> Strengths and weaknesses of this study
A key strength of the PARACHUTE trial was that it was designed and initially powered to detect differences in the combination of death and major traumatic injury. Although the use of softer endpoints, such as levels of fear before and after jumping, or its surrogates, such as loss of urinary continence, could have yielded more power to detect an effect of parachutes, we believe that that our selection of bias-resistant endpoints that are meaningful to all patients increases the clinical relevance of the trial.