I think it is all in the application and, of course, training.

Years ago we were at Shootin' Iron Academy in Oklahoma, Paul Abel presiding. He was just finishing up with a lady as we arrived.

She was in her fifties and in a wheelchair. As Paul later explained, she had been assaulted as she went out the door of her urban apartment, in her wheelchair.

As we watched, Paul stepped aside. There was a silhouette target about 10 feet away. When Paul said "GO" she slid a hand through a fold in her skirt, snapping a [small .22 revolver see below] into a line between her eyes and the head of the silhouette. In the blink of an eye she put all rounds into the head.
Edit: A comrade who also observed this chastised me for my faulty memory. The lady drew a Beretta 22, something like a Bobcat with a tip-up barrel.
Seems to me that would be effective.