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The response explains that traditional, pathology-stage based assessment for glioblastoma prognosis can be subjective and may introduce bias. The authors argue that gene-expression classification is more objective and may improve prognostic prediction, using NLRP12 as a poor-prognosis marker assessed by Cox regression to estimate survival outcomes. Additional notes address correspondence, conflicts of interest, and publication details.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reply-to-the-statistical-significance-may-be-misinterpreted/436553/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reply-to-the-statistical-significance-may-be-misinterpreted/436553.png","ImageObject",300,407,{"name":92,"@type":93},"Sophia Brooks","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main purpose of this letter?","Question",{"text":112,"@type":113},"To respond to concerns raised in a Letter to the Editor by Li et al. regarding the authors’ findings and interpretation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why do the authors prefer gene-expression classification over traditional pathology stage?",{"text":117,"@type":113},"They state pathology-stage assessment is subjective and can introduce bias, while gene expression offers a more objective and corrective prediction.",{"name":119,"@type":110,"acceptedAnswer":120},"How is NLRP12 used in the authors’ analysis?",{"text":121,"@type":113},"NLRP12 is described as a poor prognosis marker, and the authors analyze high versus low NLRP12 expression using a Cox regression model to predict survival in glioblastoma patients.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436553,1791692651,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},962084925636,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","J Chin MedAssoc  \nLetter to the editor  \nReply to “The statistical significance may be misinterpreted”  \nYu-Wen Chenga,b, Yang-Yi Chenc, Chien-Ju Lind, Yi-Ting Chene,f, Ann-Shung Lieug,h, Hung-Pei Tsaig, Aij-Lie Kwang,h,i,*  \naDepartment of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; bGraduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; cDepartment of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; dSchool of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; eDepartment of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; fDepartment of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; gDivision of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; hDepartment of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; iDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA  \nDEAR EDITOR,  \nWe would like to thank Li et al1 for their interest in our work.2 In their Letter to the Editor, they summarized our most important findings and raised a possible concern to our work. Reply below is our responses for their concerns.  \nFrom traditional the aspect of pathology, the histopathological stage is the currently widely used for analysis, but we hope to create a newly classification to predict the prognosis of glioblastoma. Because the pathological stage is subjective, there still consist of bias for the prognosis. If we classify from the gene expression, the amount of the expression will be objective and provide more corrective prediction. From the database of website and the result of our research, NLRP12 is the poor prognosis marker,3,4 thus we analysis high and low expression of this gene through Cox regression model will be property as a target to predict the survival of glioblastoma patents.  \nWe would like to thank Li et al again and hope that our responses could be of help.  \nREFERENCES  \n1. Li YT, Chang WH. The statistical significance may be misinterpreted. J Chin Med Assoc 2023;86:534 .  \n2. Cheng YW, Chen YY, Lin CJ, Chen YT, Lieu AS, Tsai HP, et al. High expression of NLRP12 predicts poor prognosis in patients with intracranial glioma. J Chin Med Assoc 2023;86:88–97 .  \n3. Sharma N, Saxena S, Agrawal I, Singh S, Srinivasan V, Arvind S, et al. Differential expression profile of NLRs and AIM2 in glioma and implications for NLRP12 in glioblastoma. Sci Rep 2019; 9:8480 .  \n4. Lin Q, Wu L, Ma Z, Chowdhury FA, Mazumder HH, Du W. Persistent DNA damage-induced NLRP12 improves hematopoietic stem cell function. JCI Insight 2020;5:e133365 .  \n* Address correspondence. Dr. Aij-Lie Kwan, Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University, Hospital, Kaohsiung Medical University, 100, Tzyou 1st Road, Kaohsiung 807, Taiwan, ROC. E-mail [address: aijliekwan@yahoo.com.tw](address: aijliekwan@yahoo.com.tw) (A.-L. Kwan).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 535.  \nReceived February 13, 2023; accepted February 16, 2023.  \ndoi: 10. 1097/JCMA.0000000000000908.  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \n[www.ejcma.org](www.ejcma.org) 535  \n\u003Czdoi: 10.1097/JCMA.0000000000000908>","cbCaimQijLJNLHud","https://ap.wps.com/l/cbCaimQijLJNLHud","pdf",282484,"English","# Letter to the editor\n## Response to concerns\n## References and publication notes","[{\"question\":\"What is the main purpose of this letter?\",\"answer\":\"To respond to concerns raised in a Letter to the Editor by Li et al. regarding the authors’ findings and interpretation.\"},{\"question\":\"Why do the authors prefer gene-expression classification over traditional pathology stage?\",\"answer\":\"They state pathology-stage assessment is subjective and can introduce bias, while gene expression offers a more objective and corrective prediction.\"},{\"question\":\"How is NLRP12 used in the authors’ analysis?\",\"answer\":\"NLRP12 is described as a poor prognosis marker, and the authors analyze high versus low NLRP12 expression using a Cox regression model to predict survival in glioblastoma patients.\"}]","Reply to “The statistical significance may be misinterpreted” | PDF",1790678365]