Sit up and take notice about avian flu

This week in the BMJ for the paper by Walsh et al are offered the conclusion that investment in intermediate care in community hospitals may be more cost effective than financing nurse led care for post-acute patients in acute hospitals. 1 2But the study itself, which confirms existing evidence on the costs of nurse led intermediate care in acute settings, 3 4 tackles neither the effect nor the cost of intermediate care in community hospitals.How then can such a conclusion be drawn?Walsh et al do not make this assertion.The author of the comment offers no support.Our own review of the evidence on nurse led intermediate care found no quality evidence for either the effect or cost of intermediate care in community settings. 5 The BMJ has been at the forefront of setting standards for the reporting of primary research.However, the editors must be aware that many readers simply pick up a take home message from comment, like this, 1 in the journal.