Results The performance of GSA-SNP and i-GSEA4GWAS looked quite different in terms of the number of hits (Table 1). GSA-SNP detected 27-94 hits for either the imputed or unimputed genotype dataset with GO gene sets, while 9-20 hits were detected with KEGG gene sets. Consistently, more gene sets were hit with the scheme of using the second-best p-value of a gene than the best one. Previously, it has been recommended that one assign the second-best, not the best, p-value to a gene due to a concern that the use of the best p-values of a gene may produce more false positives than the second-best one [4]. We compared the distribution of gene scores that were calculated based on the best and the second-best p-values using a high-volume scatter plot that represented the local density of points by a false color representation (Fig. 1). One may notice the densely populated points along the diagonal axis, meaning that the differences in gene scores were small for the majority of genes. Nevertheless, there were many genes off-diagonal; for these genes, the gene scores that were calculated with the best p-values were larger than those calculated with the second-best p-values. While this effect was negligible for the genes having high scores (p < 10-4), many genes having low scores displayed large differences. The latter were genes that had only one SNP within its boundary plus 20 kb of padding standing out in terms of significance and the rest falling short. If the best SNP of a gene had been located within a strong linkage disequilibrium (LD) block, the second-best SNP would have been chosen from this block with a p-value close to the best one. On the other hand, if the best SNP is in weak LD with the second-best one, they would differ from each other considerably. Considering that Fig. 1 was based on the highly densely imputed genotypes, those genes that showed a large difference may have been located within narrow LD blocks or recombination hot spots where imputation may be invalid. Indeed, the genes that were not located within haplotype blocks showed larger differences in gene scores than those located within haplotype blocks (Supplementary Fig. 1). For those genes located within haplotype blocks, there were inverse relationships between the block size and the difference in gene scores (Supplementary Fig. 2). It is also possible that the apparent associations seen with the best p-values may have been due to random errors; assigning the second-best p-value to a gene may then reduce false associations. One may argue that the large difference between the best and second-best scores for some genes may be due to the small number of SNPs for those genes. If this is the case, there should be an inverse relationship between these two quantities. As shown in Supplementary Fig. 3, there is no such evidence. Here is the rationale for the more hits made by GSA-SNP with the use of the second-best p-values than the best p-values in assigning them to a gene. GSA-SNP assigns a score to a gene set by averaging gene scores (-logP) of its member genes and calculates Z-statistic by subtracting the mean of all gene scores from the gene set score. Assigning the second-best p-value to a gene produces lower gene scores than assigning the best one. While this effect is more pronounced with low-scoring genes, the high-scoring genes suffer little. Since the mean of all gene scores would also decrease by using the second-best p-values compared to the use of the best p-values, the resulting Z-statistic for a gene set that is composed of high-scoring genes would then increase, yielding more hits. The GSA-SNP runs with p-values of the imputed genotypes consistently produced fewer hits than with those of the unimputed genotypes. Imputation guesses the genotype of an untyped marker and fills it in. The GWAS p-value of an imputed SNP can be either larger or smaller than those of the neighboring genotyped, unimputed ones. For the former cases, it would not change the best p-value that is assigned to a gene. On the other hand, for the latter cases, the best p-value that is assigned to a gene can get smaller. As shown in Fig. 2, the imputation increased the significance of many genes. This has the effect of reducing the number of hits for the GSA-SNP runs with the imputed dataset compared with the unimputed one, similar to the argument given above for the schemes of assigning the best or second-best p-values to a gene. With the p-values of the imputed SNPs, i-GSEA4GWAS claimed 1,070 GO terms as significant, almost 40-fold more than GSA-SNP, which yielded only 27 terms. Even with the p-values of the original unimputed SNPs, i-GSEA4GWAS produced about 4.6 times more terms than GSA-SNP (283 vs. 61). It appears that i-GSEA4GWAS unrealistically produced too many hits (about 1/3 of the input GO terms), hampered by the high proportion of false positives. This trend was much more pronounced with GO than KEGG, probably due to the more redundant nature of GO than KEGG. Unlike GSA-SNP, which reported fewer hits with the imputed dataset than the unimputed one, i-GSEA4GWAS produced about 5 times more hits with the former than the latter. Why did i-GSEA4GWAS perform even more poorly with the imputed dataset that should be more ideal in terms of marker density than the unimputed one? i-GSEA4GWAS assigns the best p-value to a gene and evaluates the gene set score by comparing the distribution of gene scores (-logP) of a gene set to that of all gene scores. The significance of the gene set score is estimated by the FDR, which compares the unpermuted distribution of the gene set scores with that of the gene set scores generated from a number of SNPpermuted datasets. The gene set score is multiplied by a factor, k/K, where k represents the proportion of so-called 'significant' genes within the gene set and K represents the proportion of 'significant' genes of all genes. i-GSEA4GWAS defines the 'significant' genes as those that are mapped with at least one 'top 5%' SNP. This step is a unique feature of i-GSEA4GWAS, which has the prefix 'i' in its name. Generally, an imputed dataset has much higher marker density than the corresponding unimputed one (4.45-fold difference in our case). The so-called 'top 5%' SNPs will be more with the imputed dataset than the unimputed one (again, a 4.45-fold difference in our case). This corresponded to p-value cutoff of 0.047 in our case. The number of so-called 'significant' genes does not increase as much as the increase in the marker density: from 2,967 genes for the unimputed dataset to 4,156 genes for the imputed one in our case. The concept of augmenting gene set scores by the proportion of 'significant' genes may be useful, as demonstrated previously in comparison with GSEA [5, 14]. However, the 'top 5%' threshold used by i-GSEA4GWAS may be too high, inflating the false positive rates. This inflation may be more pronounced with an imputed dataset - 1,000 more genes were treated as 'significant' with our imputed dataset than with the unimputed one. Probably, this is one of the main reasons for the particularly poor performance of i-GSEA4GWAS with the imputed dataset.