Letters First, as noted in our Methods and Limitation sections, practices and protocols to replicate the outcomes of their Petrick et al correctly point out that we were only able to best performers. evaluate a subset of accredited centers within our data set. Andrew M. Ibrahim, MD, MSc If anything, a more inclusive assessment—including more Justin B. Dimick, MD, MPH accredited centers—would likely demonstrate more varia- tion, not less. Because all 12 states in our study consistently Author Affiliations: Department of Surgery, University of Michigan, Ann Arbor demonstrated variation within themselves, we believe our (Ibrahim, Dimick); Center for Healthcare Outcomes and Policy, University of findings to be robust and would replicate if more states were Michigan, Ann Arbor (Ibrahim, Dimick); Surgical Innovation Editor, JAMA assessed. Surgery (Dimick). The second point raised by Petrick et al concerns the geo- Corresponding Author: Andrew M. Ibrahim, MD, MSc, Center for Healthcare Outcomes and Policy, Department of Surgery, University of Michigan, 2800 graphic proximity of high-performing and low-performing cen- Plymouth Ave, Bldg 10-G016, Ann Arbor, MI 48109-2800 (firstname.lastname@example.org). ters. They overstate our position in misquoting the article as Published Online: January 3, 2018. doi:10.1001/jamasurg.2017.4590 declaring, “lower-quality centers were almost uniformly lo- Conflict of
JAMA Surgery – American Medical Association
Published: Feb 13, 2018
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