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Reply to Kuriyama and Urushidani.

TO THE EDITOR—We thank Drs Kuriyama and Urushidani for their comments regarding our systematic review. Our primary aim was to evaluate the effect of strategies of prevention of hospitalacquired pneumonia on mortality in the intensive care unit (ICU). We a priori planned all the various head-to-head comparisons and chose the strongest outcome, which is mortality. In their comments, Kuriyama and Urushidani also suggest performing a network meta-analysis to evaluate the benefit of different strata. These indirect comparisonsmay also have some limitations because of the variation of the control groups (including year of