Reply to Letter to the Editor by Kaya C, et al.

jpedsurg.org

We thank Kaya and their colleagues for their interest in our paper. As in our discussion, we acknowledge that our study is significantly limited by its retrospective, non-randomised design. This leaves the possibility of a multitude of confounding factors affecting our findings, not least variability of surgeon preference. The decision as to whether or not to completely resect all necrotic bowel was at the discretion of the senior surgeon operating. We have made an attempt to control for this with a comprehensive set of demographic data and an approximation of the overall state of the baby using the nSOFA score, but acknowledge that this remains imperfect with other, unmeasured factors potentially being at play.

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Article · Mar 2024 · 1 min read

In brief

The authors respond to methodological concerns about their necrotizing enterocolitis study, acknowledging limitations of the retrospective design and surgeon variability in bowel resection decisions. They note attempts to control for confounders using demographic data and nSOFA scores, while recognizing unmeasured factors may influence outcomes.

Study limitations include retrospective design and lack of randomization, allowing for multiple confounding factors.
Surgical decision-making (extent of necrotic bowel resection) was at individual surgeon's discretion, introducing variability.
Authors attempted to control confounders using demographic data and nSOFA score but acknowledge incomplete adjustment.
Unmeasured factors may still influence study findings despite statistical controls applied.

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