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Great Artical in Aug BJA - must read
- Thread starter ether_screen
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Did not see it. If it is there, please provide a synopsis.
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Not much info from the article. Here's the abstract:
Comparative effectiveness and safety of physician and nurse anaesthetists: a narrative systematic review{dagger}
Smith AF, Kane M, Milne R.
Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK.
BACKGROUND: Despite widespread debate on the merits of different models of anaesthesia care delivery, there are few published data on the relative safety and effectiveness of different anaesthesia providers. Method. We conducted a systematic search for, and critical appraisal of, primary research comparing safety and effectiveness of different anaesthetic providers. RESULTS: Our search of Medline, EMBASE, CINAHL, and HMIC for material published between 1990 and April 2003 yielded four articles of relevance to the question. The studies used a variety of methodologies and all had potential confounding factors limiting the validity of the results. CONCLUSIONS: In view of the paucity of high-level primary evidence in this area, it is not possible to draw a conclusion regarding differences in patient safety as a function of provider type. There are difficulties in classifying events as 'anaesthesia-related', and also in the variable definitions of 'supervision' and 'anaesthesia care team'. We suggest that existing attempts to show differences in outcome might usefully be complemented by studies examining measures of anaesthetic process.
PMID: 15298878 [PubMed - as supplied by publisher]
Comparative effectiveness and safety of physician and nurse anaesthetists: a narrative systematic review{dagger}
Smith AF, Kane M, Milne R.
Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK.
BACKGROUND: Despite widespread debate on the merits of different models of anaesthesia care delivery, there are few published data on the relative safety and effectiveness of different anaesthesia providers. Method. We conducted a systematic search for, and critical appraisal of, primary research comparing safety and effectiveness of different anaesthetic providers. RESULTS: Our search of Medline, EMBASE, CINAHL, and HMIC for material published between 1990 and April 2003 yielded four articles of relevance to the question. The studies used a variety of methodologies and all had potential confounding factors limiting the validity of the results. CONCLUSIONS: In view of the paucity of high-level primary evidence in this area, it is not possible to draw a conclusion regarding differences in patient safety as a function of provider type. There are difficulties in classifying events as 'anaesthesia-related', and also in the variable definitions of 'supervision' and 'anaesthesia care team'. We suggest that existing attempts to show differences in outcome might usefully be complemented by studies examining measures of anaesthetic process.
PMID: 15298878 [PubMed - as supplied by publisher]
So basically the article said no study has been done adequately to compare the two. It came to NO conclusion. Don't misinterpret this to mean that CRNA = MDA's or are just as safe. It just says no conclusion could be made based on their literature review. It is critiquing the studies. Meaning, the highly sqewed numbers AANA throws out in the air as well as those the influx of CRNA's on this board post, have no meaning according to the authors of the study.
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Did you even read the article. ether_screen???? I read it and it says exactly what the the abstract says above. All currently published data has too many confounding factors to draw any statistically significant conclusions. In other words all the current data is worthless. This article is a narrative, not a meta analysis. Even this article holds no merit.
