The Diffusion of a Medical Innovation: Is Success in the Stars? Further Evidence‪.‬

1. Introduction In Burke, Fournier, and Prasad (2007) we examined the role that local interaction among physicians played in the adoption and utilization of stents following their introduction in the mid-1990s. Our interest was in the mechanics of social learning in medical practice, and the key hypothesis was that of asymmetric effects, whereby high-status physicians (stars) exert greater influence than others. Given the limitations of data, this is a challenging question to resolve empirically. Our paper was grounded in the belief that significant progress could, nevertheless, be made. The Comment (Huesch 2009) raises important questions, and, to a considerable extent, we are sympathetic to its concerns. In response, we have performed some of the suggested tests, to the extent feasible with the data. The new results are found to strengthen our previous conclusions. On balance, we think the evidence continues to point to star effects in the diffusion of stents. Of course, much work remains to be done.