We thank Dr Gould for his comments regarding our study of endobronchial ultrasound performed with and without aspiration.1 One of his main concerns is the denomination of “randomized clinical trial” that we gave to our study. There was, indeed, a randomization used in our study. Of note, instead of randomizing patients or lymph nodes (LNs) to one technique or another, we preferred to use both techniques in each LN and randomize the order in which they would be performed. This way, each LN would provide its own control, and, additionally, this type of randomization would prevent the first-pass bias. We call the first-pass bias the fact that the first sample, in our experience, provides the best quality material, since the LN has not been traumatized by the needle yet.