Mr. CRACKPOT (Madison River Collaborative Randomized And Controlled Knowledgeable Piscatorial Options Trial)

Background: Evidence-based fly fishing, like evidence-based cardiology, is growing in importance as the scientific method is increasingly applied to day-to-day experience. In this randomized trial, we use fly fishing and modern clinical and statistical methods as a metaphor to examine ourselves and illustrate several areas of importance and humor. Methods: A randomized, controlled trial of three different fly patterns used to catch trout on a publicly owned fishery in America's oldest national park. Three investigators each fished three different fly patterns using a predetermined method and time assignment to discover which pattern caught the most fish, which caught the largest fish and to see if fly pattern correlated with type of trout caught. Results: The bead-head soft hackle caught more fish (13) over a three-hour period compared to the feather duster (5) and grass hopper imitation (5); p=0.025. However, larger fish (> 12 inches in length) were more frequently caught on hoppers (5 of 5 vs. 1/10 bead head and 0/4 duster; p=0.001). Fly pattern did not correlate with type of trout caught. Conclusions: In this randomized trial, we have shown that the bead head soft hackle catches more fish than feather duster or grass hopper, but the hopper catches the larger fish. These findings have implications regarding fly choice for many current anglers.