We thank Drs. Morfeld and Erren for conveying their agreement of our consideration of chronoytpe as a potential effect modifier, and not as a potential confounder, in the relationship between shift work and ovarian cancer (1). Their proposition to consider chronodisruption as a single time-dependent variable that incorporates both chronotype and working history (2) is very interesting and indeed would offer parsimony to the analysis of this interaction. Has this variable been validated and used in an epidemiologic study? Does it take into account the different mechanisms by which chronodisruption has been hypothesized? We look forward to seeing future epidemiologic studies that use this chronodisruption variable.
See the original Letter to the Editor, p. 1404
Disclosure of Potential Conflicts of Interest
No potential conflicts of interest were disclosed.
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