In Reply Dr Karp raises concerns about the way we explained several statistical concepts to a wide audience of practicing clinicians.
With respect to the author’s first 5 points, he is technically correct. We would argue, however, that our presentation is very close to accurate technically, understandable to clinicians, and will not result in misleading inferences. Experience with other Users’ Guides in which we have used similar approaches—ie, pragmatic explanations that capture the essence of the concept but that may not be technically pristine—gives us considerable confidence in this inference.1
Agoritsas T, Merglen A, Guyatt GH. Adjustment Strategies in Studies of Therapy—Reply. JAMA. 2017;317(21):2238–2239. doi:10.1001/jama.2017.4887
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