We are pleased that Drs Kuwahara and colleagues took the time to scrutinize our article. We would like to address each of their specific concerns.
First, we disagree with the argument that our cost-effectiveness model was inadequate because it omitted sufficient analysis of disease recurrence. The goal of our study was to compare different treatment modalities, for most of which long-term follow-up data are scanty, questionable, or simply absent. Were we to use the limited long-term data in a haphazard fashion in our analysis, we would indeed be guilty of poor methodology. As it was, we were determined to compare apples with apples (short-term data with short-term data) rather than apples with oranges (some short-term data and some long-term data).