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In Reply: We agree with Drs Treadwell and Turkelson that comments could have been provided pertinent to study quality. Our experience, however, in conducting meta-analyses in other topic areas is that sensitivity analyses that account for global study quality do not lead to substantially different conclusions, particularly when a large number of studies are analyzed. Juni and colleagues¹ have demonstrated the difficulty in the use of summary scores for evaluation of study quality. In this regard, we look forward to the publication and evaluation of the ongoing work by ECRI on assessing quality for individual outcomes within studies.

In performing our study, our objective was to be inclusive and not exclusive: any attempt at being exclusive by narrowing down the inclusion criteria used to select the 136 reports could be met with the criticism that we were selecting articles to reflect our own point of view—a judgment we most assiduously . . . [Full Text of this Article]

Henry Buchwald, MD, PhD
buchw001@umn.edu
Department of Surgery
University of Minnesota
Minneapolis

Yoav Avidor, MD
Ethicon Endo-Surgery Inc
Cincinnati, Ohio

Eugene Braunwald, MD
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, Mass

Michael D. Jensen, MD
Department of Medicine
Mayo Clinic College of Medicine
Rochester, Minn

Walter Pories, MD
Department of Surgery
East Carolina University School of Medicine
Greenville, NC

Kyle Fahrbach, PhD; Karen Schoelles, MD
MetaWorks Inc
Medford, Mass

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