Download PDFPDF

Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists: a retrospective study from the NHS England Trauma Audit and Research Network dataset
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Claims of cycle helmet benefit: Selection bias has a stronger claim as explanatory factor.

    In their recent paper Dodds et al. analysed cycling-related injuries recorded in the NHS England Trauma Audit and Research Network (TARN) Database for the period from 14 March 2012 to 30 September 2017(Dodds et al., 2019). They claim their methods show an association between cycle helmet use and reductions in, crude 30-day mortality, severe traumatic brain injury (TBI), intensive care unit requirement and neurosurgical intervention. Cycle helmets are light structures, generally weighing 250g to 600g, and are typically composed of a thin shell of stiff plastic outside a thicker shell of expanded polystyrene foam. The standard approval tests simulate simple falls, with no other vehicles involved (ROSPA, 2018). They are not rated for high-energy impacts involving moving motor vehicles. Eighty four per cent of fatality and serious cyclist accidents reported to the police involve motor vehicles (ROSPA, 2017). Cycle helmets are shaped to "cup" the top of the skull rather than enclose the head, which means they need a system of well-adjusted straps to stay attached in the event of a crash. When worn by non-enthusiast cyclists they are often poorly adjusted or the wrong size (Parkinson and Hike, 2003; Thai et al., 2015). When claims are made of "significant correlation between use of cycle helmets and reduction in adjusted mortality and morbidity associated with TBI and facial injury" (Dodds et al., 2019), then some observers will be immediately sceptical an...

    Show More
    Conflict of Interest:
    I have been a volunteer advocate for active travel for most of my adult life.