Published on 01-23-2014 10:08 AM
Number of Views: 5400
SO recently this was posted on facebook.
This total load of excrement comes from the silber study done in 2000. Its not even a relevant study but has alot of issues besides that.
First anesthesia was not the intent of the study and it never was about providers and mortality. It was done in ONE state (PA) and was about something totally different. The original authors required the ASA to change the name for their "massaged" study and the ASA shopped over 20 journals who all refused to publish it because of its glaring inaccuracies and frankly non-existent science.
Silber Study in Medical Care (this is not the one published in Anesthesiology they like to quote but the ACTUAL study they based it off of)
[Silber, JH, Williams, SV, Krakauer, H, Schwartz, JS. “Hospital
and Patient Characteristics Associated With Death After
Surgery. A Study of Adverse Occurrence and Failure to Rescue.”
Medical Care. 1992;30:615.]
The Silber study examined the death rate, adverse occurrence rate, and failure rate of 5,972 Medicare patients undergoing two fairly low-risk procedures —elective cholecystectomy and transurethral prostatectomy.
The study did not discuss any anesthesia provider except physician anesthesiologists; the study did not even mention CRNAs. The study, therefore, had nothing to do with CRNAs and did not compare the outcomes of care of nurse anesthetists to those of anesthesiologists.
The study did not address any aspect of CRNA practice; it certainly did not explore the issue of whether CRNAs should be physician supervised.
The Silber study was a pilot study, i.e., a study to demonstrate the feasibility of performing a more definitive study concerning patients developing medical complications following surgery. It would be inappropriate to formulate public policy based on the Silber study; the study does not address CRNAs, and cannot be considered conclusive even about the issues that it does address.
The Silber study states, at page 625:
This pilot project examined ideas that, to our knowledge, have not been examined previously, and more work is needed before