Assess whether reported statistical results for selected categorical outcomes can be reproduced from published aggregate counts, while considering changes in operative practice alongside reduced operative time.
Approach:
Reconstructed comparisons: Recalculated overall group comparisons for postoperative complications and mesh fixation from the published 3 × 2 tables using Pearson chi-square tests; also applied a two-sided Fisher–Freeman–Halton exact test to complications.
Trend and procedural changes: Tested the complication trend using chronological phase scores of 1, 2, and 3, and compared reported operative duration and mesh-fixation rates across phases.
Key Findings:
For complications (8/42, 4/42, and 2/42), reconstructed Pearson chi-square testing gave p = 0.105, and the Fisher–Freeman–Halton exact test gave p = 0.135, rather than the reported p = 0.048.
For mesh fixation (18/42, 14/42, and 9/42), the reconstructed overall Pearson test gave p = 0.110, rather than the reported p = 0.048.
The complication counts were compatible with a declining temporal trend: the linear-by-linear association test gave p = 0.038, close to the reported trend p = 0.032.
Operative duration decreased from 88 to 58 minutes, while mesh fixation decreased from 42.9% to 21.4%.
Interpretation:
The correspondence does not dispute the reported decrease in operative time or the temporal complication pattern. It requests clarification of categorical comparisons that are not readily reproducible from the published aggregate data. Reduced mesh fixation may have contributed to shorter operative duration alongside improved technical efficiency; the correspondence notes that stratified descriptive data could help distinguish these explanations.
Limitations:
Calculations used published aggregate counts and do not reproduce the original patient-level analysis, statistical output, or analytical workflow.
The source does not provide stratified descriptive data to separate the contribution of reduced fixation from improved technical efficiency.
Conclusion:
The authors request clarification of the statistical tests and inputs used for the reported categorical outcomes.
