In Reply We would like to thank Medina and colleagues and Thompson Jr and colleagues for their interest and thoughtful comments on our article.1 We completely agree that the goal of observational studies is not to refute clinical trials, but rather to complement them through assessment of real-world practice. In the Prostate Cancer Prevention Trial, prostate-specific antigen (PSA) values for men being treated with finasteride (a 5-α reductase inhibitor [5-ARI]) were automatically adjusted for the effect of the medication by a relatively complicated formula where the PSA was doubled for the first couple of years, then multiplied by 2.3 for subsequent years.2
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Sarkar RR, Rose BS. 5α-Reductase Inhibitor Use in Patients With Prostate Cancer—Reply. JAMA Intern Med. 2019;179(10):1440–1441. doi:10.1001/jamainternmed.2019.3620
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