Thank you for your interest in our article.1 You raise a number of issues, and we will reply to them sequentially.
We agree that the pantoprazole group may have had some degree of selection bias, as these patients seem to have been sicker, as indicated by their significantly higher APACHE II scores. Whether this had any impact on outcome, however, remains unknown for 2 reasons. As we noted in the article, no prior studies have specifically identified acuity as a risk factor for upper gastrointestinal bleeding (UGIB) in the critical care setting, although acuity might seem to be an obvious predisposing factor for this complication.2,3 Also, despite the significant difference in acuity scores between the groups, except for the incidence of UGIB, no other differences in outcome parameters were identified, suggesting minimal if any clinical significance of their conditions.
With regard to your second point, we...