Difference between an NP and PA

[InfoNerd101]

Aside from having different licensing/ governing boards and an NP having a registered nurse background prior to becoming a mid-level practitioner, what else is the difference between an NP and PA?

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[pamac]

So you are back trolling again?

 

[Mad Jack]

1,400 hours of mandatory training at the advanced level, as well as a broad base of knowledge versus just one area.

 

[InfoNerd101]

So you are back trolling again?

Can I just ask why the hell everyone on this forum is so obsessed with the concept of "trolling?" You know that there are people out there in school that ask questions out of curiosity... But everyone is so quick to jump to conclusions and get their kickers in a twist to defend their 'high and mighty' turf.

Also btw, do you people seriously having nothing better to do than be caddy, sit there and scroll back through other people's profiles and observe all the questions they asked so u then can sit there and come at them with the whole "well according to June such and such u asked this question and then asked that question."

 

[InfoNerd101]

1,400 hours of mandatory training at the advanced level, as well as a broad base of knowledge versus just one area.

This 1400 hours and such that you speak of, is that on the part of the NP or PA?

 

[Mad Jack]

This 1400 hours and such that you speak of, is that on the part of the NP or PA?

PA.

 

[InfoNerd101]

PA.

Oh ok so where NP's will get a masters in a specific area such as mental health or nurse anesthesia, the PA will have a broad understanding in multiple areas

 

[Mad Jack]

Oh ok so where NP's will get a masters in a specific area such as mental health or nurse anesthesia, the PA will have a broad understanding in multiple areas

Pretty much. It's a generalist versus specialist approach. Except with primary care NPs, which I feel just get a lower quality version of what PAs get in regard to the broad education.

 

[Makati2008]

Keep it professional guys


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[762513]

1,400 hours of mandatory training at the advanced level, as well as a broad base of knowledge versus just one area.

My FNP program has more than 1500 hours of clinical training time and is in the top 10% of graduate schools in the country. The AACN regulates DNP education and sends out frequent directives to improve consistency between the schools. It sounds like your opinion may be based on outdated information.

 

[Mad Jack]

My FNP program has more than 1500 hours of clinical training time and is in the top 10% of graduate schools in the country. The AACN regulates DNP education and sends out frequent directives to improve consistency between the schools. It sounds like your opinion may be based on outdated information.

My opinion is based on the minimum AACN standards. Feel free to read them. While there are better programs, when selecting a product you look at its minimum standards, not the outliers.

 

[762513]

My opinion is based on the minimum AACN standards. Feel free to read them. While there are better programs, when selecting a product you look at its minimum standards, not the outliers.

Feel free to link the standards so I don't need to just take your word for it, and also link PA education standards so we can compare directly.

 

[Mad Jack]

Feel free to link the standards so I don't need to just take your word for it, and also link PA education standards so we can compare directly.

http://www.aacn.nche.edu/education-resources/evalcriteria2012.pdf

Criterion III.E: The NP program/track has a minimum of 500 supervised direct patient care clinical hours overall. Clinical hours must be distributed in a way that represents the population needs served by the graduate.

One would think that with all of your education you could have found what it took me literally 10 seconds of Googling for me to find without having to ask me for it.

 

[762513]

http://www.aacn.nche.edu/education-resources/evalcriteria2012.pdf

Criterion III.E: The NP program/track has a minimum of 500 supervised direct patient care clinical hours overall. Clinical hours must be distributed in a way that represents the population needs served by the graduate.

One would think that with all of your education you could have found what it took me literally 10 seconds of Googling for me to find without having to ask me for it.

Great, now how many hours are required of PA programs?

I'm happy to see you actually research and post fact, 99% of what you give is opinion and unbelievably offensive comments. See above.

 

[Mad Jack]

Great, now how many hours are required of PA programs?

I'm happy to see you actually research and post fact, 99% of what you give is opinion and unbelievably offensive comments. See above.

The ARC-PA doesn't set specific hour requirements, just as medical schools don't. The minimum standard requires that students rotate with preceptors in the following areas:

Supervised clinical practice experiences should occur with preceptors practicing in the following disciplines: ANNOTATION: PA education requires a breadth of supervised clinical practice experiences to help students appreciate the differences in approach to patients taken by those with varying specialty education and experience. Supervised clinical practice experiences used for required rotations are expected to address the fundamental principles of the disciplines below as they relate to the clinical care of patients. Subspecialists serving as preceptors might, by advanced training or current practice, be too specialty focused to provide the fundamental principles for required rotations in the disciplines below. Reliance on subspecialists as preceptors in the disciplines below is contrary to the intent of this standard. a) family medicine, b) internal medicine, c) general surgery, d) pediatrics, e) ob/gyn and f) behavioral and mental health care.

The shortest clinical didactic phase I've heard of in all of PA education was 12 months, at 40+ hours per week (many rotations, such as surgery and inpatient internal medicine, you're doing 60-80). Compare that with the shortest NP program I've encountered- an online program with a total of 500 required hours that you have to find your own preceptors for. There is an obvious quality disparity. Feel free to find me a PA program that offers less than 12 months of full-time clinical education though, as the ARC-PA would never accredit such a program, as the minimum they expect six 7 week core rotations and two 4 week electives with two weeks of vacation allotted.

 

[762513]

The ARC-PA doesn't set specific hour requirements, just as medical schools don't. The minimum standard requires that students rotate with preceptors in the following areas:

Supervised clinical practice experiences should occur with preceptors practicing in the following disciplines: ANNOTATION: PA education requires a breadth of supervised clinical practice experiences to help students appreciate the differences in approach to patients taken by those with varying specialty education and experience. Supervised clinical practice experiences used for required rotations are expected to address the fundamental principles of the disciplines below as they relate to the clinical care of patients. Subspecialists serving as preceptors might, by advanced training or current practice, be too specialty focused to provide the fundamental principles for required rotations in the disciplines below. Reliance on subspecialists as preceptors in the disciplines below is contrary to the intent of this standard. a) family medicine, b) internal medicine, c) general surgery, d) pediatrics, e) ob/gyn and f) behavioral and mental health care.

The shortest clinical didactic phase I've heard of in all of PA education was 12 months, at 40+ hours per week (many rotations, such as surgery and inpatient internal medicine, you're doing 60-80). Compare that with the shortest NP program I've encountered- an online program with a total of 500 required hours that you have to find your own preceptors for. There is an obvious quality disparity. Feel free to find me a PA program that offers less than 12 months of full-time clinical education though, as the ARC-PA would never accredit such a program, as the minimum they expect six 7 week core rotations and two 4 week electives with two weeks of vacation allotted.

There are online PA programs popping up all over the country. That is one of your standards of quality as well. As there is no actual number given we just must assume that no school is slipping through the cracks based on their accreditation. My program is a brick and mortar public university with 1000 clinical hours during the practicums and 500 during my residency semester, I'll take that over an online PA school.

I believe you told me I wasn't going to get an education the first time I posted on SDN while having no idea who I was or what I was doing.

You're just a bully, plain and simple. There isn't any dispute about that fact.

 

[Mad Jack]

There are online PA programs popping up all over the country. That is one of your standards of quality as well. As there is no actual number given we just must assume that no school is slipping through the cracks based on their accreditation. My program is a brick and mortar public university with 1000 clinical hours during the practicums and 500 during my residency semester, I'll take that over an online PA school.

I believe you told me I wasn't going to get an education the first time I posted on SDN while having no idea who I was or what I was doing.

You're just a bully, plain and simple. There isn't any dispute about that fact.

"All over the country" lol. Yeah, one, that hasn't even taken its first class in yet and has not received accreditation at Yale. There are dozens upon dozens of online NP programs, and one proposed online PA program that was shot down by the ARC-PA.

There's plenty of nurse practitioner schools that turn out good grads. There's equally as many, if not more, that turn out poor ones. As to minimum hours and programs skirting by with poor rotations, it's pretty unlikely. The ARC-PA has a reputation for hitting hard and heavy any time a program's standards slip.

 

[762513]

"All over the country" lol. Yeah, one, that hasn't even taken its first class in yet and has not received accreditation at Yale. There are dozens upon dozens of online NP programs, and one proposed online PA program that was shot down by the ARC-PA.

There's plenty of nurse practitioner schools that turn out good grads. There's equally as many, if not more, that turn out poor ones. As to minimum hours and programs skirting by with poor rotations, it's pretty unlikely. The ARC-PA has a reputation for hitting hard and heavy any time a program's standards slip.

I counted 4 after a 10 second Google search. I'm sure there are many more.

 

[Mad Jack]

I counted 4 after a 10 second Google search. I'm sure there are many more.

*citation needed

There are no online PA programs as of yet. Link me to such a program's website and I'll applaud you and admit that I'm wrong for all the world to see.

 

[762513]

*citation needed

Drexel, UW Madison, Yale, and others. Not at a computer right now.

 

[Mad Jack]

Drexel, UW Madison, Yale, and others. Not at a computer right now.

http://drexel.edu/cnhp/academics/graduate/MHS-Physician-Assistant/#pnlCurriculum
http://www.fammed.wisc.edu/pa-program/curriculum/
https://medicine.yale.edu/pa/

Yale's failed to be accredited. No one has heard anything about it moving forward for nearly a year, and it is likely dead in the water. It was to be the very first, and it failed, because the ARC-PA didn't want to dilute the brand. Your other programs have zero online options.

 

[762513]

http://drexel.edu/cnhp/academics/graduate/MHS-Physician-Assistant/#pnlCurriculum
http://www.fammed.wisc.edu/pa-program/curriculum/
https://medicine.yale.edu/pa/

Yale's failed to be accredited. No one has heard anything about it moving forward for nearly a year, and it is likely dead in the water. It was to be the very first, and it failed, because the ARC-PA didn't want to dilute the brand. Your other programs have zero online options.

I know people who UW Madison's distance learned PA program.

 

[762513]

I know people who UW Madison's distance learned PA program.

8 second Google search
http://www.guidetoonlineschools.com/degrees/healthcare/physician-assistant#list

 

[Mad Jack]

I know people who UW Madison's distance learned PA program.

Prove to me that such a program exists.

There might be distance lectures for year one (which isn't a big deal, and a lot of medical schools basically do as well), but there is no "choose your own adventure, find your own preceptor" NP style curriculum without established inpatient clinical affiliations. It's the clinical aspect of online NP programs that is problematic.

 

[Mad Jack]

8 second Google search
http://www.guidetoonlineschools.com/degrees/healthcare/physician-assistant#list

All of thise list schools that have PA programs but also offer online coursework. None of have online PA programs. That site is just a simple algorithmic database of every school that has online programs in anything, and cross-refernces that with what degrees they offer, regardless of if those degrees are online or not. It's a simple scam website, which you'd know if you spent the thirty seconds it took to click on it and then cross-reference the links it spat out rather than just Googling up some third party site with a sketchy name no one has ever heard of and taking its results as fact lol.

 

[762513]

Oh, so after I proved you wrong you're pulling the whole "I-didn't-mean-what
-I-exactly-said." Nice.

I went to Drexels website. It's online. I know people who went to UW Madison. It's online.

 

[Makati2008]

Please keep it professional. Further arguing will lead to thread closure.


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[Mad Jack]

Oh, so after I proved you wrong you're pulling the whole "I-didn't-mean-what
-I-exactly-said." Nice.

I went to Drexels website. It's online. I know people who went to UW Madison. It's online.

I'm legitimately asking you to post a link the the pages where it says that they are online programs. I can't find it, on either of them.

 

[Mad Jack]

http://drexel.edu/cnhp/academics/graduate/MHS-Physician-Assistant/
Scheduling:
During the didactic (primarily classroom) phase of the curriculum, most classes will be scheduled during the daytime hours; however, it may be necessary to schedule some classes during evening hours. All students are required to attend all classes as scheduled and to subordinate any personal commitments (i.e., employment or family responsibilities) to the training schedule.

In the clinical phase of training, students will be learning in diverse clinical settings with varying daily and weekly schedules that may involve daytime, evening, or weekend hours. Students must give priority commitment to assigned schedules at clinical sites.

Did find one for UW Madison tho, I admit I'm wrong there, and that one has come up before.

http://www.fammed.wisc.edu/pa-program/curriculum/tracks/#distance

A couple of programs, regardless, do not make the rule. Online NP programs are many, and their quality is generally poor. Even on Allnurses posters own up to the poor quality of some online NP programs and how standards should be increased:
http://allnurses.com/nurse-practitioners-np/online-vs-traditional-900654.html
http://allnurses.com/nurse-practitioners-np/are-online-np-476504.html
http://allnurses.com/student-nurse-practitioner/online-nurse-practitioner-911499.html

 

[deleted6669]

to the best of my knowledge there are no 100% online PA programs. a few have partial didactics online. many PA programs have online postgrad degree options, so that is likely what is popping up for google searches. U. North Dakota and U. Wisconsin have partially online programs, but those are the only 2 I know of and I have been involved with the field for almost 30 years. Yale is trying to get a program accredited, but is facing stiff opposition from alumni and the profession at large. I know of no PA programs with less than 1500 hrs of clinicals and most have > 2000 hrs. I had around 3000 over 54 weeks.

 

[762513]

http://drexel.edu/cnhp/academics/graduate/MHS-Physician-Assistant/
Scheduling:
During the didactic (primarily classroom) phase of the curriculum, most classes will be scheduled during the daytime hours; however, it may be necessary to schedule some classes during evening hours. All students are required to attend all classes as scheduled and to subordinate any personal commitments (i.e., employment or family responsibilities) to the training schedule.

In the clinical phase of training, students will be learning in diverse clinical settings with varying daily and weekly schedules that may involve daytime, evening, or weekend hours. Students must give priority commitment to assigned schedules at clinical sites.

Did find one for UW Madison tho, I admit I'm wrong there, and that one has come up before.

http://www.fammed.wisc.edu/pa-program/curriculum/tracks/#distance

A couple of programs, regardless, do not make the rule. Online NP programs are many, and their quality is generally poor. Even on Allnurses posters own up to the poor quality of some online NP programs and how standards should be increased:
http://allnurses.com/nurse-practitioners-np/online-vs-traditional-900654.html
http://allnurses.com/nurse-practitioners-np/are-online-np-476504.html
http://allnurses.com/student-nurse-practitioner/online-nurse-practitioner-911499.html

You won't get an argument from me that a brick and mortar school is superior to distance learning; thats why I choose to go to one.

However, if Yale is going this direction, I see more online PA programs in the future. It throws the "minimum standards" of brick and mortar education argument out the window.

 

[Mad Jack]

You won't get an argument from me that a brick and mortar school is superior to distance learning; thats why I choose to go to one.

However, if Yale is going this direction, I see more online PA programs in the future. It throws the "minimum standards" of brick and mortar education argument out the window.

For 99% of currently educated PAs, their educations were superior to NPs. That's just a fact. That the future is going to be different doesn't change that.

 

[762513]

For 99% of currently educated PAs, their educations were superior to NPs. That's just a fact. That the future is going to be different doesn't change that.

That's an opinion. Facts come with p values.

 

[Mad Jack]

That's an opinion. Facts come with p values.

Given the differences between your board exams, I think one can state that factually, physician assistants are expected to have a wider and more in-depth knowledge base. That would make it a fact that, to be certified, a PA must have a stronger education than an NP, quantitatively. Compare your board review material side by side- NP expectations are much lower.

 

[762513]

Given the differences between your board exams, I think one can state that factually, physician assistants are expected to have a wider and more in-depth knowledge base. That would make it a fact that, to be certified, a PA must have a stronger education than an NP, quantitatively. Compare your board review material side by side- NP expectations are much lower.

Pointless argument. You know it's an opinion, you're just trolling. The rigor of the board implies the depth of the education, it proves absolutely nothing. Just an opinion from a competitive antagonist, nothing more.

 

[Boatswain2PA]

Aside from having different licensing/ governing boards and an NP having a registered nurse background prior to becoming a mid-level practitioner, what else is the difference between an NP and PA?

I believe you've asked this question several times before, but in case I'm wrong about that I'll give you quick answer.

Clinically there is very little difference between them. There are some geographical and specialty variations between which is "preferred" for specific positions, but generally there is very little tactical differences between them.

Strategically the NP profession is moving legislatively away from any required supervision. This means, in many states, a NP can start his/her own clinic, or be hired by a CVS/Walgreens/Dillons/etc "Doc in a Box" clinic without having to pay for a physician to supervise them. But I don't believe there will EVER become a time where PAs/NPs will work in hospitals without supervision....nor should they.

A few years out of school the biggest factor of how "good" a provider is is that particular person's devotion to their profession and specialty. Some of the best providers I have ever known were NPs; and they were great because (after NP school) they spent the time and effort to learn medicine.

The biggest difference is in schooling. PA schools are generally standardized and are all accredited by the same organization. They teach about 3 years of medical school in about 2.2 years time. It's a LOT of information, it's a LOT of work, and it's TERRIFIC education. Every PA school teaches you how to practice medicine. Arguably, the 2 biggest differences between PA school and medical school is that medical school provides greater depth of the science (deeper pathophys, anatomy, pharm, etc) while preparing the new physician to enter into a residency. Meanwhile PA school prepares the new PA to start seeing patients on day one (with some necessary supervision).

NP schools, on the other hand, have a wide range of quality. There are many NP programs that are entirely online, and require the student to arrange for their own preceptor site, and requires as few as 500 clinical hours. Additionally, when you delve into what many of these NP programs actually teach they are unbelievably weak in science and medicine, and heavy in "nursing leadership" type classes....stuff that most people call "fluff".

 

[762513]

There are exactly zero online PA programs. The one attempted by Yale failed due to extreme backlash from the PA community who strongly feel online education is simply inferior than in-person.


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Wrong, maybe, and wrong. We were just discussing in class how the AACN is working to clarify the final DNP program thesis by sending directives.

You may be right that 500 hours is not enough clinical time, although I would be interested in seeing what the research shows.

There is an online PA program at UW Madison. I know people who have attended. Yale is still seeking accreditation, and will most likely be successful shortly. You may want to do your research before making a post.

 

[tatsuchi]

Possibly drive-by posting, but prior to reading this thread my personal experience and bias has been towards PAs, based on their clinical acumen and management compared to NPs. And I've worked at institutions that utilized both.

Seeing @IknowImnotadoctor primp and posture about insisting standards of NPs as being up to par and demeaning PA programs on anecdotal evidence and avoiding the statements put up by others regarding PAs does not exactly forward their cause either.

 

[762513]

Possibly drive-by posting, but prior to reading this thread my personal experience and bias has been towards PAs, based on their clinical acumen and management compared to NPs. And I've worked at institutions that utilized both.

Seeing @IknowImnotadoctor primp and posture about insisting standards of NPs as being up to par and demeaning PA programs on anecdotal evidence and avoiding the statements put up by others regarding PAs does not exactly forward their cause either.

Please give me a specific example of my primp and posturing in relation to the fact that NPs on the forum have been told that we literally don't have a medical education and are "low level" providers.

Defending the fact that supervised NP and PAs have identical outcomes and stating based on evidence NPs must have adequate education in order to be able to achieve equal outcomes.

If defending constant NP abuse and bashing is posturing please clarify your definition on the subject.

Here, let me help you with the context. This was my first post on SDN in which militant PAs attacked my profession for no reason. Enjoy.
http://forums.studentdoctor.net/threads/current-dnp-students-thoughts.1193454/

 

[tatsuchi]

Please give me a specific example of my primp and posturing in relation to the fact that NPs on the forum have been told that we literally don't have a medical education and are "low level" providers.

Attitude comes a long way in advocating your cause. I'm not aware if you've always had a chip on your shoulder, or it was an effect of being frustrated for some reason with how things are, but from the standpoint of a newcomer all I've read in here are retorts and no effort to personally clarify your own statements on points that are being made against you.

Defending the fact that supervised NP and PAs have identical outcomes and stating based on evidence NPs must have adequate education in order to be able to achieve equal outcomes.

Would be interested in seeing these studies on these identical outcomes, that being said I find it hard to extrapolate a lot of studies with outcomes on clinicians in general because they are not usually based on independent practice. It's easy to have good outcomes when you always have a physician as backup or support.

 

[762513]

Attitude comes a long way in advocating your cause. I'm not aware if you've always had a chip on your shoulder, or it was an effect of being frustrated for some reason with how things are, but from the standpoint of a newcomer all I've read in here are retorts and no effort to personally clarify your own statements on points that are being made against you.


Would be interested in seeing these studies on these identical outcomes, that being said I find it hard to extrapolate a lot of studies with outcomes on clinicians in general because they are not usually based on independent practice. It's easy to have good outcomes when you always have a physician as backup or support.

I didnt have a chip on my shoulder until I posted on SDN excited to talk shop with other NP students only to be openly mocked and told my career is an absolute joke by the same militant PAs and med students responding on this very thread. Posted the thread above, read for yourself

There was a meta-analysis with rigorous methodology already linked and discussed that proves that supervised NP outcomes are actually comparable to MDs. I won't rehash that debate, you can find it quickly on this forum.

The idea of supervision is equal to collaborative agreements, and the issue with those are the giant variability of the requirements. In some instances a 10% chart review is mandatory, in others a NP simply needs a physician willing to answer a phone call. Add onto this an extra layer of complexity in which the physician is literally paid by the NP, which calls into question how much over sight there really is.

I can see how you may interpret my statements; just realize I am treating these posters with the exact same level of respect they treat me.

 

[762513]

PAs and med students can compare their own education to that of NPs and be highly reflective of the differences. When PA and med students contrast the requirements they need to achieve to safelt practice medicine with those with NP students the issues become very clear. This is why PAs and physicians are so highly critical of NPs having any prescriptive authority and extremely vocal reactions against NPs being completely autonomous. On the other hand NP aren't in the position to evaluate PA and medical education as they aren't living and experiencing that education or jumping through those hoops and are repeatedly told they achieve a level of education that is "equivalent" to that of a family physician.

I know of no family physicians or PAs who cannot read basic EKGs or X-rays yet a vast majority of NPs receive no education on this critical topics. That is just the tip of the iceberg.

I have covered many, many times, and you know this, that NP's should not be allowed independent practice with their current education.

Your belief that PA's can be critical of NP's but not vice versa is not valid. If it was the case that NP education is inadequate why do meta-analysis show comparable outcomes between the professions. It's either insane luck from hundreds of studies p values being skewed or the foundation of your argument is invalid.

PA's are not in a position to evaluate DNP education because "they aren't living and experiencing that education or jumping through those hoops" either.

My DNP program is 8 semester, almost 4 semesters of which are identical to the PhD nursing program. I have 1500 clinical hours mandatory as part of my education.

I will continue to show the same amount of respect that I am shown, which is to say, very, very little.

 

[Mad Jack]

I have covered many, many times, and you know this, that NP's should not be allowed independent practice with their current education.

Your belief that PA's can be critical of NP's but not vice versa is not valid. If it was the case that NP education is inadequate why do meta-analysis show comparable outcomes between the professions. It's either insane luck from hundreds of studies p values being skewed or the foundation of your argument is invalid.

PA's are not in a position to evaluate DNP education because "they aren't living and experiencing that education or jumping through those hoops" either.

My DNP program is 8 semester, almost 4 semesters of which are identical to the PhD nursing program. I have 1500 clinical hours mandatory as part of my education.

I will continue to show the same amount of respect that I am shown, which is to say, very, very little.

All of the studies done to date on NP outcomes have used either poor metrics or methodology, likely due to their mostly being funded by organizations that personally benefit from NP practice expansion.

 

[762513]

All of the studies done to date on NP outcomes have used either poor metrics or methodology, likely due to their mostly being funded by organizations that personally benefit from NP practice expansion.

Wrong.

 

[Mad Jack]

Wrong.

[citation needed]

Show me a study, and I'll show you where it falls short.

 

[762513]

[citation needed]

Show me a study, and I'll show you where it falls short.

You made the assertion that all NP outcome studies are flawed. I'm not going to do your work for you. Find every study ever conducted, critique it with a biostatistician, and prove your point.

 

[Mad Jack]

You made the assertion that all NP outcome studies are flawed. I'm not going to do your work for you. Find every study ever conducted, critique it with a biostatistician, and prove your point.

I've already done it in other threads. You are aware we get a thorough education in biostatistics and study design in medical school, right?

 

[762513]

You have linked every study ever performed on NP outcomes and sat down with a PhD biostatistician and shown how these studies do not constitute acceptable evidence? No, you haven't, because having education in biostatistics and knowing when to use Chi-Square vs Anova is not the same as actually knowing when a study is unacceptably flawed or not. That is what PhD's do. Being an expert in the diagnosis and treatment of disease does not make you an expert in research studies. There are PhD/MD's for that.

 

[762513]

Here is the link on the meta-analysis proving the safety of NP care: http://www.medscape.com/viewarticle/810692. Before you state the journal it was published in invalidates the results just don't. You know how foolish of a thing that is to say. I am waiting for a critique with a biostatistician of the 39 studies showing supervised NP care is safe proving that all studies are unacceptably flawed in methodology and p value outcomes. Once you have waded through that, the literature review of the study was conducted on 27,000 articles. I am waiting for an evaluation of all 27,000 articles. Only then will your statement "All of the studies done to date on NP outcomes have used either poor metrics or methodology" be correct.

 

[Makati2008]

Let's keep it professional everyone


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