re: Wisconsin Hospital Replaces All Anesthesiologists with CRNAs

Haha plenty of books. I used to read 150 pages a night before medical school. I've unfortunately retained the habit of buying books I'm interested in despite having absolutely no time to read them, even before bed, so my collection has grown quite a bit but I haven't read a book cover to cover in a little while. But I still read a ton for all the school work I have. I've given up all my hobbies for this schooling, except for shitposting an hour or so a day on this website, although some days I've posted for longer because I don't have anyone to share all my pedantry with.

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they have increased adverse outcomes compared to anesthesiologists.

Paper 1
Paper 2
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Adjusted odds ratios for death and failure-to-rescue were greater when care was not directed by anesthesiologists (odds ratio for death = 1.08, P < 0.04; odds ratio for failure-to-rescue = 1.10, P < 0.01), whereas complications were not increased (odds ratio for complication = 1.00, P < 0.79). This corresponds to 2.5 excess deaths/1,000 patients and 6.9 excess failures-to-rescue (deaths) per 1,000 patients with complications.

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You have to analyze research articles to make sure they are a high level of evidence and not outdated to ensure you are disseminating the most accurate evidence.

Paper 1

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In this study, we utilized data from the National Survey of Ambulatory Surgery (NSAS) from the years 1996 and 2006 to determine patient and health care system-related risk factors for overnight admission after ambulatory knee and shoulder surgery.

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data older than 10 years is extremely outdated and considered weak evidence in the medical field.

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Disposition other than routine discharge to home residence decreased significantly between 1996 and 2006, from 8.5% to 0.6% for knee (P < 0.0001), and 21.5% to 4.8% for shoulder procedures (P < 0.0001).

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there was a considerable difference in the number of adverse events from 1996 compared to 2006. Meaning that most of the adverse events they looked at occurred in 1996... do we really think the credibility of the current CRNA field should be based on data from 1996?

Paper 2 - this is the paper your quote is from...

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All Pennsylvania Medicare claims records for patients 65 yr or older were analyzed for general and orthopedic surgical admissions between 1991 and 1994.

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This is even older...
Some education on odds ratios may also be beneficial... resource: Odds ratios

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The magnitude of the odds ratio is called the “strength of the association.” The further away an odds ratio is
from 1.0, the more likely it is that the relationship between the exposure and the disease is causal. For
example, an odds ratio of 1.2 is above 1.0, but is not a strong association. An odds ratio of 10 suggests a
stronger association.

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The odds ratios you quoted of 1.08 and 1.1 mean undirected anesthesia is not causal of adverse events.

What the research states in plain terms cannot always be taken at face value because researchers and the purpose for each study can be biased. You really have to make sure articles are high levels of evidence and double check the years research/data was obtained. articles should also be read carefully and thoroughly before being posted. This is how misinformation is spread.

The overall conclusion may still be correct, however, more recent/stronger evidence should be disseminated.