Many a Truth Said in Jest -- Evidence-Based Flying

Leslie Citrome, MD, MPH


June 21, 2010

Evidence-based Flying: A New Paradigm for Frequent Flyers

Citrome L
Int J Clin Pract. 2010;64:667-668


Originally intended as an April Fool's Day prank (with the full cooperation of the publisher of the journal involved), this editorial extols the virtues of evidence-based flying, whereby an individual flyer's preferences and values are used together with the best available evidence to help select airlines on which to fly. Number-needed-to-fly is introduced as a means of comparing airlines on their on-time departure rates (ie, how many flights one has to take with one airline vs another before expecting to avoid 1 additional departure delay). Number-needed-to-upgrade is another metric that answers the question of how often one can expect to be upgraded to first class when selecting among the different airlines, assuming equal loyalty club standing. Finally, a plea is made for greater transparency on the part of the airline industry to allow for end users to make fair and balanced comparisons.


Accompanied by a press release and a video on YouTube, this satirical piece was taken seriously by many people, including the author's brother, who berated the author for not sharing this discovery with him sooner. When the article was republished on Medscape, the first reader-reviewer gave it the lowest rating possible -- 1 star. It appears that this April Fool's Day joke was too deadpan in delivery and possibly hit too close to home. Although inappropriate as a medical journal article, in retrospect the concept of evidence-based flying actually makes some sense. Who knew?

Available at:


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: