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Systematic review and meta-analysis of efficacy of helmet use and helmet laws to reduce mortality and cervical spine injury in adult motorcycle riders: A practice management guideline from the Eastern Association for the Surgery of Trauma

Asanthi M. Ratnasekera, S. Seng, Stuart K. Gardiner, Caroline Butler, A. Goldenberg-Sandau, Ning Lu, Hiba Abdel Aziz, Rachel D. Appelbaum et al.

Journal of Trauma and Acute Care Surgery, 2025

8 citations

Abstract

BACKGROUND

Motorcycle crash fatalities remain a significant public health concern. Traumatic brain injury is a leading cause of death following motorcycle crash. We aim to provide evidence-based guidelines pertaining to helmet use and helmet laws with respect to important outcomes including mortality, cervical spine injury, and discharge disposition.

METHODS

An evidence-based systematic review was performed to answer the following Population, Intervention, Comparator, Outcomes (PICO) questions: PICO 1-Should adult motorcycle riders wear helmets or not wear helmets to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? PICO 2-Should motorcycle universal helmet laws (UHLs) or no UHLs be enacted to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? An academic medical librarian searched Medline, Cochrane CENTRAL, CINAHL, Embase, Engineering Village, Health and Safety Science Abstracts, Scopus, SPORTDiscus, TRID, the VHL Regional Portal, and Elsevier. The Grading of Recommendations Assessment, Development, and Evaluation methodology was used to assess the quality of the evidence and create recommendations. The working group reached consensus on the final evidence-based recommendations. The study was registered in PROSPERO (CRD42020172705).

RESULTS

A total of 28 studies were identified for analysis for PICO 1, and 10 studies were identified for…

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Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

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