We thank Drs DiMaio and Kim for their thorough review of our paper. Conducting research in this arena is challenging and we concur that there are problems inherent to retrospective record review, but it is at present the only realistic method to ensure the feasibility of study conduct in clinical practice owing to the benign nature of most pancreatic cysts. Both integrated molecular pathology (IMP) and the Sendai model were treated equally regarding “information in,” which was abstracted directly from actual medical records without reinterpretation or subjective review.