In Reply We appreciate the letter from Petrick et al regarding our study¹ on the variation in rates of complication observed at accredited bariatric centers. They raise several important points that we wish to clarify.

First, as noted in our Methods and Limitation sections, Petrick et al correctly point out that we were only able to evaluate a subset of accredited centers within our data set.¹ If anything, a more inclusive assessment—including more accredited centers—would likely demonstrate more variation, not less. Because all 12 states in our study consistently demonstrated variation within themselves, we believe our findings to be robust and would replicate if more states were assessed.

在答复中，我们感谢Petrick等人关于我们的研究¹的信，信中涉及在认可的减肥中心观察到的并发症发生率的变化。他们提出了几个我们要澄清的重要观点。

首先，正如我们的“方法和限制”部分所述，Petrick等人正确地指出，我们只能评估数据集中认可中心的一个子集。¹如果有的话，一个更具包容性的评估（包括获得更多认证的中心）可能会显示出更多的变化，而不是更少。由于我们研究中的所有12个州始终在内部表现出变异，因此我们认为我们的发现是可靠的，并且如果评估了更多的州，这些结果将会重复。