{'fraction_non_alphanumeric': 0.03664921465968586, 'fraction_numerical': 0.005638340716874748, 'mean_word_length': 4.684210526315789, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Reply to Dr Corrao and colleagues

Sir, We wish to thank Dr. Corrao et al. [1] for their highly valued comments regarding our recent work [2]. We agree on some of the mentioned study limitations, but some issues may be discussed further. First of all, we know that double-blind, randomized controlled trials may have biases. As reported in our paper in the section regarding discussion and conclusions, our study suggests that there is no evidence of relevant differences in the efficacy of Ginkgo biloba and donepezil in the treatment of mild-to-moderate Alzheimer’s dementia. Obviously, as we have outlined, larger samples of patients should be considered to confirm these results. Secondly, there were five (20%) drop-outs in the G. biloba group and four (16%) drop-outs in the donepezil group. Dr. Corrao et al. affirm that a drop-out at follow-up equal or more than 20% compromises the overall quality of a trial. In our opinion this drop-out rate clearly reflects peculiar clinical features of enrolled patients, as psychiatrists and neurologists working in the field of dementia know. Furthermore, it is apparent that the drop-outs in the donepezil group were due to adverse events (diarrhea, nausea, vomiting, and restlessness), the same observed in many other studies, while the drop-outs in the G. biloba group were not imputable to adverse events (loss of follow-up or caregiver request). As for considerations regarding the statistical analysis section, we agree with the observation that our resulting scores could be non-normally distributed, but the number of cases are sufficient enough to use parametric tests analysis. In fact, a preliminary analysis of our data was conducted using the Shapiro–Wilk normality test (W) [3]. The null hypothesis of the test is that samples considered are taken from a normal distribution, thus P < 0.05 for W rejects this supposition of normality. In our case W was not significant, so we were not obliged to use nonparametric methods. We do not assume that the result of this test is clear evidence of normality or non-normality, but, in such perspective, we used t-test comparing each group in two different times (baseline and after 24 weeks). In conclusion, we wish to thank Dr. Corrao et al. for appreciating the scientific value of our paper, notwithstanding all considered limitations. One obvious issue is the fact that knowledge about treatment of Alzheimer’s dementia advances. As research progresses, new facts may emerge.