Effectiveness of Bicycle Helmets in Preventing Head Injury in Children

This study analyzes the effectiveness of bicycle helmets in preventing head injuries in children. It examines the hypothesis that wearing helmets can reduce the risk of severe head injuries in bicycle accidents among kids. The study population includes children driving bicycles, and the intervention treatment focuses on providing care for specific head injuries. The control treatment involves monitoring patient outcomes, and the primary outcome is the severity of head injuries. The study addresses potential confounders and compares the case control study with an ideal randomized controlled trial.

Effectiveness of bicycle helmets in preventing
head injury in children: case control study

Table of Contents
What hypothesis was the study testing?...........................................................................................1
In order to test this same hypothesis more robustly, one could conduct an ideal or “target trial”.
Define such a trial in terms of:.........................................................................................................1
a. Study population, including the eligibility and exclusion criteria .....................................1
b. Intervention treatment, including when the exposure time should start ............................1
c. Control treatment ...............................................................................................................1
d. Follow-up ..........................................................................................................................1
e. Primary outcome ................................................................................................................2
f. Causal contrast....................................................................................................................2
Draw a directed acyclic graphs (DAGs) for a) the ideal randomized controlled trial you would
like to perform; and b) the case control study showing the exposure, outcome and a set of
plausible potential confounders.......................................................................................................2
(a) The ideal randomized controlled trial you would like to perform....................................3
b) The case control study showing the exposure, outcome and a set of plausible potential
confounders............................................................................................................................3
Adapt the DAG you created for question 3 to show the extent to which the design and analysis of
this case-control study accounted for potential confounders. Briefly explain, with reference to
epidemiological concepts you have been taught, how these confounders were addressed.............4
Contrast this case control study with your ideal “target trial” in terms of chance, bias,
confounding and applicability/generalisability................................................................................4
References........................................................................................................................................5

What hypothesis was the study testing?
In context of this article, it has been analysed that investigation has hypothesis that use of
bicycle helmets are favourable in terms of preventing the hard injuries among kids (Høye, 2018).
It includes the criterion of focussing on specific research objective of examining the risk of
injury to the head as well as the effect of wearing helmets at the time of bicycle accidents
between children. However, it is observed that using helmets while driving bicycle may prove
beneficial as they are capable to avoid acute as well as severe head injuries among kids to secure
them.
In order to test this same hypothesis more robustly, one could conduct an
ideal or “target trial”. Define such a trial in terms of:
a. Study population, including the eligibility and exclusion criteria
This article has been focussed on the target population of children driving bicycle which impact
positively on their health by avoiding severe head injuries. It includes the fact that some of
individuals are excluded as the patient was non-resident and the patient’s general practitioner
declined to participate respectively (Kurt and et. al., 2017). The study population is defined as
sample or population which is recruited for conducting the study in effective manner. There is a
study protocol which explains that characteristics of eligible participants that will participate in
the study. The present study is conducted for explaining people that wearing helmet is very
important for people as it leads to reduce the risk of head injury. There is need to manage and
create awareness among people so that they realise that helmets can be helpful in minimising risk
of accidents. The number of respondents taken in this study are 50. These are people who ride
bicycle and they know there are some risks while riding it. These respondents will be asked
questions about problems that are present while riding bicycle.
b. Intervention treatment, including when the exposure time should start
The intervention treatment includes the way of providing care as soon as possible for
specific injury. It is very important to treat the particular injury of head among kids and avoid the
relevant complications by delivering desired facilities for improving health condition.

c. Control treatment
The treatment of head injuries is required to be controlled via monitoring the patient
outcomes regularly after providing medications and care services to make sure wellness of kids.
It includes to provide accurate medical facilities with proper dose of medicines in order to make
injured child wellbeing.
d. Follow-up
Considering the head injuries among kids and respective severity, it has been analysed that
care professionals are required suggest to parents and elderly people to not allow their kids for
bicycling without helmet. It is required to recommend parents to make wear of helmets
compulsory to ride bicycle for kids to avoid severe head injuries as well as its consequences for
them.
e. Primary outcome
As mentioned in the article, it has been evaluated that primary outcome is that head injuries
are generally severe and it also has severe consequences like heavy bleeding, loss of
consciousness etc.
f. Causal contrast
In context of given articles, it has been identified that avoiding helmets during riding on
bicycle is cause of severe head injuries which can be prevented easily to secure life of kids.
Draw a directed acyclic graphs (DAGs) for a) the ideal randomized controlled
trial you would like to perform; and b) the case control study showing the
exposure, outcome and a set of plausible potential confounders.
As per selected research article, it has been evaluated that kids are not ready to wear helmets
while riding bicycle but it is very important to save them from severe injuries. it includes the fact
that when kids are doing bicycle riding then they may expose to minor or major accidents which
are responsible for causing several kinds of injuries for them. However, it is observed that
helmets are much effective as well as efficient in order to prevent had injuries and their severe
consequences (Michael, Davenport and Draus, 2017). It includes the head injuries are
responsible for causing heavy bleeding or complicated psychological problem that may or may
not be curable in medical settings. In context of this study, it has been founded that potential
research outcomes includes that wearing helmets to ride bicycle among kids can be considered as

an effective strategy which is beneficial to avoid severe injuries of head. It is observed that some
of psychological problem may occur that are not curable then a small accident may become
responsible to spoil the entire life of an individual. It is very important for children to wear
helmets mandatorily while riding on a bicycle to secure their health condition by avoiding severe
head injuries respectively.
(a) The ideal randomized controlled trial you would like to perform

b) The case control study showing the exposure, outcome and a set of plausible potential
confounders
Adapt the DAG you created for question 3 to show the extent to which the
design and analysis of this case-control study accounted for potential
confounders. Briefly explain, with reference to epidemiological concepts
you have been taught, how these confounders were addressed.
Considering the given research article, it has been analysed that target population has
individual with severe head injuries and participants with other injuries without head injuries and
some are with scalp problem and skull damage. It includes that kids belong to different classes of
society in which some of them are aware of using helmets as their guardians make them
informed whereas reaming are free of using helmets due to which they have acquired severe
head injuries. However, it has been evaluated that severe injuries are related to scalp and skull
which impact negatively on psychological state of them. It is observed that some of selected
participants from target population has been facing state of losing consciousness which is
influencing their regular life (Joseph and et. al., 2017). Meanwhile, it includes the fact that some
of participants do not have better economic condition due to which they are not able to afford the
expensive treatment of their severe injuries. It consists the fact that guardians, elderly people and
parents are required to be focussed on this aspect to make helmets compulsory. Moreover, it is

necessary for legal authorities or government to make helmets on bicycle compulsory to reduce
such injuries among kids.
Contrast this case control study with your ideal “target trial” in terms of
chance, bias, confounding and applicability/generalisability.
Considering the selected article, it has been analysed that wearing helmet is beneficial to
avoid severe head injuries but informing kids for cycling carefully with using helmets is
favourable to eliminate the risk of occurring accidents as well as respective severe injuries. It
includes the efforts of government to suggest elderly people with the help of advertisements to
use helmets and remain careful along with appealing guardians to remain with kids of possible.

References
Books and journals
Høye, A., 2018. Bicycle helmets–To wear or not to wear? A meta-analyses of the effects of
bicycle helmets on injuries. Accident Analysis & Prevention, 117, pp.85-97.
Kurt, M. and et. al., 2017. Modeling and optimization of airbag helmets for preventing head
injuries in bicycling. Annals of biomedical engineering, 45(4), pp.1148-1160.
Michael, P.D., Davenport, D.L. and Draus, J.M., 2017. Bicycle helmets save more than heads:
experience from a pediatric level I trauma hospital. The American Surgeon, 83(9),
pp.1007-1011.
Joseph, B. and et. al., 2017. Bicycle helmets work when it matters the most. The American
Journal of Surgery, 213(2), pp.413-417.