Dear Editor:
We reviewed the comments made by Cristian Ramos-Vera with great interest, and we thank him for his comments. His comments will allow us to lead the reading from the “stan dard framework of frequentist statistics based on significan ce assumptions” towards Bayesian models and thus avoid dichotomous biases for future interests in the manuscript.
Our team has applied Bayes’ theorem in cervical cancer diag nostic studies1, however, as Bayesian methods are diverse, in this study we did not apply this analysis, which according to the analysis of the letter agrees with our findings.
We know that case-control studies are subject to the action of different biases, so in this study, we take the necessary precau tions to reduce and avoid them in the context of the Peruvian lockdown due to COVID-192. Our main objective was not to generalize their findings but to know the risk factors of the rural Andean population for COVID-19, however, we agree that the Bayesian analysis deepens in refining the statistical conclusions and provides better quality to the clinical response3.
Given that the p-value is not sufficient for clinical interpreta tion4, certain factors (such as effect size and sample size) can undermine the conclusions, resulting in large amounts of bias. One of our limitations was the sample size since in the context of confinement and social distancing it has been difficult for us to voluntarily enroll patients in the study. The applied Ba yesian analysis has highlighted this small sample size as the cause for the wide ranges for arterial hypertension and Diabe tes mellitus type 2 as risk factors. Further studies are required to evaluate on a large scale the risk factors for COVID-19 in the Andean and Amazonian populations, improving the Peru’s investment priorities in science and technology5.
As noted in the letter, the Bayesian approach can be very useful in SARS-CoV-2 research, improving the traditional sta tistical approach, thus, scientific paradigms are changing as is being seen in levels of evidence, levels of significance, and scientific writing 6-7. We believe that we have contributed to the discussion about the risk factors of the Andean Peruvian po pulation against COVID-19 in a perfect way.