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In Reply: Dr Bosch and colleagues suggest that we have selected studies based on their results. As we clearly stated, however, we established explicit eligibility criteria and blacked out all study results prior to determining study eligibility so that we were unable to select or reject an article based on the study results. Articles for inclusion in a systematic review are selected on the basis of meeting prespecified methodological criteria, not on the basis of where they are published. Doctoral dissertations undergo peer review that is as rigorous, if not more rigorous, than that for articles published in medical journals.

Bosch et al also suggest that Irvin's study¹ found only a "small . . . higher probability of dying in a for-profit dialysis unit." Patients and many clinicians are likely to think that an increase of as much as 7% in their relative risk of dying, suggested by the data . . . [Full Text of this Article]

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