Determining optimal catheterization rates/The authors respond

Second, the authors suggest that the highest regional average catheterization rates for men (638 per 100 000 population) and women (314 per 100 000 population) are lower than optimal catheterization rates. However, higher rates of catheterization have already been reached in several regions considered in this study for men and for women (Fig. 3 and Fig. 4 in the article),1 and there are reportedly no signs of a plateau effect. It is not clear why those higher values were not considered as the rates that are also lower than optimal catheterization rates, because that would be in accordance with the applied method of detecting an optimal rate of catheterization.