To determine whether parachutes are effective in preventing major trauma related to gravitational challenge, a systematic review was performed of all studies examining the effects of using a parachute during free fall. Data sources included Medline, Web of Science, Embase, and the Cochrane Library databases. The main outcome measure was death or major trauma, defined as an injury severity score > 15. The authors were unable to identify any randomized controlled trials of parachute intervention. They concluded that the effectiveness of parachutes has not been subjected to rigorous evaluation by randomized controlled trials.

Comment: Advocates of evidence-based medicine have criticized the acceptance of interventions that have been evaluated only by observational studies. The use of parachutes during free fall is one such unproven intervention. The authors of this report suggest that everyone might benefit if the most radical proponents of evidence-based medicine organized and participated in a double blind, randomized, placebo-controlled, crossover trial of the parachute.

Smith GCS, Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327:1459-1461.