Reacción a "Substituting physicians for nurses in hospital interventions does not affect patient safety, says review"

The shared study provides somewhat surprising results, both in terms of the topic analysed and the possible conclusions.

The review shows that, in most of the hospital settings evaluated, replacing doctors with nurses offers equivalent clinical and safety outcomes, with specific improvements in chronic diseases and processes where health education is key.

These results may open up a line of research on this topic, including different aspects of interest such as an analysis of the implementation of different actions, protocols, and interventions.

An appropriate methodology is described, although some limitations could justify a careful interpretation of the results provided. This does not mean that we should not trust the results, but rather that we should interpret them within their context. 

As indicated, the heterogeneity, moderate risk of bias and enormous diversity of interventions require the results to be interpreted within each clinical context.

Part of the observed equivalence can be explained by the protocolisation of care and the filtering of complex patients. Many of the studies include stable or chronic patients, not critical patients, and therefore few patients in highly complex medical situations are included. It is possible that certain benefits may be due to characteristics specific to nursing care (more time, more support).

In summary, we believe it is appropriate to interpret the results derived from a review of heterogeneous studies cautiously, as there appears to be a general lack of blinding and loss to follow-up. In addition, there is likely to be variability in quality of life measures, regulatory differences, and possible selection of reported outcomes. Despite the above, it seems an interesting topic to expand new lines of research to clarify all possible uncertainties.