To the Editor: Dr Gallagher and colleagues examined the risk of bleeding associated with dexamethasone administered to children undergoing tonsillectomy. The audiors concluded that dexamethasone was not associated with bleeding requiring reoperation, using a noninferiority threshold of 5%. Gallagher et al applied the same threshold of 5% to all bleeding end points (any bleeding, bleeding requiring re-hospitalization, reoperation due to bleeding) to indicate non-inferiority. We agree that an increase of 5% in level I bleeding (any bleeding) might not necessarily be of clinical relevance. However, an increase of 5% in level III bleeding (ie, those needing a reoperation) is quite different.
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