In Reply We used the term lactic acidosis in the title of our study1 to be consistent with previous literature and to facilitate study identification.2 However, our study1 does not use lactate concentration to define acidosis events. In addition, our study is observational, and the ability to infer causality—even with techniques such as propensity score matching and active comparator analyses—is limited.
Lazarus B, Shin J, Grams ME. Lactic Acidosis, Metformin Use, and Dose-Response Association—Reply. JAMA Intern Med. 2018;178(10):1427–1428. doi:10.1001/jamainternmed.2018.4430
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.