Clinical quality registries for clinician‐level reporting: strengths and limitations

j 16 A p il 2 0 18 IN REPLY: We thank Sypek and colleagues for their response to our article and their discussion regarding appropriate identification and management of outliers from clinical quality registries. We agree that outliers may occur at both site and clinician level; however, issues of statistical validity are particularly pertinent at the clinician level, where activity volume is generally lower and there are potential consequences for the individual clinician.