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Bicycle Helmet Effectiveness in Preventing Injury and Death


This case examines the cost-effectiveness of three interventions to increase utilization of bicycle helmets to avert head injuries in individuals 18 years of age and under in Onondaga Count, NY.

Students are initially presented with data on head injuries, hospitalization, and death related to bicycle use. They then appraise a published study on the effectiveness of bicycle helmets in averting head injury. Finally, students work in groups to determine the cost-effectiveness of each intervention by calculating implementation costs and the specific number of head injuries averted associated with intervention.

The three interventions are legislative, school, and community-based campaigns to increase helmet use. Students are provided with budget estimates and assumptions needed to complete the exercise. Cost-effectiveness analysis, cost- benefit analysis, and related concepts are discussed, including provider versus societal perspectives and importance of sensitivity analysis.


  • Define "cost-effectiveness" and how it is measured
  • Review cost-effectiveness analysis examples from the medical literature
  • Interpret trends from data from a State Health Department
  • Critically appraise a published clinical study
  • Critically appraise strengths and weakness of different study designs
  • Calculate and apply cost-effectiveness principles
  • Apply economic evaluation concepts