The use and meaning of the parachute metaphor in biomedicine: a citation analysis of a systematic review and a randomized trial of the parachute for freefall

Abstract

<b>Background:</b> Numerous authors have used the 'parachute' analogy to comment on the importance of and need for randomized, controlled trials (RCTs) in the hierarchy of medical evidence. <b>Methods:</b> The authors completed a retrospective literature analysis examining publications citing the 2003 parachute paper by Smith and Pell and a 2018 RCT of a parachute by Yeh <i>et al.</i> For all of the articles that directly analogized a medical intervention to a parachute, the authors identified the desired outcome of the practice and searched PubMed for relevant RCTs. <b>Results:</b> Authors citing the parachute analogy are often critical of RCTs and often draw comparisons to interventions that are not parachutes.

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