In Reply We appreciate the response to our recent publication1 by Hoffman and colleagues on behalf of the ROMICAT investigators and are particularly grateful to them for making the data from ROMICAT II2 publicly available for analysis by independent investigators without conflict of interest or a technology-specific agenda. Hoffman et al claim that the patients randomized to the standard evaluation arm who did not undergo testing were, at some point, reevaluated and found to be at such low risk that testing was felt unnecessary. We are unable to find evidence in the trial protocol2 of any process for reevaluation of patients once they were consented and randomized. In fact, the protocol specifically states “…only patients in whom the ED [emergency department] attending feels that further inpatient testing is required will be included.”2