Talk:Bicycle helmet/Archive 3

Source Reliability?
Most sources in this article seem to be peer-reviewed journal article, government reports, and the like, but there are some links to anonymous pieces from apparently partisan websites. For example, there is citation 47 "Commentary: A case-control study of the effectiveness of bicycle safety helmets". Bicycle Helmet Research Foundation. Retrieved 2007-08-25." There is apparently no author listed, just "BHRF Commentary," and it is apparently self-published/not reviewed by third parties. Is this a reliable source? See Identifying reliable sources

Nelsonsnavy (talk) 19:12, 3 February 2012 (UTC)


 * It looks like the best source available. Erik Sandblom (talk) 16:09, 7 February 2012 (UTC)


 * It is peer reviewed by the editorial board. If we felt the need to get further opinion we'd do that, but the occasion hasn't arisen. If you were to limit the term "peer-review" to "peer-review by people other than those whose opinion on the subject you particularly respect" most scientific journals probably wouldn't qualify. I suggest that it's Reliable. But I really need to leave that decision to others. I hope that helps. Richard Keatinge (talk) 14:49, 9 February 2012 (UTC)


 * In this particular case, it's unclear whether it's written and edited by the same people. Either way, my concern is that the science section provide the reader with an overview (and a more streamlined overview, at that--please see discussion in the re-write section) of the published, professional science, not commentary pieces, editorials, etc. Nelsonsnavy (talk) 13:46, 10 February 2012 (UTC)

History of designs
The History of designs section has eight paragraphs and only one source, a dead link. I don't know if the material in this section is potentially contentious, but it does seem a bit strange to present so much info without sourcing it. I could certainly imagine a curious reader wanting some sources for further reading.Nelsonsnavy (talk) 17:07, 7 February 2012 (UTC)

Article rebuild
Geniescience is unhappy with this page and wishes a complete rebuild. Please can we estable whether or not there concensus for such a move? Obscurasky (talk) 19:40, 2 August 2011 (UTC)

It's a minor obstacle, to ask those who are keen to help, to add that specific content which they see as relevant to the subject. The outcome in the next few days or weeks will be worth the small discomfort. -geniescience Sept 2006 signed in first time (talk) 19:59, 2 August 2011 (UTC)


 * Just throwing away all the current content without discussion is not the way to go. I have found the current article useful for references on related issues; it also has been worked on quite a lot, and is better than it was a few years ago. Bicycle helmets are a completely different thing from motorcycle helmets, and should be treated as such. Murray Langton (talk) 21:43, 2 August 2011 (UTC)

Bicycle helmets are a completely different thing from motorcycle helmets, and should be treated as such, and they are indeed treated as such, because they have separate articles. Now do this: look at the Form of that other article, to see that there is no polemic inside that article. Hint hint. Some cyclists love to go at high speed, some motorcycle riders are slow riders, and the two kinds of helmets produce Very Different articles. Hint hint. This article needs to be rebuilt, and doing so will require input from those who are highly motivated to do so. Some of you the motivated have identified yourselves by reverting things so suddenly. The article needs A New Start, with All The Content That You Wish To Port Over to the New Article, and which you can justify. Never has anyone suggested throwing away all the current content without discussion. Yes, the article has been worked on quite a lot, and that is the source of the problem: people owning large stretches of content. "... Problem: Editing a particular page has become tricky, too many people are stuck discussing endlessly, and no progress can be made. How to proceed: Discover the Most Interested Persons..." I don't see a consensus emerging for a long long time. -- Geniescience Sept 2006 signed in first time (talk) 05:54, 3 August 2011 (UTC)


 * At Talk:Bicycle_helmet_laws an editor suggests that we need "Bicycle helmet article for the scientific debate, Bicycle helmet laws for a generic coverage of the laws (as well as mention of the debate) and Bicycle helmets by country to summarise all aspects of helmets for any country that has anything worth mentioning." It seems reasonable to me. I cannot see how removing most of the content of this article - far from perfect, but useful and the result of a lot of work - will help. Richard Keatinge (talk) 10:00, 3 August 2011 (UTC)

In other languages the article is simpler. I'll rebuild this one by basing its structure on one of the other language articles. geniscienceSept 2006 signed in first time (talk) 21:47, 4 August 2011 (UTC)


 * I look forward to your draft, and consensus for a change, first. It may be worth remembering that most of the relevant sources are in English - it's the default language of science, and a major language in most of the areas where helmets are popular. Richard Keatinge (talk) 06:27, 5 August 2011 (UTC)


 * Geniescience, it is important that you just do a draft, either in your userspace or here on the talk page, rather than replacing the existing article. That way we can have some useful discussion and suggest amendments. Murray Langton (talk) 06:35, 5 August 2011 (UTC)

I agree that this article needs a major overhaul. 100+ sources, some questionable, some questionably summarized, and more than a few of them used for apparent editorial debate? More useful and readable would be concise summaries of major issues instead of trying to squeeze in any and every source imaginable to create an endless back-and-forth commentary. Nelsonsnavy (talk) 14:45, 7 February 2012 (UTC)


 * I agree there's too much "he said-she said". I rewrote part of the science and risk sections to clarify that science gives different answers depending on how you ask the question. This is more useful to readers then to note every criticism of every study. There is also too much duplication between the sections "are helmets harmful" and "Opponents". Erik Sandblom (talk) 16:18, 7 February 2012 (UTC)


 * I'll see if I can help with that. I think the important thing is to help the reader become aware of the major issues but not try to summarize the hundreds of articles and websites relating to the topic, much less play out some debate by proxy. It's one thing to let readers know there's debate, another to try to re-create the whole thing here in excruciating detail. Nelsonsnavy (talk) 16:30, 7 February 2012 (UTC)


 * So why did you cite the same study twice: 'Another review of case-control studies found "consistent data indicating that wearing an industry-approved bicycle helmet significantly reduces the risk of head injury during a crash or collision."[52] A 2000 meta-analysis of sixteen studies found "clear benefits of helmets in terms of injury risk. The upper bounds of the 95% confidence intervals provide conservative risk reduction estimates of at least 45% for head injury, 33% for brain injury, 27% for facial injury and 29% for fatal injury."[53]' then omit a peer-reviewed paper criticizing this work? You appear to be providing substantial detail about some studies, but not subsequent peer-reviewed publications that criticize them. This creates a false impression.


 * More importantly, the debate concerns the difference between the result of case-control studies and what happens when population helmet wearing rates increase substantially. This is not unique to bicycle helmets. Similar phenomena have been noted in relation to hormone replacement therapy and heart disease, as well as taking vitamin supplements and the risk of cancer - case control studies gave at different result to the 'gold standard' of randomized control studies.  I'm sure this was in previous versions of this page.  Who removed it and why?  It seems to be very relevant to the debate about case-control studies of bicycle helmets that case-control studies are known to produce incorrect and misleading results. User:Dorre  —Preceding undated comment added 00:43, 12 February 2012 (UTC).


 * The section "Opinions for and against the compulsion or strong promotion of helmets" is being filled with organisations recommending helmet use. I think the section should be restricted to a discussion of laws and campaigns, not wether or not people should wear helmets. For example, many cyclist organisations recommend wearing helmets but caution against laws because of the negative impact on public health. This is more valuable information to the reader. Erik Sandblom (talk) 12:16, 9 February 2012 (UTC)


 * I take your point and considered that, too. As it stood, info on helmet advocacy and law support were mixed together awkwardly, if not confusingly; rather than just cut, I decided to re-organize it so that there is a clearly stated differentiation, with a few relevant examples for each. Here's why: the article is not just about helmet laws (there's a separate article for that), but about helmets in general, and also because when I first started researching the topic, I, as a reader, wanted to understand who advocated wearing helmets, who advocated laws, and who opposed either/both but could not readily find that info laid out clearly.


 * On the one hand, you don't want to overburden readers with too much info; on the other, you want to anticipate the sorts of questions they might have. I will try to pare the section back. Anyone else have input on this?


 * And along the same lines, Erik, what are your thoughts about the following approach to the Science section: include a brief introductory statement/disclaimer along the lines of "There has been much scientific research on bicycle helmets, yielding sometimes-conflicting results. Certain studies have been the subject of criticism, and that criticism in turn the subject of further objections. However, detailing the objections to specific studies is beyond the scope of this article." (unless we can find one of key importance that has been universally discredited--I can't recall one) Then go on to more briefly summarize the research, removing all the he-said-she-said. I could do a rough example draft of the beginning of it on my user page for people to consider. If that's an approach we could agree on, we could work as a team to streamline the article that way.Nelsonsnavy (talk) 14:07, 9 February 2012 (UTC)

Another thought: any support for moving helmet law supporters/opponents info over to the Bicycle helmet laws article? Right now it just has two brief, vague sentences on the matter. It would add important info to that article while streamlining this one, just leaving a brief section here on who advocates wearing them (versus legislating them).Nelsonsnavy (talk) 14:30, 9 February 2012 (UTC)


 * Lots of good ideas here. I agree that we should take advanage of the existence of the Bicycle helmet laws article. I suggest we should have a Main article pointer and sentence or two here.


 * I'd be happy with the idea of an introduction to the Science section, but I'd also suggest that going through at least the main scientific arguments is a core function of this article. 11:50, 12 February 2012 (UTC)


 * I agree about the science (and please see my detailed comments in the section below). My main concern is that we present it in a neutral fashion that frankly acknowledges its contentiousness but then proceeds to lay out key findings on different topics (head protection, reduced numbers of cyclists, etc.) in a way that lets the general, disinterested reader get a lay of the land from which they can proceed to dig into the primary material and criticisms thereof as they see fit. I believe we should focus on the scientific findings themselves first and foremost. Hopefully this week, I'll start porting the info about legal matters over to the law article. That seems not only logical but also a way to address complaints about weak points in both articles.Nelsonsnavy (talk) 13:45, 12 February 2012 (UTC)

Rewrite section on opinion
I think the section on opinion is much too long. The important thing is that most cyclist organisations recommend using helmets but are either opposed to laws, do not take a position on laws or want laws reviewed. Some, including CTC and ECF, are opposed to both laws and helmet promotion. They adopt this position because cycling is healthy and cyclists live longer. We should state that and re-use the sources in the section "is cycling risky". Maybe even move that whole section to this section. And briefly note the safety in numbers effect in one or two sentences with wikilinks and sources.

The opinions of individual experts are interesting but are not needed here because they are covered by the cyclist org's positions, so they can go. What the doctors think is not really relevant because a) just about nobody cycles in those countries (modal share 1-2%) and b) they are biased toward seeing injuries, so they can go too.

We should list pro-compulsion positions of non-doctor organisations such as road safety orgs.

The legislation section could also be shortened. Just mention which countries or states have all-ages helmet laws. Then mention that many other countries have helmet laws for children, see bike helmet law page. Erik Sandblom (talk) 16:12, 9 February 2012 (UTC)


 * I would support a rewrite - so long as it reflects the fact that this page is not restricted to helmet use in utility cycling. Mountain biking, downhilling, road/track racing, etc, should all recieve equal consideration in this article - much of which is already heavily slanted towards a roady perspective.


 * I haven't looked into it, so I may be wrong, but I would imagine that, for example, the CTC and ECF's opposition to helmet promotion is restricted to road cyclists? If this is the case, it's an important qualification, and needs mentioning.Obscurasky (talk) 22:59, 9 February 2012 (UTC)


 * Indeed abbreviation would be good, maybe a summary along the lines of Erik's suggestion, perhaps leaving plenty of references in case anyone wants to explore further.


 * I'm not familiar with any organization whose opinion makes a major distinction in helmet policy between different types of cycling, but as soon as anyone presents reliable sources I'll change my mind. Richard Keatinge (talk) 10:12, 10 February 2012 (UTC)


 * Please see my latest comments and questions in the re-write section; they pertain directly to this discussion. I'm curious what the consensus is before I make any changes. I agree with this compromise measure: "maybe a summary along the lines of Erik's suggestion, perhaps leaving plenty of references in case anyone wants to explore further." As I mention above, names of specific groups for/against wearing and/or compulsion was something I was looking for when first researching the issue and could not find readily, so I think it's a service to a reader unfamiliar with the issue to offer such specifics.


 * @Erik, as to medical groups, I see them as directly germane to the issue. It's a health issue, and some people are going to want to know how medical professionals--not just cyclist groups--weigh in on the issue. And after all, what type of organization is likely to get consulted or quoted in an attempt to pass/alter/repeal helmet laws? They carry weight, for better or worse. And the BMA's stance has been rather newsworthy, actually. Btw, I find it odd to learn that nobody cycles in countries like the US or Britain :) Nelsonsnavy (talk) 13:37, 10 February 2012 (UTC)


 * Before we make more changes, it would be salutary to take a step back and review the strengths and weaknesses of the whole article and see how its coverage relates to the helmet law article before proceeding. Here's my initial take:


 * -"History of Design" needs sourcing


 * -penultimate paragraph of "History of Standards" can be cut as it's redundant with other info in article


 * -"Design Intentions and Standards" can be compressed into previous section


 * -"Criticism of current standards; new designs" needs to be renamed at the very least since it doesn't mention new designs


 * -"Fit and care" iirc, "how to's" are not recommended for articles here?


 * -"History of use" intro needs source


 * -"Is ordinary cycling risky enough to require helmets?" incorporate this into science section


 * -"Science" keep focus on academic scientific research in recognized professional venues and remove opinions proffered by advocacy groups; give overview of relevant topics without bogging in down in repetition or noting every criticism of every study--section should be for general reader seeking overview of the science.


 * -"Are helmets useful? Desirable effects of helmet use" divide by topic instead of method: literature showing protective effects, literature showing no effects or harmful effects (need to add info about possible increased likelihood of neck injury--see Elvik 2011). That approach would presumably necessitate a similar topic-based division throughout science section instead of the current binary pro-con division.


 * -"Are helmets harmful? Undesirable effects of helmet use" most of this, as with "desirable effects" section could be streamlined


 * --"Opinions for and against the compulsion or strong promotion of helmets" leave info about helmet-use supporters/detractors but move info about law supporters/detractors and legislation to Bicycle helmet law article leaving just a brief overview and pointer to that article


 * -"Legislation and culture" Culture section could go; it's rather random as it stands Nelsonsnavy (talk) 18:40, 10 February 2012 (UTC)

New Draft
Here's my draft for a new Opinion section. Please note, we are not dispensing advice on wether or not you should wear a helmet. We are only briefly summarising the opinion of notable organisations on wether helmet laws and helmet campaigns are a good idea. I think the law section, "Legislation and culture", should become it's own section. Erik Sandblom (talk) 14:29, 14 February 2012 (UTC)

Supporters
Many medical groups support helmet laws. These include the British Medical Association, American Medical Association,, the American College of Emergency Physicians, and Temple University's Public Health Law Research program.

Some road safety advocacy organisations also support helmet laws, such as Sweden's NTF.


 * Quick suggestion: the fundamental problem is that you've removed all the groups that advocate helmet wearing. Discussing that is not a case of this article proffering advice but rather letting the reader understand how widespread support for helmet wearing is among a variety of groups. That's an important point readers should come away with since this article is about helmets in general, not just helmet laws or who argues about those.Nelsonsnavy (talk) 13:30, 15 February 2012 (UTC)

Opponents
Most cyclist unions oppose helmet laws. Some are neutral while others are opposed to both laws and campaigns. The League of American Bicyclists strongy recommends the use of helmets but does not take a position on helmet laws.

The Danish and Swedish cyclist unions recommend wearing a helmet, but are opposed to a law because it would reduce cycling and damage public health. .

The Cycling Advocates' Network of New Zealand says that the helmet law is not working as intended and should be reviewed. The German cyclist union ADFC says a helmet law would be a net loss for public health.

The European Cyclists' Federation, the British CTC and the Dutch Fietsersbond are opposed to both laws and campaigns because they exaggerate the risk in cycling and are damaging to public health.

Regular cyclists live longer. Therefore, if helmet laws reduce cycling, they are damaging to public health.

End draft.


 * A couple quick comments: alter/remove "Most cyclist unions oppose helmet laws" unless we can get actual figures. I could imagine, for example, that there are many cycling groups in America that take no position on the issue since all-ages MHL's are rare there. CAN can't rightly be classified as an "opponent": they call for a review of the law's effects, but make it clear they do not actively oppose the law and treat the whole matter as a low priority. Remove last two sentences--personal editorial argument--unless they are attributed to a specific group's criticism of MHL's. Nelsonsnavy (talk) 13:21, 15 February 2012 (UTC)


 * One other suggestion: give equal time. If you're going to explain or quote the rationales of opponents, you should do the same for proponents.Nelsonsnavy (talk) 13:24, 16 February 2012 (UTC)


 * I'm unhappy with the last sentence because it comes across as POV; "Regular cyclists live longer. Therefore, if helmet laws reduce cycling, they are damaging to public health." This is not a universally accepted statement and, if it's going to be used, it shoud be attributed to whichever groups are making the claim, not presented as a statement of fact. Obscurasky (talk) 16:51, 16 February 2012 (UTC)


 * Agree with all above. Nelsonsnavy and Obscurasky are right, not everyone agrees that less cycling is bad for health. We already use the reference twice: A minority view, but it's there. Richard Keatinge (talk) 09:00, 1 March 2012 (UTC)

End draft.

"

Case-Control Studies and Approaches to this Article
I'm concerned about the way this article is at times being used to present a questionable picture of certain topics, such as helmet case-control research, or to engage in debate instead of report it. Recently, a relatively elaborate argument, since reduced, was inserted into that section to debunk case-control studies in general; in another instance, criticisms of a single study by a single source were quoted at length. I see a few problems with this approach.

It can present a skewed or biased view of a particular topic. My view is that an encyclopedia article such as this should provide the general, disinterested reader with a clear, brief, and accurate overview of a topic, to be used as springboard for further research. In the case of case-control studies of helmets, from looking at the literature of individual studies, I've noted wide general agreement in their findings that helmets offer some level of head protection, with sometimes even rather emphatic conclusions. (I.e., they're not all saying, "well, maybe they can help, but I don't know" :) ) Meta-analyses and reviews offer a very similar picture.

If we're to give an accurate, objective overview of the science, that's the impression the reader needs to come away with first and foremost. As it stood, if someone unfamiliar with the topic were to read the section in question, the last point they'd come away with would be that case-control studies can be unreliable. But, they can also be reliable, and other types of studies can be flawed. I felt the need to at least balance the assertion, but of course we now have an expanding miniature debate about case-control studies in general :) I suggest we remove that bit entirely to keep the focus on what the research says, not whether it might or might not be flawed. Inserting every criticism or proviso for every piece or type or research on bicycle helmets will lead to a never-ending article.

Article neutrality and objectivity to me means you present the evidence showing both the helpful and harmful consequences of helmet use, as described in the literature, without sweeping it under the rug or trying to debunk it yourself. OTOH, if a key scientific article on the topic has been widely questioned or refuted by researchers themselves, that would be worthy of mention since it would give readers a better understanding of the state of the research. Nelsonsnavy (talk) 13:49, 13 February 2012 (UTC)


 * I tend to agree that we don't need a section on case-control studies in general and would support removing this. You are absolutely right that almost all such studies conclude strongly that helmets offer significant protection and we should say so, with a little caution and a reference to Elvik. I suggest it's important to note that we do have good references to serious, even invalidating criticism of this work, and that studies higher up the hierarchy of evidence generally do not, in this case, confirm the case control work. Richard Keatinge (talk) 15:12, 13 February 2012 (UTC)


 * I meant that we should consider removing the paragraph about the nature of case-control studies in general, not the whole section; after all, case-control research on helmets is pretty abundant and influential and worthy of discussion. I concur on the other points, though; I don't mean to imply that we should we never note objections to studies, but my chief concern is that we not bog the article down in back-and-forth debate that obscures the topic at hand. (I ran into that very problem when I first learned that helmets were hotly debated and tried to get some insight from Wikipedia as to who was arguing what and why.) And hopefully, readers will take it as a given that scientific research, for all its strengths, can be flawed or outright wrong.Nelsonsnavy (talk) 18:44, 13 February 2012 (UTC)


 * I support Richard's suggestion. I have grave concerns about the statement: "A Cochrane review by Thompson, Rivara and Thompson of five case-control studies found that "helmet use reduces the risk of head injury by 85%, brain injury by 88%".  These are the estimates from TRT 1989, not the combined results from all studies.  The Cochrane review provides a combined estimate (See "Head injury studies": The summary odds ratio for head injury was OR 0.31 (95%CI 0.26 to 0.37)). But, as was pointed out in a peer-reviewed paper (Robinson, 2007: Bicycle helmet legislation: Can we reach a consensus?), the risk of head injury increases with crash severity.  An OR of 0.31 means that in crashes severe enough for 90% of non-helmeted cyclists suffer head injury, so would 73.6% of helmet wearers. Is that what Wiki readers understand by an 85% reduction in head injury?  If not, then I strongly recommend a re-write by someone with the appropriate training, such as Dr Richard Keatinge.  — Preceding unsigned comment added by Dorre (talk • contribs) 22:19, 14 February 2012 (UTC)


 * Thanks. The criticisms of the case-control studies are indeed severe, and there are arguments in Reliable publications that, if accepted, render the entire corpus meaningless. The criticisms are not universally accepted and some grossly optimistic figures are still widely and fervently presented. I'm sure we can come to some consensus presentation, but it will have to be done carefully and under Wikipedia rules in which personal expertise counts for almost nothing, in which indeed genuine expertise is often a marker for a strong opinion on one side of a debate and therefore needs to be treated with particular caution. Those rules are the only way that this sort of crowdsourcing can work and I feel a strong personal commitment to them. The only use of expertise here is the ability to present the published evidence, first, in the article to tell the notable stories neutrally, clearly, briefly, and comprehensively, and second, on talk pages, to gain consensus for the resulting high quality encyclopaedic articles. From my point of view this enables me to edit articles on which I have no expertise whatever, but where I do have something to add. In articles where I do have a professional or enthusiastic-amateur understanding, I hope that I can be a better editor, but I still can't use my personal understanding to claim any privilege about what goes into the article. In the specific case here, I have made some important changes to the article in the last few years, but I have also left quite a lot of it in a state that I don't personally approve of, purely to avoid any perception of ownership of the article. I'm grateful to Nelsonsnavy for raising several of these issues, and also to other contributors, and I am confident that we can come to a consensus on improving the article.

That said, how shall we structure the important story of case-control studies? I'd suggest the main points are:

Many of them exist and they all indicate an important reduction in head injuries. So do their multiple reviews/meta-analyses. I wouldn't list them all in the article, except as a list of references if anyone wants to go to the trouble.

The 88% figure is so widely quoted in tertiary sources that I suggest it really has to go in, possibly with a comment that no other study has suggested so high a figure. Perhaps also with a little note, since odds ratios simply are not equivalent to a risk reduction estimate, that this figure "would correspond to a reduction of head injuries by x% due to helmets"?

Recent reviews are at the top of the tree for Reliability and we need to include at least Elvik and the Cochrane review. The Elvik review in particular suggests that these studies are affected by serious biases and possibly do not show net benefit when neck injuries are included. It also points out that the message of helmet effectiveness is not supported by the time-trend studies which are higher up the hierarchy of evidence.

There are Reliable comments (including at least one by myself which I therefore need to be extra-cautious about) that point out ways that these studies may be entirely wrong, and these ways are strongly supported in the cases where relevant figures are available. Any study may be confounded, and in at least two studies there is a close association between helmet non-use and risk-taking (alcohol in one, lower social class and riskier riding locations in another). In one study there are also figures to suggest that some crashed cyclists claim, when they can (i.e. where they don't have a head injury) a high rate of helmet use, and this alone could account for all the positive results of all of these studies.

Is there any consensus on the above list of points for inclusion? If not, could we have your suggestions? Richard Keatinge (talk) 10:39, 15 February 2012 (UTC)

I'll try to look through it again--not much time atm. I will fix the summation of the Cochrane review; apologies if I made an an error. My guiding principle and concern--the very reason I got involved in editing some of the helmet-related articles--is that they should present a neutral view of the subject. Anything that smacks of editorial attempts to sway the reader to one "side" needs to be excised or at least reviewed critically by multiple editors. We need to present the facts, not tell people how they should think about them or insert arguments of our own; with a controversial subject such as this, attempts to do so are too easily abused or at the very least misunderstood. Either way, it's heartening that there's a lot of serious discussion about how to make this article better.Nelsonsnavy (talk) 13:01, 15 February 2012 (UTC)

Have added a link to the wiki page on odds ratios and, as Richard suggested, an example and reference to what an OR of 0.31 means for crashes where 90% on non-helmeted cyclists suffer head injury. I think Richard's comments about the association between helmet non-use and alcolhol/lower social class are worth noting, if there is consensus. Would there be consensus in adding, after the reference to TRT 89, references to literature that cite the 85% reduction in head injuries? (talk) —Preceding undated comment added 21:19, 15 February 2012 (UTC).


 * My vote is to keep is simple: our job is merely to report, not to offer personal (re)interpretations--a practice that goes against the spirit, if not the letter, of Wiki guidelines and poses particular problems when dealing with a potentially controversial subject--and not to try to convince people that one (type of) study is better, worse, flawed, etc.


 * And by keeping it simple, I also conceive that to mean keeping it streamlined. If you start adding criticisms of one study or type of study, then in fairness, you need to go through the entire article add them for every study--and then add the counter-criticisms. For instance, why are there no admonitions to the reader that studies showing a decline in ridership with the enactment of certain helmet laws demonstrate only correlation, not causation? Of course, the net result of inserting that sort of thing everywhere will be a bloated (if not biased) disaster of an article.Nelsonsnavy (talk) 13:21, 16 February 2012 (UTC)


 * Simple and streamlined are good, and we need references for everything, plus consensus (based on secondary sources and, I hope, some judgement of scientific relevance) for inclusion. We may well be able to get in every substantial counter point that has been made - their numbers are limited and it's a good way to document a controversy - and if we can do so while keeping things simple and streamlined, it might actually make the article a lot better.


 * All the studies in this area are observational and all show "correlation not (necessarily) causation". Some are higher on the recognised hierarchy of evidence than others. We may indeed need to make those points explicit. Richard Keatinge (talk) 10:36, 17 February 2012 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/20006204 has the correlation between alcohol use and helmet non-use: Am J Emerg Med. 2010 Jan;28(1):68-72. Alcohol, bicycling, and head and brain injury: a study of impaired cyclists' riding patterns R1. Crocker P, Zad O, Milling T, Lawson KA.

OBJECTIVE: The aim of the study was to examine the interactions between alcohol, bicycle helmet use, experience level, riding environment, head and brain injury, insurance status, and hospital charges in a medium-sized city without an adult helmet law. METHODS: A study of adult bicycle accident victims presenting to a regional trauma center over a 1-year period was undertaken. Data were collected at the bedside regarding helmet use, alcohol use, experience level, location and type of accident and prevailing vehicle speed (for road accidents), and presence and degree of head or brain injury. RESULTS: Two hundred patients 18 years or older were enrolled from December 2006 through November 2007. Alcohol use showed a strong correlation with head injury (odds ratio, 3.23; 95% confidence interval, 1.57-6.63; P = .001). Impaired riders were less experienced, less likely to have medical insurance, rarely wore helmets, were more likely to ride at night and in slower speed zones such as city streets, and their hospital charges were double (all P values <.05).

Richard Keatinge (talk) 10:36, 17 February 2012 (UTC)

Bold edit
I hope that others like this edit of the case-control section: http://en.wikipedia.org/w/index.php?title=Bicycle_helmet&action=historysubmit&diff=477386862&oldid=477071814. I have to say, I feel that it summarizes and references all of the directly-applicable scientific arguments and conclusions in a brief, accessible, and encyclopedic way, without getting into analogies or peripheral arguments, mentioning only the very notable figures, and gives due weight to them all. I feel that we could do the same sort of thing for the other scientific sections. I can only look forward to comments. Richard Keatinge (talk) 12:44, 17 February 2012 (UTC)

At first glance, that seems an admirable rewrite: concise, informative, and balanced. We should all look through the rest of the article for ways to improve other sections. (I listed some preliminary suggestions previously.)Nelsonsnavy (talk) 13:55, 18 February 2012 (UTC)

I spoke too soon. Looking at this further, there's apparently a major problem: the editor seems to be quoting himself as a source, unless there are two different Richard Keatinges in question. It's apparently not an original peer-reviewed research study, either, but rather an argumentative essay about published research. (Source 59 "Objective observation of helmet use is essential.") This raises serious questions. Unless someone can clarify this and provide strong reasons why it should remain, I suggest removing the item in question ASAP.Nelsonsnavy (talk) 15:56, 25 February 2012 (UTC)


 * As I mentioned above before I made the edit, it's the same Richard Keatinge, as part of the discussion in a peer-reviewed journal. Maintaining the suggestion that it's a good reference for the point, I'd better limit my role in any further discussion. Richard Keatinge (talk) 19:21, 25 February 2012 (UTC)


 * One of the problems is that it's an argumentative letter to the editor, not a source of fact or original peer-reviewed research. BMJ: "Rapid responses are electronic letters to the editor and new ones are published each day." It hardly seems appropriate for an editor here to make a point by quoting his or her own letter, particularly since that letter is taking a public stance on one side of this controversial issue.Nelsonsnavy (talk) 14:22, 26 February 2012 (UTC)

I'm concerned about the multiple citations of Thompson, Rivara and Thompson, especially since their work was apparently funded by Snell. As well as their paper claiming an 88% reduction in brain injuries, Nelsonsnavy's version cited their Cochrane review and their meta analysis at http://depts.washington.edu/hiprc/practices/topic/bicycles/helmeteffect.html Essentially, these meta analyses consider a very similar set of studies, although with different methodology and inclusion criteria, so one version from the same authors would seem to be adequate. The big difference in approach seems to be the Elvik re-analysis, which in Table 2 reports an OR of 0.85 for head, neck or face injury based on 33 estimates, with the most recent 9 estimates showing an OR or 1.00 - no effect at all. A balanced approach would report the magnitude of both sets of estimates, the 63-88% claim, and Elvik's OR of .85, which corresponds to less than 15% of injuries prevented - none in the most recent studies.--Dorre (talk) 23:19, 28 February 2012 (UTC)


 * "Essentially, these meta analyses consider a very similar set of studies, although with different methodology and inclusion criteria, so one version from the same authors would seem to be adequate." As you say, different publications, different info. The one that you excised had the particular benefit of making it easy for readers to pursue further independent study of the literature. If different publications with similar content by the same author present a problem, then we need to go through this whole article and remove the repeated multiple citations to other authors/sites within the same section. E.g., two citations to Robinson in "Health benefits of cycling." I don't see the practice as inherently problematic, as long as the sources meet Wiki guidelines.Nelsonsnavy (talk) 18:50, 29 February 2012 (UTC)


 * As a side note, I noticed a few places that accidentally cite not the same author but rather the same exact source twice (i.e., two refs to the same web page, one after the other) for the same sentence and have started removing them. Any help with that would be appreciated to clean up the article.Nelsonsnavy (talk) 19:04, 29 February 2012 (UTC)

Bold edits by two editors
Thanks for your hard work. At http://en.wikipedia.org/w/index.php?title=Bicycle_helmet&action=historysubmit&diff=479450440&oldid=479370031 I have removed discussion of how badly wrong case-control studies have been in other areas - with apologies, but I really cannot see this as appropriate for this article. I have also re-inserted, as references only, some comments including one of my own. To report the main heads of the discussion, per Reliable sources, is fundamental to a good encyclopaedic article. We don't need endless argumentation nor sidetracks, but an article that does not outline the main bases of discussion cannot be a good one.

And I have removed the separate heading for meta-analyses, again with apologies. All of the meta-analyses in this area are re-workings of the case-control studies, they can only be as good as their constituent studies, and their logical place is as part of the discussion of the case-control studies. I have left in the recent French study, with a link to the full article since it's free, but I don't think we need it in particular as an example. What I'd suggest is a list, as references, of case-control studies. Richard Keatinge (talk) 11:28, 29 February 2012 (UTC)


 * The problem I see with the most recent edits is that the article is moving in the wrong direction again, towards bloat and argumentation. I was trying to pare it down so it would provide an readable overview for the general reader, who can then follow the sources.


 * Now, for instance, there's a big block of somewhat rambling data about Australian cycling levels, notably removing the fact that long-term levels are at their peak according to one source. Nowhere in the paragraph are there any sources directly stating that helmet laws actually caused any of these changes; it is mere implication. Why is a rather large section of the article built on this implication?


 * This sort of thing is a disservice to the reader from a readability standpoint, an instance of redundancy with another article, and an attempt to make a partisan argument instead of presenting a simple, readable overview of the facts for the disinterested, lay reader. Until we can all come to a consensus about how to proceed with this sort of thing, I added back some long-term data, so the reader at least gets a broader, more balanced picture.


 * As to meta-analyses, whatever their constituent sources might be, they are different in kind from single studies and are said to come at the top of the Hierarchy of evidence. They really need to have their own section on those grounds. "they can only be as good as their constituent studies" Whether they are good or not is not up to us to decide. Our goal is to report.


 * I'm curious, too, why there are 8 citations for criticisms of just one study, two of which are duplicates, two from the same author, two from another individual, one a letter to the editor, etc.? Rather comical overkill and again a disservice to the reader in that there are no sources of support for the article presented, other than one quotation from its authors. Some semblance of balance would be nice.Nelsonsnavy (talk) 14:53, 29 February 2012 (UTC)


 * "I have left in the recent French study, with a link to the full article since it's free, but I don't think we need it in particular as an example. What I'd suggest is a list, as references, of case-control studies." On the contrary, I think we do need at least some examples, otherwise we give the false impression that the science centers on just one article, when in reality, it seems more like political argument centers on that one article; the science is much broader. Plus, if we're going to go with lists, then we have to consider what other references in the article we're going to accord the same treatment.Nelsonsnavy (talk) 13:13, 29 February 2012 (UTC)


 * Personally I would want a reason to emphasize any one study, and would go with the much-quoted TRT '89. I suppose putting in the latest case-control study is reasonable. A list of references might be useful, but a reference that includes an up-to-date list might be even better. Can anybody suggest one? Richard Keatinge (talk) 09:19, 1 March 2012 (UTC)

Less Bicycle Use Section
The section "Less Bicycle Use" needs to be re-examined in earnest because it's built on a questionable hypothesis with limited sources: "When mandatory bicycle helmet laws were enacted in Australia, slightly more than half of bare-headed cyclists ceased to ride their bicycles frequently. In the UK between 1994 and 1996, in areas where cyclist counts dropped, wearing rates increased and where the number of cyclists increased, helmet wearing rates fell."

The reference to the UK doesn't even deal with a helmet law.

One cited study for the assertion regarding Australia, "Head injuries and bicycle helmet laws," says "However, the two major surveys using matched before and after samples in Melbourne (Finch et al. 1993; Report No. 45, Monash Univ. Accident Research Centre) and throughout NSW (Smith and Milthorpe 1993; Roads and Traffic Authority) observed reductions in numbers of child cyclists 15 and 2.2 times greater than the increase in numbers of children wearing helmets." So, she's just talking about children in two geographically and temporally limited surveys.


 * Before you draw any conclusions from this, you should realise that many schools banned their pupils from riding to school at that time,  because of concerns that the schools and the individual teachers could be held liable by judges for failing to enforce the wearing of helmets by children, both on and off the school premises.   So the schools took the line of least resistance and banned riding to school.Eregli bob (talk) 19:31, 4 March 2012 (UTC)

The other study, by the same author, "No clear evidence from countries that have enforced the wearing of helmets," deals with some of the same data. In neither source do I see the author say that in Australia, slightly more than half of bare-headed cyclists ceased to ride their bicycles frequently. Could someone please point to it in case I'm overlooking the obvious?

Of equal concern, we have sources showing substantial long-term post-law increases in cycling, cycle-commuting, and bike sales in Australia.

http://www.austroads.com.au/abc/images/pdf/Australian_National_Cycling_Strategy_2011-16.pdf http://www.carrsq.qut.edu.au/publications/corporate/bicycle_safety_fs.pdf http://www.vicroads.vic.gov.au/NR/rdonlyres/29A3CEDE-B1A0-492E-8158-2210C11E5D01/0/Report_on_Cycling_to_work.pdf

Nelsonsnavy (talk) 18:18, 26 February 2012 (UTC)


 * Good points there. I've tried to reorganize it, get rid of duplication, and so on. A first cut only. Richard Keatinge (talk) 16:21, 29 February 2012 (UTC)


 * Thanks for your edit. I have had another go, trying to keep the better science (controlled studies and step changes) definitively on this page, referring to Bicycle helmets in Australia for further information. Richard Keatinge (talk) 14:56, 1 March 2012 (UTC)


 * I have split the Hagel and Pless reference into two, with appropriate quotations, reflecting our separate discussions of head protection and effects on the amount of cycling. (Their comments on the protective effects are particularly odd. Their article was an invited companion piece to Robinson 2006, notable for its careful and comprehensive use of all available concurrent control groups. Yet they complain that it was "without any concurrent comparison groups". It's quite a bizarre comment, especially when they follow it with an uncontrolled comparison of their own, and the rest of the piece also reflects rather a lot of misunderstandings. However, it's in the literature and is Reliable for our purposes. Putting it next to the clear graphs from controlled studies seems to be appropriate.) At least their comment about in-line skating etc doesn't contradict the evidence in front of them. Richard Keatinge (talk) 15:05, 1 March 2012 (UTC)


 * It's all rather odd on both sides, with no one firmly establishing or refuting causality. Either way, the big problem now is that this section of the article again makes no explicit assertion that there is any link between the helmet law in Australia and changes in cycling. I.e., this section has been reverted to an editorial argument. We should report on the literature that actually asserts causality. Otherwise, it's just statistics that could be attributable to a multitude of factors.Nelsonsnavy (talk) 17:09, 1 March 2012 (UTC)


 * We report the literature that provides evidence on reduced cycling as a result of helmets, a scholarly argument. If we come to a consensus that the counter-arguments are feeble and lack conviction, I suppose we could say so. What do you suggest? Richard Keatinge (talk) 19:20, 1 March 2012 (UTC)


 * There should be some mention that a scholar is actually making the explicit claim of causality; whether or not it's well founded, at least that would give context to what appears currently in the article as merely coincidental changes with no causal linkage being posited, except by innuendo. No, it wouldn't be appropriate for us as editors to interject into the article whether we feel the arguments are strong or not; that would be disastrous if everyone starting adding editorial asides about what they consider to be weak sources. Btw, one thing that still needs clarification is: "Cycling in Australia was increasing before the helmet laws were introduced and fell by roughly one-third at that time." Where's the "one third" coming from in that study, and is it for all of Australia or just the data-collection locations?Nelsonsnavy (talk) 19:50, 1 March 2012 (UTC)

Over-reliance on same sources
Looking through the References list, one can see that certain sources are weighted far more heavily than others. For instance, two articles on essentially the same subject by the same author (D Robinson) are referenced at least fourteen times, usually in tandem. I'm concerned this might be skewing the article towards one writer's point of view or findings. Are there any alternative reliable sources making the same points that we could reference?Nelsonsnavy (talk) 13:41, 2 March 2012 (UTC)


 * You have correctly identified the author responsible for most of the best work on this subject. Alternative sources are generally not quite so good. Richard Keatinge (talk) 17:19, 2 March 2012 (UTC)


 * When presentations of one side of a contentious topic repeatedly draw on the same author to found its key points, it's a problem for a well-rounded encyclopedia article.Nelsonsnavy (talk) 17:20, 4 March 2012 (UTC)

Elvik Needs Clarification
The section on Elvik has been rendered ambiguous, if not inadvertently misleading. He elaborates two things in his Discussion and Conclusions sections: the findings of his overall re-analysis of Attewell, and his interpretation of the four "new" studies he's added to those used by Attewell. His conclusion about "no overall benefit" refers only to his analysis of those four studies, not his whole meta-analysis, which draws different conclusions that need to be rendered clearly. The way the section is re-written now does not make these distinctions as clear as they could be.Nelsonsnavy (talk) 14:30, 26 February 2012 (UTC)


 * How about something like this:

A 2011 re-analysis of Attewell et al. (2001) by Elvik finds that it was influenced by publication bias and time-trend bias. When "these sources of bias are controlled for, the protective effects attributed to bicycle helmets become smaller than originally estimated." The re-analysis finds that helmets "clearly" reduce the risk of head injury and provide slight protective effects for the face, but apparently not for the neck. Elvik finds that four studies not included in Attewell et al. show "no overall effect of bicycle helmets ... when injuries to head, face or neck are considered as a whole." Nelsonsnavy (talk) 14:40, 26 February 2012 (UTC)


 * Seems good to me. Richard Keatinge (talk) 17:29, 26 February 2012 (UTC)


 * OK, I'll put that in. Nelsonsnavy (talk) 17:36, 26 February 2012 (UTC)


 * That's not sufficient. You cannot find influence of publication bias - well short of discovering an actual competent and complete study that was deliberately surpressed.  Elvik uses a method of estimating the possible effect of publication bias.  It's essentially a confidence interval based on social rather than mathematical factors.  It's a bit unfair to say that it changes Attewell's findings, because Attewell explicitly states that publication bias would reduce his figures but not, he believes, by much, and Elvik confirms exactly that.  He also confirms (slightly strenghthens) Attewell's original calculations.
 * The "head, facial, and neck injuries" bit is weak, as it is unclear how Elvik derived the disjunction since the original papers do not provide statics for that category, and it does not seem to be of much a priori interest. Hew Johns (talk) 16:45, 13 April 2012 (UTC)

Is ordinary cycling risky enough to require helmets?
Any thoughts on this section? It doesn't answer the question, nor should it, as it's presumably a personal judgement call about perceived risk levels. It also has redundant info and sources about cycling's health benefits, which are discussed/cited later in the article. Maybe re-title the section and add in a few more stats comparable to the first couple paragraphs, removing the redundancies from the last paragraph?Nelsonsnavy (talk) 15:04, 29 February 2012 (UTC)


 * Absolutely. I've removed the bits about health benefits to later, see what you think. The remains of the section are the (referenced) comments made by people who have used different types of figure to express very different personal judgements. Again this is about documenting the debate and not our own judgements. Personally I think it's not too bad at present. Richard Keatinge (talk) 16:21, 29 February 2012 (UTC)


 * First glance: removing/moving the redundant bits about health benefits is helpful. (I think more and more that this article needs a ground-up overhaul to comb out all those sorts of issues, and the works cited list is a mess.) I think the section is still problematic in that the second paragraph doesn't deal with head injury per se, which is what helmets pertain to. Plus, the paragraph is limited to just two countries. Maybe just put in a few stats from a variety of nations regarding head injuries per year for cyclists or something to that effect, re-titling the section accordingly?Nelsonsnavy (talk) 17:26, 29 February 2012 (UTC)
 * 'Ordinary' is vague. Does it refer to utility cycling - and if so, why not call it such? Also, with regard to the statistics given - were they gatherered from data relating to only 'ordinary cyclists' or do they include data from other form of cycling too, like mountain bikers? Obscurasky (talk) 13:06, 1 March 2012 (UTC)
 * 'Ordinary' is indeed vague. It's what at least one source has used. I'll be happy to differentiate the science by type of cycling if sources have done so.
 * At the moment we have a mishmash of figures, based on what sources have used in this debate. I suppose we could change to figures that we think are more relevant, but we should get them from sources who are using them in the debate. Richard Keatinge (talk) 14:23, 1 March 2012 (UTC)


 * The article isn't about a bicycle helmet debate per se, but about bicycle helmets. I'll try to find some sources so this section can say something relevant.Nelsonsnavy (talk) 17:41, 1 March 2012 (UTC)
 * My point is that, if statistics are being used to support claims about 'ordinary cycling', it's important that they do actually relate only to that specific genre. If the data used includes, for example, injuries sustained by mountain bikers, then it is would be wrong to apply the results specifically to 'ordinary cyclists' - whatever 'ordinary' means. Obscurasky (talk) 22:29, 1 March 2012 (UTC)


 * I understand. "Ordinary" is certainly vague. Any consensus on just deleting the section? It's not really offering much of use to the reader atm.Nelsonsnavy (talk) 12:44, 2 March 2012 (UTC)


 * Again it's about documenting what others have thought relevant to the debate, and the numbers of casualties / risk level is a significant part of that debate. Richard Keatinge (talk) 18:50, 2 March 2012 (UTC)


 * I have removed the word "ordinary" as it's unclear and I don't think we need it. But I put back the rest - head injuries are a subset of all injuries. Richard Keatinge (talk) 22:39, 4 March 2012 (UTC)


 * 'Ordinary' is indeed unclear, but the problem is that, without some kind of qualification (like 'ordinary') the section becomes meaningless. Cycling is a broad church, and it's impossible to apply the same arguments to road users and mountain bikers alike. The debate over helmet use does not extend to genres such as mountain biking, downhilling, etc - but any reader would be hard pushed to tell that from this article.Obscurasky (talk) 01:24, 5 March 2012 (UTC)


 * In this section, in the second paragraph, the first sentence "Per mile, in the United Kingdom, cycling has an overall risk of injury and death similar to walking but higher than driving.[30]" is not supported by the text in the citation. The citation does include a statement to the effect that in the UK cycling has a higher fatality rate than driving, but nowhere it states or implies that it's "similar to walking".  Let's be clear that "not a more risky activity", in the cite, does not mean "similar" by any stretch, even if it were a defensible claim (which it is not).


 * The first sentence of the 2nd paragraph might be defensible if the "editor" had used "per hour" instead of "per mile". In that case, the editor needed to qualify the statement far better as to the boundaries of the claim made.


 * The second sentence in the second paragraph of the section: "Measured per hour, the risk of driving, cycling and walking are similar.[31][32]" is sloppy. The first cite [31] shows in Chart 2, quite the opposite (not similar at all). Taken at face value, with the same basis in hours, the cyclist fatality rate per hour is more than twice that of a pedestrian (0.25 vs. 0.11).


 * The second cite [32] fares no better when examined. It clearly lists fatalities per billion passenger-hours as follows: car: 130, foot: 220, pedal cycle, 550.  What tortured reasoning can find these figues to be "similar"?  Also, this reference is wholly unverifiable as it has no author and no citations of its own! Doesn't Wikipedia have any standards regarding what you can plug in as a "reference"?  Good gracious!146.23.68.40 (talk) 17:54, 14 March 2012 (UTC)

Major Problems
This article has some serious problems that need addressing:

1) The article does not present the reader with a realistic picture of the general uniformity of expert scientific and medical opinion confirming the efficacy of helmets for injury prevention. I was able to find over 50 government reports, literature reviews, and peer-reviewed research articles in major scientific/medical journals asserting their efficacy. The articles span approximately 25 years and multiple countries. Contrary articles from similar-quality sources seem to be dramatically fewer and come mostly from the same few authors. (I strongly encourage others to do their own independent searches of the professional literature to draw their own conclusions about the state of the science.)

As such, the existing presentation in this article seems to violate one of Wikipedia's key principles:

WP:UNDUE "Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint. Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of or as detailed a description as more widely held views."

As it stands, the article quite rightly represents an alternative viewpoint--there are reputable peer-reviewed, scientific sources questioning helmet effectiveness--but the article does so in a way that fails to impart upon the reader the breadth and prominence of mainstream scientific/expert consensus on the matter.

2) Related to the above, this article is about bicycle helmets, not about the bicycle helmet debate per se, but it seems to confuse or conflate the two: the latter topic could conceivably benefit from having its own article, just as Wikipedia has separate articles for other controversial topics, such as capital punishment and capital punishment debate.

3) A significant amount of information, including a few potentially contentious assertions, lacks citations.

4) A single author, D. Robinson, is cited 16 times, giving that author undue weight; notably, a number of key arguments against helmet effectiveness or laws presented in this article keep returning to this one author. If the same opinions or findings were widely held, it would be easy (and recommendable) to also quote from other researchers as references to these topics.

5) The article relies on questionable sources for key arguments: letters to editors, anonymous articles (dubious accountability and credibility), partisan websites, etc.

For help determining the reliability of sources, please see

Reliable_sources and Identifying_reliable_sources_(medicine)

6) In the section on case-control studies, one scientific study on bicycle helmets is "rebutted" with 6 footnotes/sources, a number of them duplicating the same authors or website. This is again a problem of undue weight:

Neutral_point_of_view "Pay attention to headers, footnotes, or other formatting elements that might unduly favor one point of view, and watch out for structural or stylistic aspects that make it difficult for a reader to fairly and equally assess the credibility of all relevant and related viewpoints."

Stacking up a string of footnotes does not make a source more "wrong," but certainly seems to be used here to imply such a thing. — Preceding unsigned comment added by Nelsonsnavy (talk • contribs) 20:20, 4 March 2012 (UTC)


 * We're not counting votes or bibliometrics here. We have quite a few sources that repeat the same methods - in some cases, leaving out essential control group information - and come to the same conclusions. We have others that point out these mistakes, avoid them, and come to different conclusions. Since both sets of conclusions are still asserted we report both sides, with data and appropriate references. As others have pointed out and certain quotations make clear, the debate can become quite tetchy, and we report that fact too. That is not a problem of any size, it is a good way to produce a top-quality encyclopedia article, though not one that unequivocally supports the usual initial assumptions about the subject nor one that comes to a totally clear conclusion. However, if you have noticed duplicate references, deleting them seems a really good idea. Richard Keatinge (talk) 22:34, 4 March 2012 (UTC)


 * "We're not counting votes or bibliometrics here."


 * WP:UNDUE
 * "Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint. Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of or as detailed a description as more widely held views."


 * It appears that Wikipedia does require a certain amount of bibliometrics. Hew Johns (talk) 19:26, 14 April 2012 (UTC)


 * In regards to point 2) above, I agree. "Are helmets harmful"? is misleading.  The body in the article never argues that it is harmful to the user, but rather to the health of society or a proposed cycling population.  We agree, then, that it is NOT HARMFUL to the user.  The public health benefits of bicycling, being arguably the same as or similar to that of other exercises, does not belong in the Bicycle Helmet article.  Just my two cents... (OK perhaps worth slightly less)

146.23.68.40 (talk) 16:22, 14 March 2012 (UTC)


 * That still leaves hanging by helmet straps - fortunately it seems to be very rare. Richard Keatinge (talk) 11:20, 13 April 2012 (UTC)


 * I agree with point 2 above. This is supposed to be an ENCYCLOPAEDIA. The article is ridiculously over-long, convoluted to the point of unreadability and has probably the worst case of Citation Overkill I've yet seen on Wikipedia. It's awful - just one POV against another. The article in 2004 was infinitely better. Hohenloh + 12:49, 3 August 2012 (UTC)

Dead link
The first citation is a link to an archived table of contents that doesn't link to the body of the report, "The Department of Transport (UK) 2002. Road safety research report. Bicycle helmets: review of effectiveness (No.30)." Is there a link to the full report? --Nbauman (talk) 04:45, 4 April 2012 (UTC)


 * Unfortunately I can't find one. We do have a reference to the paper version and the relevant quotation, which should be adequate. The link to the table of contents is indeed of very limited use. I have replaced it with a link to the summary, which does include a comment relevant to the point referenced. Richard Keatinge (talk) 09:10, 4 April 2012 (UTC)

This article is just wretched!
Okay, I started thinking about correcting some of the problems I saw - the misrepresentation of Elvik, the missing counter-argument to the cycling exercise outweighs risk, the conflation of case control and time trend goals, but then I went and read the citation for "A cost-benefit analysis by a Canadian academic concluded that helmet laws are counter-productive if cycling decreases by more than one quarter of one percent." - It's a set of power point slides for a classroom lecture on cost-benefit analysis with numbers pulled out of the air with no apparent claim to being anything more than an interesting classroom example. So I decided the best thing was to voice a strong objection to the whole article. Hew Johns (talk) 05:01, 13 April 2012 (UTC)


 * Thank you for the constructive comment on the reference, which I have replaced by a more academic one. Richard Keatinge (talk) 11:19, 13 April 2012 (UTC)


 * Not that I can see. Is one of us missing something? Hew Johns (talk) 19:17, 14 April 2012 (UTC)


 * Okay, I shall strike it as we seem to agree it is not a source. Hew Johns (talk) 17:15, 17 April 2012 (UTC)


 * Ah, I missed that one, thanks. It's a pretty poor source. Richard Keatinge (talk) 20:39, 17 April 2012 (UTC)

Cleanup of Opponents section
I removed the following, because a citation had not been found for about 5 years:

For context, one evaluation of the relative merits of different cycle safety interventions estimated that 27% of cyclist casualties could be prevented by various measures, of which just 1% could be achieved through a combination of bicycle engineering and helmet use.

— Preceding unsigned comment added by Andythechef (talk • contribs) 23:05, 19 October 2012‎ (UTC)

anti-helmet bias
There seems to be too much anti-helmet bias in the article and I think I can see why. Virtually the whole article seems to written from the point of view of utility cyclists. There is no debate, for example, about the usefulness of helmets in mountain biking, but NOWHERE in the article is that point made. Mountain biking is masive, all over the world, and this article needs re-writting in a way that represents all forms of cycling. MTB UK (talk) 12:09, 16 December 2012 (UTC)
 * I am not familiar with any of the scientific literature that specifies the type of cycling. And, almost everywhere, almost all cycling is utility cycling. In short, and correct me if I'm wrong, the scientific debate doesn't differentiate between activities though it is mainly about utility cycling. The popularity of helmets in various activities is an entirely different issue and I did manage to find one reliable reference that points out that helmets are more popular in sports cycling. I suppose it's reasonable to leave the phrase "utility cycling" in the lede. Richard Keatinge (talk) 17:51, 16 December 2012 (UTC)
 * So maybe the problem is that the 'scientific literature' isn't representative of the bigger picture? I was at my local cycle centre this morning (mountain biking) and there were litrally hundreds of cylists and not a single one without a helmet. The fact is (and it is a FACT) that there is no debate about the usefulness of helmets in the mountain bike comunity. No-one reading the article would be aware of that, because it is slanted towards utility cycling. MTB UK (talk) 18:49, 16 December 2012 (UTC)
 * I'm really sorry not to make myself clear. The scientific debate is about helmets, wherever used. The various sub-tribes of "cyclist" have their own opinions and arguments, which may or may not have anything to do with science. Opinion in a sub-tribe may (and at other times may not) use evidence, but that isn't the same as scientific debate, opinion and science may come to entirely different conclusions. Suppose someone collects evidence on the cycle accidents presenting to a specific hospital, and comes to the conclusion that neck braces prevent 88% of broken necks in "cycle accidents". Someone else collects different evidence, and concludes that the things are close to useless and have significant disadvantages. We then have a scientific debate, making little reference to exactly what style of cycling the victims were doing at the time. And, whatever the true figure may be, utility cyclists generally decide that they are not going to use the things, while another sub-tribe facing a higher perceived risk adopts the things en masse. We then also have a difference of opinion. That's a fairly close (counterfactual) analogy. Our job on Wikipedia is to produce a form of words that will tell the story briefly, clearly, and on the basis of reliable sources. So far I think we're doing fairly well. Let's keep on trying! Richard Keatinge (talk) 21:16, 16 December 2012 (UTC)
 * So can you produce a single piece of scientific evidence that demonstrates helmets are not benificial for mountain bikers?MTB UK (talk) 22:48, 16 December 2012 (UTC)
 * As far as I recall there is no evidence limited to any cycling subculture that describes the results of helmets on head injury in that subculture. There probably are reliable sources that describe the use of helmets among mountain bikers. Richard Keatinge (talk) 08:09, 17 December 2012 (UTC)
 * Ive just read the section 'Undesirable effects of helmet use' again. Most of the arguements are irrelevant to mountain bikers and, in common with the rest of the article, the bias is towards raod safety. The section 'Rotational injury' is interesting and relevant to mountain bikers, but seems only to be hypothesis. Any way, whether or not that is a fact, on balance, wearing a helmet offers useful protection for off-road mountain bikers and no one, that I have ever heard of, argues otherwise. And there is no scientific evidence to dispute it either. This is not acurately reflected in the article.MTB UK (talk) 11:06, 17 December 2012 (UTC)
 * We continue then with a dichotomy between opinion among mountain bikers, and the lack of subtribe-specific scientific evidence. (The rotational injury suggestions are based on some quite good testing with crash dummies, but indeed I know of no direct evidence that it's important in real crashes.) Our wording needs to reflect this, and to be based on reliable sources. I did manage to find a comment about helmet use being higher for sportive cyclists; what sources can you present and what wording do you suggest? Richard Keatinge (talk) 11:27, 17 December 2012 (UTC)
 * "We continue then with a dichotomy between opinion among mountain bikers" - I don't know what you mean by that. I thought you wanted the article to concentrate on the scientific debate? But what ever, the big problem for me is that the article gives the impression that there is equal disagreement in the scientific comunity (and maybe elsewhere) regarding the usefulness of helmets for both mountain bikers and road cyclists. I don't believe that. There are NO scientists arguing that helmets are not useful for mountain bikers - and you could not show me that there are. It's not enough to say that there is "no evidence limited to any cycling subculture", because it's just not feasible to believe any scientists or scientific arguements exists to say that helmets are not useful for mountain bikers. The article, as it is currently written, is dishonest because it implies that there is.MTB UK (talk) 18:22, 19 December 2012 (UTC)
 * There also isn't any specific evidence to say that helmets aren't, or are, useful on Wednesdays when cycling on a country A road. So we aren't really required to mention days of the week or road classification in the article, whatever anyone thinks about the matter. Do you have any evidence to support your "fact"? If you can produce a reliable source for (as I suppose to be true) the fact that the great majority of mountain bikers in the UK wear helmets voluntarily, or just believe them to be useful, we can reasonably say so. Richard Keatinge (talk) 18:58, 19 December 2012 (UTC)
 * No, the problem is that neither the scientific community, nor riders are interested in whether cycling helmets are "useful". Cycling helmets are not meant to make riding easier, or faster, or more visible.  They are meant to protect the head.  As Nelsonsnavy already noted clinical studies are very consistent in showing a risk factor reduction.  This same article shows that, if read carefully.  More later. Hew Johns (talk) 22:05, 21 December 2012 (UTC)
 * Richard, I just don't follow your argument and, honestly, I think you've got yourself a little confused. There are no scientists, and no scientific arguments, that exist to say that helmets are of no benefit for mountain bikers, but the article implies there IS (and that’s dishonest). There’s no mention, on the other hand, that helmets are more useful on a particular day of the week, so your analogy just doesn’t hold water.


 * My son does downhill racing, can you imagine anyone arguing (scientifically or otherwise) that I should send him hurtling off downhill without a helmet on? The debate just doesn't exist as far as mountain biking is concerned, and it needs to be clear in the article that the arguments which are advanced (questioning the usefulness/effectiveness of helmets) do not apply to all areas of cycling.MTB UK (talk) 16:08, 23 December 2012 (UTC)


 * Two of my sons also like the odd bit of downhill racing, but that has nothing to do with Wikipedia. If you can find reliable sources that say that mountain bikers all believe that helmets are useful, and/or that they all wear them, we can report it. If you can find WP:Reliable sources that describe an empirical finding of benefit from helmets in downhill racing, we can report that too. As it is we have opinion and scientific study that says, for bicycling in general, helmets don't, (or, depending on who you read, do) offer significant benefit. As far as I know there is nothing that makes the scientific argument in specific forms of cycling activity. Or on particular roads, though I have seen blog etc. comments about helmet utility on different sorts of road or track. We don't make comments about helmet utility on A roads as opposed to popping down a quiet street for some milk, and until we can produce reliable sources, we should continue to avoid mentioning the issue. This is Wikipedia and our imagination is not the point. We need reliable sources. Richard Keatinge (talk) 07:58, 24 December 2012 (UTC)
 * I used the example of my son to illustrate how silly it is to argue that the scientific debate, over the usefulness of helmets, includes mountain biking - and least of all children who engage in downhill racing. The debate just DOES NOT EXIST but this is not reflected in the article. If you're saying the scientific debate does include mountain biking, then it's surely you who needs to find WP:Reliable sources to support that claim - because it's obvious to every man and his dog that it does not.MTB UK (talk) 15:20, 24 December 2012 (UTC)


 * Question; Please can someone tell me where I can find the list of Wiki rules (like WP:Reliable sources) and whether there's one to cover the need to reference 'obvious' points? Thanks.MTB UK (talk) 15:27, 24 December 2012 (UTC)
 * Try List of guidelines. No original research is probably what you are looking for, especially the bit that reads:

"The prohibition against OR means that all material added to articles must be attributable to a reliable published source, even if not actually attributed. The verifiability policy says that an inline citation to a reliable source must be provided for all quotations, and for anything challenged or likely to be challenged—but a source must exist even for material that is never challenged. For example: the statement: "Paris is the capital of France" needs no source, because no one is likely to object to it and we know that sources exist for it. The statement is attributable, even if not attributed."

Incidentally, posts in a forum suggest that there are some downhill riders who disagree with you, though they are described as a very small minority.

I hope this helps. Richard Keatinge (talk) 17:54, 24 December 2012 (UTC)


 * "an inline citation to a reliable source must be provided for all quotations, and for anything challenged or likely to be challenged"


 * Despite the reference to 'general cycling' in the opening paragraph, the section 'Science: measuring helmet effectiveness' does not break down cycling by type - and clearly implies that scientific arguments, which question the usefulness/effectiveness of helmets, relate to all areas of cycling - well I challenge that assumption.


 * Even where a criticism of helmet effectiveness may be relevant to the field of mountain biking (eg Rotational Injury) I do not believe any author of any relevant scientific literature has claimed that these outweigh the benefits of helmet use in activities such as mountain biking. And it's certainly not sufficient to conclude otherwise on the basis that they failed to specify the type of cycling they are refering to. If the scientific arguements do relate to all areas of cycling, then a citation must be found to meet the Wiki verifiability policy.MTB UK (talk) 02:31, 25 December 2012 (UTC)


 * A quick check of our scientific references shows that they refer to cyclists, cycling, bicycle-related injuries etc. tout court. Indeed they'd have trouble doing much else because I know of no routinely-used coding system that accurately collects data on the exact details of what you were doing when the accident occurred, and none of the studies that employed special data collection seem to have tried to collect those details either. Sensibly, and in accordance with policy, this article doesn't go in to details which are not supportable from the sources; we don't need references to omit comments that have never been made.


 * You will need to provide reliable sources if you want to include your idea that the science does not apply to mountain biking, or to any other specific form of cycling. I do not think that any such sources exist, though you may well find, and could perfectly reasonably include, reliable sources that say that the great majority of mountain bikers use helmets and think that they are effective. Merry Christmas! Richard Keatinge (talk) 11:37, 25 December 2012 (UTC)


 * I have briefly looked through the references for relevant 'scienific litriture', but I don't know khow how to access them online, if you could provide some links I'd appreciate it.


 * For now though, if what you say is correct, it seems to me the problem is that the 'scientific literature' is either flawed or is being misapplied. Clearly (and indisputably) Mountain biking (particularly downhill racing) is a completely different discipline to utility cycling and it is simply not possible to make generalised statements, regarding the usefulness of helmets, that apply 'across the board'. What's more, you don't need to be a scientist to know that, if these authors are using data gathered from one discipline, and then applying it to another, or applying it generally, then that is a deeply flawed approach.


 * If the literature talks about collisions with motor vehicles, then it can't be talking about off-road mountain biking, so are you absolutely certain that the scientific references used in this article really do apply equally, across all the various cycling genre?MTB UK (talk) 00:41, 28 December 2012 (UTC)


 * I can't be certain, and indeed I'd expect effectiveness to vary somewhat across genres. The data just isn't there to tell us. Most of the literature just lumps all of the cycling accidents together though I seem to recall that some of it does differentiate between motor vehicle accidents and others. Richard Keatinge (talk) 09:54, 28 December 2012 (UTC)


 * If 'most literature just lumps all of the cycling accidents together', isn't that like gathering data from motor rally accidents and then applying it to ordinary car users?


 * There doesn't appear to be any more I can add to this debate, but don't confuse that with an assumption that you have somehow 'won me over'. There's nothing you have said in this thread to make me think any differently about this article; it's written from the point of view of utility cyclists and the result (intentionally or unintentionally) is that criticisms of helmet use, which clearly relate to road users, are being misapplied to include mountain bikers too.


 * What's more, I have come to the conclusion that the scientific literature itself may well be flawed. Authors are using data gathered from vastly different types of cycling and are thus forced to reach only generalised conclusions, which;


 * a) are then misapplied by others to specific types of cycling.


 * b) are nonsense anyway since it's impossible to make general conclusions that are relevant to such a wide-ranging sport. Indeed, I remain convinced that no scientific argument even exists to say that helmet use is not beneficial for off-road mountain bikers . You will NEVER find any author who argues, for example, that helmets are not beneficial for downhill racers.


 * Thank you for taking the time to converse with me. MTB UK (talk) 14:54, 28 December 2012 (UTC)


 * And my thanks for your time and trouble. I don't entirely disagree with you anyway - I'd personally guess that most of the cyclists in the studies are either utility cyclists or children playing, with a large minority of racers and a small minority of mountain bikers. Findings of efficacy might indeed vary between populations. My only point is that we don't actually know any of these things and we should avoid making definite statements that we can't support from reliable sources. Richard Keatinge (talk) 17:07, 28 December 2012 (UTC)