Ranapurwala

The addition of a formal pre-dive checklist reduced the rate of both major and minor mishaps reported during recreational scuba-diving

Clinical bottom line:

1. The addition of a checklist reduced the incidence of major mishaps reported by 36%

Citation/s:1. Ranapurwala SI, Denoble PJ, Poole C, Kucera KL, Marshall SW, Wing S. The effect of using a pre-dive checklist on the incidence of diving mishaps in recreational scuba diving: a cluster-randomized trial. Int J Epidemiol. 2016 Feb;45(1):223-31.
Lead author's name and email: Shabbar Ranapurwala shabbarkaid@gmail.com

Three-part Clinical Question:For recreational scuba divers, does the addition of a pre-dive checklist to the usual pre-dive preparation, result in any improvement in the rate of diving mishaps?
Search Terms: scuba; checklists; safety

The Study:Single-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adult qualified scuba divers at four locations and recruited at the shore before a planned dive.
Control group (N = 467; 426 analysed): No intervention except the request to complete a post-dive log.
Experimental group (N = 693; 617 analysed): As above but with the addition of a pre-dive checklist

The Evidence:

 

Non-Event Outcomes

Time to outcome/s

Control group

Checklist group

Relative risk

Rate of major mishaps/100 dives

Post-dive

10.2

7.5

RR 0.64 (95%CI 0.46 to 0.87)

Rate of major or minor mishaps/100 dives

Post-dive

19.5

15.5

RR 0.68 (95%CI 0.50 to 0.93)

Comments:
1. This trial was cluster randomised by computer generated sequence and was concealed allocation. There were 70 intervention allocations (30 control, 40 intervention) including a total of 1043 individual divers. The imbalance of numbers between groups was discussed and seems due to chance. 
2. Authors used a complicated regression process for known confounders including sex, age, BMI, poor visibility, animal attack and others. They also examined adherence to the checklist.
3. NNT to avoid a major mishap was 37 dives.

Appraised by: Mike bennett m.bennett@unsw.edu.au ; Monday, 23 August 2021
Kill or Update By: August 2026

 

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