In 1, we presented a new indicator of change, the IpC, which is based on the total improvement a group of subjects experienced over time, relatively to the total change that could be achieved by this group.Yarias 2, reading our paper, identified two points that he sees as limitations to our work: (a) We assumed that changes in an ordinal variable (e.g., from poor to regular, from regular to good) are linear, and (b) it is possible to identify paradoxical results if one compares groups of subjects with very different baseline scores.We thank this opportunity to further discuss these aspects of our paper. Relatively to (a) one should note that the debate on the use of measurement scales goes is not new or unknown 3, 4, Precisely to avoid such problems, we stated that "In the present study, the approach is more indicated to clinician-rated scales, for which problems such as variation in the meaning of change according to the position of a subject in a scale are less important. Examples of these are physiological variables that are measured against a standardized, agreed-upon scale, developed and applied after consensus is achieved in a field" 1.
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