Response to the letter to the editor: recalibrating evidence: a cautionary note on the use of post hoc thresholds in IPD meta-analyses

We are grateful to the author of the letter for his interest in our recent paper, ‘Role of the calcium stimulation test in diagnosing medullary thyroid cancer: is it adequate to achieve a diagnosis in both sexes? An individual patient data meta-analysis’ in the European Thyroid Journal (2025), and for his comments on the methodological aspects of our IPD meta-analysis. We would like to clarify our methodological choices and address the concerns raised. Regarding the absence of PROSPERO registration, we recognize that registration would have improved transparency. We defined the analytic framework and objectives before conducting the analyses at the ‘NIKE’ (Neuroendocrine tumors Innovation Knowledge and Education) workshop held by Prof. Annamaria Colao, Prof. Antongiulio Faggiano, and Prof. Andrea M Isidori. The aim of the workshop was to boost the advancement of knowledge in various aspects of neuroendocrinology. However, we recognize the value of protocol registration to limit potential bias. This limitation was acknowledged in our paper, and we agree that future research should adopt protocol registration as a standard practice.