

    Dear Editor

    IP is gaining a reputation in the cycling community as a journal lacking in objectivity when it concerns the effectiveness of bicycle helmets. Its past zealous defence of flaws found in helmet research that IP has published gives cause for concern.

    Its latest silence over the identification of a serious calculation error (Annan [1]) raises serious ethical questions as well as doubts about...

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    Conflict of Interest:
    None declared.
  • Published on:
    Fundamental error in "Trends in serious head injuries..." Cook and Sheikh 2003

    Dear Editor

    The main conclusion of Cook and Sheikh,[1] that a bicycle helmet prevents 60% of head injuries, is incorrect due to a fundamental error in the way they have treated their percentages. A correct analysis demonstrates unequivocally that there must be major confounding factors in their data set that they have failed to take into account, and therefore any estimate of helmet effectiveness is purely speculat...

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    Conflict of Interest:
    None declared.
  • Published on:
    Policy must be evidence-based to succeed

    Dear Editor

    “Policy must be evidence-based to succeed.”

    It is reported [1] that as the rate of helmet use by English cyclists increased by six percentage points from 16% to 22%, the proportion of hospital cases with serious head injuries declined slightly more for cyclists than pedestrians. This is advanced as evidence that cycle helmets prevent 60% of serious head injuries.

    The effectiveness of c...

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    Conflict of Interest:
    None declared.