Reply to letter regarding “Does Pregnancy Increase the Need for Revisional Surgery after Laparoscopic Adjustable Gastric Banding?” (MS#OBSU-D-10-00107R1)

Abstract

In reply: Dr. and Mrs. Dixon point out the possibility of a type 2 error. Because of insufficient numbers studied, a difference that is statistically significant may have been missed. We agree. In fact, we have acknowledged at three separate points within the discussion the trends of the data, the possibility of a type 2 error and that, with even greater numbers, a statistically significant difference may have been demonstrated. But is the statistical significance of the difference of greater important than the clinical significance of the difference? The database for this study of 5,467 LAGB patients with 192 women having one or more pregnancies is the largest studied so far. It would represent many times more pregnancies than the lifetime clinical experience of a typical bariatric surgeon for a particular operation, and yet, we cannot show a statistically significant difference. We provide the reader with the data and a correct statistical analysis. It is now for the reader to make a personal judgement on whether those differences are clinically significant for them or not. Personally, we believe they are not.