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In Reply Dr Swartz provides an opportunity to discuss the fundamental principles of clinical research and opioid dependence treatment that guided our study. Clinical trial design involves selecting a primary, clinically important outcome at a point in time.1 Our primary outcome was engagement in treatment at 30 days. We chose engagement in treatment as the primary outcome because it is associated with decreased criminal activity, HIV transmission, and mortality.2- 4
Fiellin DA, O’Connor PG, D’Onofrio G. Opioid Dependence Treatment in the Emergency Department—Reply. JAMA. 2015;314(8):835. doi:10.1001/jama.2015.8527