In Reply Dr Hyder and colleagues contend that we incompletely represented the findings of their study of the effect of overlapping surgery on clinical outcomes by stating that their study 鈥渞eported longer length of stay for some types of overlapping cases.鈥� They note that their primary analysis showed no difference in length of stay; the difference in length of stay occurred only in a preplanned secondary analysis. Our summary of their complex set of analyses was necessarily concise, but not inaccurate.

In their primary analysis, Hyder and colleagues¹ used administrative data from their institution to assess differences in length of stay, finding no differences in outcomes for overlapping surgeries (surgeries in which the attending surgeon is not present during some part of an operation, but that do not overlap with other surgeries during their 鈥渃ritical portions鈥�). In contrast, their secondary analysis using clinical information abstracted from their institution for ACS-NSQIP, a surgical quality assessment program, found a statistically significant difference in length of stay. Each analysis had some strengths and some weaknesses relative to the other.