We thank Foroush et al.1 for their interest in our study. Positive likelihood ratios (PLRs) >1 indicate an increase in posttest probabilities on a continuous scale, compared with pretest probabilities. The guide of Jaeschke et al.2 does not suggest that PLRs should be >10, as suggested in the comment. Rather, it acknowledges that PLRs as low as 2–5 can result in important changes in probability. Regardless, our score achieved a PLR of 22.7 at cut point 0 in internal validation.