We thank Drs Meyer and Vassar for their interest in our study1 and comments on the use of the Fragility Index (FI). We agree that FI may be useful as an intuitive measure of the robustness of randomized, control trials2; however, caution needs to be exercised when interpreting the FI.3,4 Carter et al simulated 60,000 clinical trials with sample sizes ranging from 100 to 1000 per group and calculated the Fisher’s exact P-value and FI for each data study.3 They demonstrated that, similar to the P-value, the increase in the FI was not an indicator of the strength of the effect and recommended a broader approach, which would also encompass estimated effect size, study design, and mitigation of biases.