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In Reply We appreciate the thoughtful comment by Liss and Baker regarding our study1 and agree that the visit-based nature of National Ambulatory Medical Care Survey (NAMCS) leads to an inability to report on the prevalence of types of services delivered to a population, a limitation that is noted in the NAMCS documentation as well.2 However, in a presentation of trends, wherein these limitations are present across all years of study data, the comparison of rates between these years is valuable.
Kale MS, Federman AD, Keyhani S. Accurately Estimating Cervical Cancer Screening Overuse Among Older Women—Reply. JAMA Intern Med. 2013;173(13):1266-1267. doi:10.1001/jamainternmed.2013.7408