Overall, there are some issues with the paper, but very interesting. I had to read 70% of the article to be able to interpret the tables, which are just the results of step-wise binary regression modeling. My grievance is that it's written by public health/business researchers, not physicians. This takes absolutely nothing away from the research, but physicians write in a much more TL;DR way. Overall, my main comment as a limitation is that they don't eliminate the resident physician effect...pediatrics is different, but where I trained the residents did 95% of hands-on patient care and had a huge impact on decision making.
Overall, I'd say this is interesting, provocative, and neither the authors, nor can I explain the findings without jumping into conclusions. However, this is the kind of study they can build an entire career on, so we'll learn a lot more about this in the future.
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