In Reply We thank both sets of authors for their comments on our article.1 Arabi and colleagues pose several important questions about our methods, namely our choice of Brain Trauma Foundation guidelines. Only 1 of 15 clinical areas listed in the current Brain Trauma Foundation guidelines is supported by level I evidence (not using steroids); the remainder are supported by level II evidence, including intracranial pressure monitoring.2 Moreover, although intracranial pressure monitoring has fallen out of favor with some surgeons, other studies, including one from our consortium,3 continue to find a benefit for invasive monitoring, particularly for patients whose cerebral function is difficult to monitor clinically.
Dawes AJ, Cryer HG. Measuring the Quality of Care for Patients With Traumatic Brain Injury—Reply. JAMA Surg. 2016;151(3):295. doi:10.1001/jamasurg.2015.4230