Rapid response systems (RRS) have been widely adopted despite mixed results about their impact in both pediatric and adult settings. This study found a reduction in hospital mortality without a pediatric medical emergency team (PMET). The authors use their findings to illustrate the limitations of before-and-after study designs that previously demonstrated benefits of RRS. These reported benefits in pediatric settings may have resulted from any number of cointerventions rather than adoption of a PMET itself. An accompanying editorial [see link below] further advocates for investments in well-performed studies that can be cost-effective, and appropriately align limited resources to the most proven interventions.