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Dear Dr. Riess: Your comments are very incisive and accurate. You stated: "In fact the only way to judge the efficacy of a surgeon is through peer review of published results." I agree with you. Yet, I have to ask if you have ever seen a hospital or surgeon publish their own percentages for peer review voluntarily? The data that are published voluntarily are biased towards demonstrating good results - much like Iaconno's publications and your own experience. Jorge Romero