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Letter response
Response to: ‘Paying attention to arbitrary causality and the preciseness of conclusion’ by Lei et al
  1. Xingzhong Jin1,
  2. Julieta Ruiz Beguerie2,
  3. Weiya Zhang3,
  4. Christopher Leigh Blizzard1,
  5. Petr Otahal1,
  6. Graeme Jones1,
  7. Changhai Ding1,4,5
  1. 1Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
  2. 2Department of Dermatology, Austral University Hospital, Buenos Aires, Argentina
  3. 3Academic Rheumatology, University of Nottingham, Nottingham, UK
  4. 4Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5Arthritis Research Institute, 1st Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
  1. Correspondence to Dr Changhai Ding, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania 7000, Australia; Changhai.Ding{at}

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We would like to thank Dr Zeng et al1 for the comments on our paper.2 Please see the point-to-point response as below:

  1. As pointed out in the discussion of our paper, cross-sectional and case-control designs are not able to infer a causal relationship.2 The conclusion ‘low grade systemic inflammation may play a greater role in symptoms rather than radiographic changes in osteoarthritis (OA)’ does not necessarily imply a cause-effect relationship. It remains controversial whether inflammation is a cause for disease progression or a result of disease manifestation. …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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