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Comment & Response |

Deliberate Self-harm Following Bariatric Surgery—Reply

Junaid A. Bhatti, MBBS, MSc, PhD1,2,3; Avery B. Nathens, MD, PhD, FRCSC1,2,3,4; Donald A. Redelmeier, MD, MSHSR, FRCPC1,2,3
[+] 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.
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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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March 1, 2016
Amir A. Ghaferi, MD, MS; Carol Lindsay-Westphal, PhD
1Ann Arbor Veterans Administration Healthcare System, Ann Arbor, Michigan2Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor3Department of Surgery, University of Michigan, Ann Arbor
1Ann Arbor Veterans Administration Healthcare System, Ann Arbor, Michigan4Department of Psychiatry, University of Michigan, Ann Arbor
JAMA Surg. 2016;151(3):232-233. doi:10.1001/jamasurg.2015.3396.
March 1, 2016
Junaid A. Bhatti, MBBS, MSc, PhD; Avery B. Nathens, MD, PhD, FRCSC; Deva Thiruchelvam, MSc; Teodor Grantcharov, MD, PhD; Benjamin I. Goldstein, MD, PhD, FRCPC; Donald A. Redelmeier, MD, MSHSR, FRCPC
1Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada2Department of Surgery, University of Toronto, Toronto, Ontario, Canada3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
1Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada2Department of Surgery, University of Toronto, Toronto, Ontario, Canada3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada4Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
5Department of Surgery, St Michael’s Hospital, Toronto, Ontario, Canada6Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
7Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
JAMA Surg. 2016;151(3):226-232. doi:10.1001/jamasurg.2015.3414.
June 1, 2016
David J. R. Morgan, MBBS, FACEM, FCICM; Kwok M. Ho, MBBS, FCICM, FANZCA, PhD
1Department of Intensive Care Medicine, St John of God Hospital Subiaco, Perth, Western Australia, Australia
1Department of Intensive Care Medicine, St John of God Hospital Subiaco, Perth, Western Australia, Australia2School of Population Health, University of Western Australia, Perth, Western Australia, Australia
JAMA Surg. 2016;151(6):584-585. doi:10.1001/jamasurg.2015.5123.
June 1, 2016
Xiulu Ruan, MD; Katherine Bydalek, MSN, FNP-BC, PhD; Srinivas Chiravuri, MD
1Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans
2College of Nursing, University of South Alabama, Mobile
3Department of Anesthesiology, University of Michigan Health System, Back and Pain Center, Ann Arbor
JAMA Surg. 2016;151(6):585. doi:10.1001/jamasurg.2015.5129.
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