"Mortality is also likely to be the factor least impacted by surgeon experience," West said, noting that the amount of blood transfused, number of complications, length of hospital stay, and number of infections would also help to better gauge experience.
Another weakness of the study comes from the numbers themselves, West said. A study that makes a conclusion based on a "lack of statistical significance" is weaker than a study that makes a conclusion based on the presence of one and would require either much larger numbers of patients or much greater differences between the groups than those present in this study to be meaningful.
The potential minimizing of the importance of specialized trauma training in the study also bothered West. With greater proportions of general surgery training being spent on other topics, today's graduating residents spend less time dedicated to trauma. In fact, he predicted that today's graduating general surgeons will probably be less prepared for major trauma than the ones in this study from only a few years ago.
West also pointed out that other advances in medicine, such as improved CT scanning technology and the now-routine use of ultrasound, could account for at least some of the improvement seen after 1998.