To the Editor: We thank Dr. Ito for his interest in our research. Our study was a randomized controlled trial, which permitted true causal inferences to be applied to the effectiveness of the computer-assisted decision support. Thus, our conclusion was valid, regardless of the heterogeneity of the patients. Adjustment of covariates would have allowed us to explore the effects of presenting complaints and comorbidities on physicians prescribing behaviors; further inclusion of the interactions of the covariates with the decision support would allow us to examine the effectiveness of the decision support in subgroups of patients. However, these additional analyses would not alter the overall conclusion of our study, because the decision support recommendations were appropriate for all eligible patients regardless of their complaints and comorbidities, given the risks associated with their use by seniors.1–4
Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.
Author Contributions: All authors contributed in the preparation of this response letter.
Sponsor's Role: The sponsor did not play any role in writing this letter.