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Dr Gould raises important points in directing attention to our study's limited ability to assess the relationship between media exposure and suicide risk and to the possibility of selection bias.Her first point is that the control subjects lived longer than the suicide cases and thus they had more chances than the case subjects to be exposed to media coverage of the suicides. We recognized that earlier case subjects had fewer opportunities for media exposure than control subjects and stated that our small number of cases precluded analysis by opportunity for exposure. However, since exposure via television was reported for only 1 of the 13 case subjects, we believe that the differences are actual and cannot be solely ascribed to increasing opportunities for exposure during the series. Still, we agree with Dr Gould's point and believe that it would have been better to state that our study data
Davidson L, Rosenberg ML, Mercy JA. Teenage Suicide Clusters-Reply. JAMA. 1990;263(15):2051-2052. doi:10.1001/jama.1990.03440150055024