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Comment & Response
June 2016

Deliberate Self-harm Following Bariatric Surgery—Reply

Author Affiliations
  • 1Sunnybrook Research Institute, Toronto, Ontario, Canada
  • 2Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  • 3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  • 4Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
JAMA Surg. 2016;151(6):585-586. doi:10.1001/jamasurg.2015.5126

In Reply Morgan and Ho are concerned that media reporting of only relative increases in the risk of self-harm might mislead health policy makers and the public. We agree, and therefore provide actual counts, so that readers can judge absolute risks and the number needed to harm.1

Morgan and Ho also raised concerns about the representativeness of our population-based cohort study. We collected data from the Ontario Ministry of Health and Long-Term Care, which has a comprehensive bariatric surgery program.2 This specialized program supports only 3 types of surgical procedures and excludes laparoscopic gastric banding,2,3 as we acknowledged in our study.1 We believe that this patient cohort is representative because of the comprehensive reimbursement and universal health coverage.3

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