Title: Establishing of a risk prediction model for metabolic dysfunction associated steatotic liver
disease: a retrospective cohort study
Version: 1 Date: 07 Oct 2024
Reviewer's report:
The study uses a cohort over a roughly four year period with a  training a a validation cohort.  The
model includes mostly variables that are used in the diagnosis of MAFLD (as the authors point
on in the paper).    The model AUC is somewhat underwhelming (approx 0.75-0.79).  There
were a few issues I thought could use clarification
1. the authors discuss the incidence of MAFLD.  However, it seems from the methods that only
one ultrasound was done during a time period.  Is this an incidence study, or was this a cross
sectional study of prevalence?  It is not clear from the methods
2. the diagnosis of MAFLD required the presence of one metabolic risk factors and then the
authors found that the presence of these risk factors were associated with MAFLD.  Perhaps it
would make the most sense to focus on imaging evidence of steatosis?
3. I am still confused on the time dependent incidence.  Did the participants have more than
one ultrasound?
4.  Looking at figure 4, WC, blood glucose and HDL have a large influence on the diagnosis of
fatty liver.  This has been well described already.  The weight of these seems enough that this
is accounting for the majority of the model to discriminate fatty liver cases
Title: Establishing of a risk prediction model for metabolic dysfunction associated steatotic liver
disease: a retrospective cohort study
Version: 1 Date: 07 Oct 2024
Reviewer's report:
The study uses a cohort over a roughly four year period with a  training a a validation cohort.  The
model includes mostly variables that are used in the diagnosis of MAFLD (as the authors point
on in the paper).    The model AUC is somewhat underwhelming (approx 0.75-0.79).  There
were a few issues I thought could use clarification
1. the authors discuss the incidence of MAFLD.  However, it seems from the methods that only
one ultrasound was done during a time period.  Is this an incidence study, or was this a cross
sectional study of prevalence?  It is not clear from the methods
2. the diagnosis of MAFLD required the presence of one metabolic risk factors and then the
authors found that the presence of these risk factors were associated with MAFLD.  Perhaps it
would make the most sense to focus on imaging evidence of steatosis?
3. I am still confused on the time dependent incidence.  Did the participants have more than
one ultrasound?
4.  Looking at figure 4, WC, blood glucose and HDL have a large influence on the diagnosis of
fatty liver.  This has been well described already.  The weight of these seems enough that this
is accounting for the majority of the model to discriminate fatty liver cases
Please review this paper.
user
Title: Establishing of a risk prediction model for metabolic dysfunction associated steatotic liver
disease: a retrospective cohort study
Version: 1 Date: 07 Oct 2024
Reviewer's report:
The study uses a cohort over a roughly four year period with a  training a a validation cohort.  The
model includes mostly variables that are used in the diagnosis of MAFLD (as the authors point
on in the paper).    The model AUC is somewhat underwhelming (approx 0.75-0.79).  There
were a few issues I thought could use clarification
1. the authors discuss the incidence of MAFLD.  However, it seems from the methods that only
one ultrasound was done during a time period.  Is this an incidence study, or was this a cross
sectional study of prevalence?  It is not clear from the methods
2. the diagnosis of MAFLD required the presence of one metabolic risk factors and then the
authors found that the presence of these risk factors were associated with MAFLD.  Perhaps it
would make the most sense to focus on imaging evidence of steatosis?
3. I am still confused on the time dependent incidence.  Did the participants have more than
one ultrasound?
4.  Looking at figure 4, WC, blood glucose and HDL have a large influence on the diagnosis of
fatty liver.  This has been well described already.  The weight of these seems enough that this
is accounting for the majority of the model to discriminate fatty liver cases
assistant