In Reply We thank Goudra and Singh for their interest in our study of complications following anesthesia assistance for colonoscopy. Their findings of a 3-fold increase in the use of anesthesia-assisted endoscopic procedures are certainly consistent with our results in Medicare beneficiaries as well as in privately insured individuals.1,2 Although our study could not directly measure patient severity of illness and instead included a validated claims database comorbidity index,3 other studies suggested that much of the increase has been in patients at low risk for adverse events with conscious sedation.