Finally! An Air Vest Study...Air Vest Users Should Read This!

[Jealoushe]

[URL=“https://www.sciencedirect.com/science/article/pii/S1440244018305887”]https://www.sciencedirect.com/science/article/pii/S1440244018305887

[h=3]Results[/h]
As a result of falls, 3203 riders sustained no/slight injuries and 102 sustained serious/fatal injuries. While 55.0% of riders who fell were wearing an air jacket, they represented 67.6% of the serious/fatal injury outcomes. Air jacket usage was significantly associated with serious/fatal injuries in falls (X²”¯=”¯6.76; p”¯=”¯0.009). Riders wearing an air jacket had 1.7 times (95%CI 1.14–2.64) increased odds of sustaining a serious or fatal injury in a fall compared to riders not wearing an air jacket.

Interesting stuff. I hope more studies come out in the future to confirm this.

[IFG]

Thanks for posting this. I am not a fan of air vests, and I do not have the full text (I will request it through my University), but there appears to be an issue in the analysis. They say that they used a chi-square test. Since they do not mention adjusting for potential confounders through stratification, I think that they did not adjust for competition level. If the riders who wore air vests were also competing at a higher level, the association between air vest use and injury severity could be confounded by level. That is, worse outcomes were at the higher levels at which the riders were more likely to be wearing air vests.

[Jealoushe]

@IFG

Thanks for posting this. I am not a fan of air vests, and I do not have the full text (I will request it through my University), but there appears to be an issue in the analysis. They say that they used a chi-square test. Since they do not mention adjusting for potential confounders through stratification, I think that they did not adjust for competition level. If the riders who wore air vests were also competing at a higher level, the association between air vest use and injury severity could be confounded by level. That is, worse outcomes were at the higher levels at which the riders were more likely to be wearing air vests.

Are you guessing the riders at higher levels are more likely to wear air vests or did I miss that?

I have emailed the author for a copy of the full paper. Will report back if I can get a copy.

[IFG]

@Jealoushe

Are you guessing the riders at higher levels are more likely to wear air vests or did I miss that?

I have emailed the author for a copy of the full paper. Will report back if I can get a copy.

That would be my guess, and it is something that should be adjusted for in the analysis.

[HiJumpGrrl]

association, not causation, but very interesting. Especially the part about rider characteristics not explaining this–that as the levels increase, the percentage of falls per start also increase. Really well-discussed findings, I thought, given the limitations of the study It’s a start!

[HiJumpGrrl]

@IFG

That would be my guess, and it is something that should be adjusted for in the analysis.

From the discussion:
“Further, FEI reported the number of falls as a percentage of starters for each level of competition from 2014 to 2017 to be 4.8% for one-star competitors, 5.4% for two-star, 6.8% for three-star, and 13.3% for four-star.4 This rising rate of falls as competition level increased suggests that falling is not only associated with lower rider skill. It remains a possibility that riders who are at a greater risk of injury may be more likely to wear an air jacket; however, without further research, there is no data to test this hypothesis.”

[IFG]

@HiJumpGrrl

From the discussion:
“Further, FEI reported the number of falls as a percentage of starters for each level of competition from 2014 to 2017 to be 4.8% for one-star competitors, 5.4% for two-star, 6.8% for three-star, and 13.3% for four-star.4 This rising rate of falls as competition level increased suggests that falling is not only associated with lower rider skill. It remains a possibility that riders who are at a greater risk of injury may be more likely to wear an air jacket; however, without further research, there is no data to test this hypothesis.”

Will need to get the full article. Yes, falls increase, but it is severity of injury that is the outcome.

[vineyridge]

Couple of thoughts–riders wearing vests may have an inflated sense of safety and be willing to take more risks. And–do I not remember that German trained riders, at least at the upper levels, are far less likely to wear air vests than UK or NA trained riders? If so, that might be an interesting statistical exercise.

[Jealoushe]

@vineyridge

Couple of thoughts–riders wearing vests may have an inflated sense of safety and be willing to take more risks. And–do I not remember that German trained riders, at least at the upper levels, are far less likely to wear air vests than UK or NA trained riders? If so, that might be an interesting statistical exercise.

I had often wondered this. I saw this shared on Faceobok but can’t recall what page now. The comments were interesting, and a lot of air vest users being in total denial of the results. Actually arguing that air vests are safer, based on absolutely no research. So much propaganda pushing the vests with no research previously. Hopefully this study can jump start some others.

I really hope I can get the full research article.

[MsRidiculous]

I am not a huge fan of air vests either, but to be fair I don’t think this data tells us a lot in particular except that we definitely need more research, which is what the conclusion of the study states. We really know very little about what they do or don’t do and what potential good or bad can come from their use. That’s been my problem with them all along. While these numbers are certainly enough to pique your interest and raise an eyebrow, I don’t think they can really tell you a whole lot one way or the other due to so many variables. But hey, maybe it will get more people asking questions, which would be a good thing!

[Wanderosa]

I know many UL eventing riders who wear both or a hybrid vest. Anyone seen the entire study yet? How do they address this?

[HiJumpGrrl]

@IFG

Will need to get the full article. Yes, falls increase, but it is severity of injury that is the outcome.

I read the full article ;). The data for percentage of riders wearing vests per level of competition is not available. The only data broken down per level is percentage of falls per start. The data is quite weak, but the discussion does a great job of pointing that out. I’m glad someone is at least TRYING to look at it.

[vineyridge]

@Wanderosa

I know many UL eventing riders who wear both or a hybrid vest. Anyone seen the entire study yet? How do they address this?

Riders cannot compete in any recognized event without wearing a standard safety vest. Air is rider’s choice and an add-on. The standard vest is universal and so should not affect the study’s results.

I have to say that I was staggered to learn that 102 riders had “serious/fatal injuries” between 2015 and 2017 in FEI level competition. I’m assuming that includes serious concussions and broken necks and such.

[IFG]

@HiJumpGrrl

I read the full article ;). The data for percentage of riders wearing vests per level of competition is not available. The only data broken down per level is percentage of falls per start. The data is quite weak, but the discussion does a great job of pointing that out. I’m glad someone is at least TRYING to look at it.

Thanks for the info. Not presented in the article or not available to the authors?

[RAyers]

@HiJumpGrrl

I read the full article ;). The data for percentage of riders wearing vests per level of competition is not available. The only data broken down per level is percentage of falls per start. The data is quite weak, but the discussion does a great job of pointing that out. I’m glad someone is at least TRYING to look at it.

The weak data is due the fact the data is collected by the FEI, not the authors. The authors had to work with the data given and the statistically work out the risk with what has been provided.

They did an excellent job in a binary analysis and proved their hypothesis quite well: Does wearing an air vest increase risk of severe injury?

[HiJumpGrrl]

@RAyers

The weak data is due the fact the data is collected by the FEI, not the authors. The authors had to work with the data given and the statistically work out the risk with what has been provided.

They did an excellent job in a binary analysis and proved their hypothesis quite well: Does wearing an air vest increase risk of severe injury?

Exactly. This is what I was trying to say, but not communicating clearly. Thanks Reed If we could get the FEI to collect data differently (including more clear stratification of injury severity, breakdown of air vest use by level, experience of rider at level, etc), it would be a better study. I’m glad they’re looking at the data that exists, as limited as it is, and calling the shortcomings to the fore.

[IFG]

Thanks Rayers and HiJumpGirl. Sounds like they did the best they could with the limited data available.

[poltroon]

It sounds like (I have not read the paper) that there may be holes in the data that would prevent a clear conclusion that the vests are associated with higher injury rates, but conversely, it also suggests that it’s probably not the case that the vests are a significant safety improvement. If there’s a beneficial effect, it’s likely small.

[vali]

If it’s FEI then it seems we could assume they were competing at 2 star (previously one star) level, so not lower level riders. I know there’s been a few cases in the UK where riders claimed air vests worsened the severity or caused neck or spinal injuries, in theory because they put the spine or neck on a more rigid position on impact. I did martial arts and aikido for years as a teen, and still retain the ability to tuck and roll and fall well. I feel like an air vest makes it harder to do that, at least for me.

[JER]

Haven’t read the paper because I’m not in academia, a fact which will surprise exactly zero of you.

Could someone tell me how they define ‘serious’ injury?