In Reply We thank Braillon et al for their comment on the CHARMED study.1
We strongly agree that the results of this study should not be overlooked, and we believe our findings warrant large-scale implementation of cross-checking across all emergency departments (EDs). The cross-checking procedure has now been implemented in our institution, as it has in several others. To increase the acceptability of cross-checking to emergency physicians, one might wish to see the results confirmed on a larger scale. We believe our results are internally valid and methodologically robust. However, we accept that because 5 of the 6 EDs included were from a single institution (Assistance Publique-Hôpitaux de Paris) and the intervention period lasted 10 days, there may be other EDs that operate in different ways, and consequently our study may be taken as a pilot. We hope to be able to conduct another trial with better external validity and are awaiting funding approval for this larger planned trial.
Freund Y, Bloom B, Philippon A. The Health Care System Flies in the Face of Airline Security Concepts—Reply. JAMA Intern Med. 2018;178(8):1143. doi:10.1001/jamainternmed.2018.3553
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