We read with interest the letter from Aalaei-Andabili and Alavian [1] regarding our systematic review and meta-analyses of interventions to prevent hepatitis C virus (HCV) transmission among persons who inject drugs [2]. They raise many important questions. We concur with their view that the methods of meta-analyses are undergoing scrutiny and change, and we also believe that exchanges such as this may contribute to further development of the methods.In our article, we did not mention that all studies included in the HCV Synthesis Project were rated for quality, with ratings based on MOOSE criteria [3]. A description of our quality rating is published elsewhere [4]. However, in this review there were not enough studies of HCV prevention to assess quality in meta-regression analyses, and there was not enough variation in quality to transform this measure into meaningful categories (eg, "lower" vs "higher" quality) with which we could compare grouped results.
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