LAUSR

First of all, we appreciate the interest in ourmanuscript from readers of the American Journal of EmergencyMedicine. The authors of this correspondence indicated several methodological and statistical concerns regarding our manuscript. Our understanding is that the authors insisted that our conclusion can be considered as an optimistic interpretation because (1) the clinical difference between area under the curve (AUC) of the baseline disease and other variables such as mesenteric stranding and bowel dilatation is negligible, (2) there was only a small number of patients, and (3) the author believes that our study was a cross-sectional study. We would like to discuss these concerns on a point-by-point basis. Regarding comparisons of AUCs among indices, we speculated that the reader's interestmay vary from person to person. Thus, we just presented AUC of each index in Table 3 of our manuscript. Since 95% confidence intervals (CIs) calculated by Delong's method were also presented, we expect readers can evaluate statistical differences in AUCs among indices by themselves. As interpreted by data in Table 3 of our manuscript, the comparison between baseline disease and mesenteric stranding or bowel dilatation did not reach statistical significance with Delong's method. However, we think that the important fact is that the baseline disease had the highest AUC and may be easier to indicate than mesenteric stranding or bowel dilatation in a clinical setting. In this point of view, we still believe that assessment of statistical differences between all pairs of determinants is page-consuming and that showing AUC and its 95% CI of each determinant would be sufficient as data presentation. We understand the limitation of a small number of patients. But readers can interpret our data accurately considering these study limitations sincewe provided the number of patients in themethodology section and provided 95% CIs in the results section. In addition, our main focus was to investigate the most useful indices for discriminating the presence of intestinal ischemia or necrosis in patients with acute mesenteric ischemia for clinical decision-making, and the smallest required sample size in a “diagnostic test” could not be applicable because the objective is totally different between our study and evaluation of diagnostic accuracy of the newly introduced diagnostic test. We thus used the