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  1. Iolo Doull1,
  2. Hazel Evans2
  1. 1Respiratory Cystic Fibrosis Unit, Children's Hospital for Wales, Cardiff, UK
  2. 2Department of Respiratory Paediatrics, Southampton University Hospital Trust, Southampton, UK
  1. Correspondence to Iolo Doull, Respiratory Cystic Fibrosis Unit, Children's Hospital for Wales, Heath Park, Cardiff CF14 4XW, UK; doullij{at}cf.ac.uk

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We appreciate Bowler and colleagues'1 concerns and recognise that our findings2 are merely exploratory and require replication. We also recognise the sensitivities involved—the individual clinics were not specifically identified because the small number of patients would prevent meaningful deductions, instead we concentrated on the model of care. Nevertheless, individual clinics may feel aggrieved that they are lumped with others.

Bowler and colleagues point out potential weaknesses of our study. They rightly highlight the pernicious effect of social deprivation on survival in cystic fibrosis (CF),3 and we were unable to correct for these factors. There are areas of …

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