Methodological considerations in interpreting risk factors for decompression sickness in the DAN DSL database

Marroni et al. analysed over 127 000 dives to identify factors associated with decompression sickness. Although decompression stress was the strongest predictor, several unexpected associations warrant caution. Key concerns include failure to account for repeated dives by the same individuals, unclear selection into the database, and possible overinterpretation of adjusted associations. The findings should be considered hypothesis-generating, and future analyses would benefit from stronger epidemiological methods and more standardized data collection.