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We note that these Kappa estimates are likely underestimates of the inter assay reproducibility observed in current clinical practice, since 1 the GEM dataset based analysis is comparing mRNA expression with IHC from data obtained across multiple different institutions; 2 protein expression data in the NHS MR were recorded by different laboratories, using multiple methods IHC, biochemical assays, spanning several decades; and 3 the NHS TMA cases sampled only a subset of the tumor and did not have the benefit of the whole slide analysis used in routine clinical practice buy cialis online uk Wet Cell Battery letter, 171, p