Reply to MS #200503055 Thank you for giving us this opportunity to respond. We wish to apologize to the editorial staff and readership of Anesthesiology1 and the Canadian Journal of Anesthesia.2 In October 2004 we published a study in the Canadian Journal of Anesthesia and in January 2005 we published another article in Anesthesiology. At the time of the Anesthesiology submission we failed to notify the journal of the existence of the prior paper which utilized the same dataset and had similar methodology. Although the paper in Anesthesiology expanded upon the findings reported in the Canadian Journal of Anesthesia, this is inconsistent with our acknowledgement of the Instructions for Authors which states "Submitted manuscripts must not have been published elsewhere, in whole or in part...". We realize that journals must take this issue seriously. It is necessary to maintain integrity and provide the peer review process the complete information to thoroughly evaluate a manuscript and arrive at the optimal decision. While not intended to hide the existence of another manuscript our actions did not allow this process to occur. We take the issue of academic integrity seriously. We are sincerely sorry for causing this situation.