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Evidence for the Full Potential of Daily Food Choices to Minimize Premature Mortality—Reply

Evidence for the Full Potential of Daily Food Choices to Minimize Premature Mortality—Reply Letters In Reply We welcome the comments by Forbes about our article initiatives to improve safety, quality, and value in our health in measuring low-value endovascular repair of abdominal aor- systems. tic aneurysms (EVAR), but we disagree with his conclusions. First, he objects to our use of the American Society of An- Tim Badgery-Parker, MBiostat esthesiologists (ASA) classification to define “high-risk” pa- Adam G. Elshaug, MPH, PhD tients. Identifying “high-risk patients with limited life expec- Author Affiliations: The University of Sydney, Faculty of Medicine and Health, tancy” in our data is challenging. Given the available variables, School of Public Health, Menzies Centre for Health Policy, Charles Perkins our clinical advisers agreed that using the ASA classification Centre, Sydney, Australia. is reasonable. Although the interrater reliability for the ASA Corresponding Author: Tim Badgery-Parker, MBiostat, The University of score is moderate, the score is a valid indicator of periopera- Sydney, Faculty of Medicine and Health, School of Public Health, Menzies Centre for Health Policy, Level 2, Charles Perkins Centre D17, The University of tive risk. It needs to be emphasized that the ASA III and IV defi- Sydney, NSW 2006, Sydney, Australia (tim.badgeryparker@sydney.edu.au). nitions are predicated on “severe systemic disease,” implying http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Evidence for the Full Potential of Daily Food Choices to Minimize Premature Mortality—Reply

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Publisher
American Medical Association
Copyright
Copyright 2019 American Medical Association. All Rights Reserved.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2019.2208
Publisher site
See Article on Publisher Site

Abstract

Letters In Reply We welcome the comments by Forbes about our article initiatives to improve safety, quality, and value in our health in measuring low-value endovascular repair of abdominal aor- systems. tic aneurysms (EVAR), but we disagree with his conclusions. First, he objects to our use of the American Society of An- Tim Badgery-Parker, MBiostat esthesiologists (ASA) classification to define “high-risk” pa- Adam G. Elshaug, MPH, PhD tients. Identifying “high-risk patients with limited life expec- Author Affiliations: The University of Sydney, Faculty of Medicine and Health, tancy” in our data is challenging. Given the available variables, School of Public Health, Menzies Centre for Health Policy, Charles Perkins our clinical advisers agreed that using the ASA classification Centre, Sydney, Australia. is reasonable. Although the interrater reliability for the ASA Corresponding Author: Tim Badgery-Parker, MBiostat, The University of score is moderate, the score is a valid indicator of periopera- Sydney, Faculty of Medicine and Health, School of Public Health, Menzies Centre for Health Policy, Level 2, Charles Perkins Centre D17, The University of tive risk. It needs to be emphasized that the ASA III and IV defi- Sydney, NSW 2006, Sydney, Australia (tim.badgeryparker@sydney.edu.au). nitions are predicated on “severe systemic disease,” implying

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Aug 1, 2019

References

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