Reviewer's report 
 Diagnostic Value of Biochemical Markers (NashTest) for the prediction of NASH in Patients with Title: 
Non-Alcoholic Fatty Liver Disease 
 1  15 September 2006 Version: Date: 
 Edison Roberto R Parise Reviewer: 
Reviewer's report: 
General 
This article from Poynard et al. is another attempt to find a non-invasive 
marker to identify patients with NASH among those with NAFLD. In their 
previous work (Ratziu et al, 2006) the Fibrotest could identify advanced 
fibrosis in NAFLD but failed in differentiate patients with bland steatosis from those with steatohepatitis. In this study, they create a new panel of biomarkers, named NashTest. This new test according to the authors “ 
combined age, gender, the 6 parameters of Fibrotest, plus weight, height, 
AST, serum glucose, triglycerides, cholesterol and ST” . Since age, gender 
, BMI, AST, serum glucose, triglycerides and cholesterol are parameters 
from ST , the reader became confused in understanding whether there is a 
repetition of such parameters or (what seems to be the case) if ST is 
considered independently as one single parameter in NashTest. The authors 
should make clearer how they combined such parameters. 
The alcohol consumption adopted in this article is higher than the accepted 
one for the NAFLD diagnosis, but the author’s arguments in the Discussion are convincing. 
There is sufficient number of patients and controls for statistical analysis 
and the data are extensively analyzed. The title and abstract are in accordance with the findings and the paper is very well written. Therefore, we think that this manuscript can be accepted with minor 
modifications 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
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Discretionary Revisions (which the author can choose to ignore) 
Reviewer's report 
 Diagnostic Value of Biochemical Markers (NashTest) for the prediction of NASH in Patients with Title: 
Non-Alcoholic Fatty Liver Disease 
 1  15 September 2006 Version: Date: 
 Edison Roberto R Parise Reviewer: 
Reviewer's report: 
General 
This article from Poynard et al. is another attempt to find a non-invasive 
marker to identify patients with NASH among those with NAFLD. In their 
previous work (Ratziu et al, 2006) the Fibrotest could identify advanced 
fibrosis in NAFLD but failed in differentiate patients with bland steatosis from those with steatohepatitis. In this study, they create a new panel of biomarkers, named NashTest. This new test according to the authors “ 
combined age, gender, the 6 parameters of Fibrotest, plus weight, height, 
AST, serum glucose, triglycerides, cholesterol and ST” . Since age, gender 
, BMI, AST, serum glucose, triglycerides and cholesterol are parameters 
from ST , the reader became confused in understanding whether there is a 
repetition of such parameters or (what seems to be the case) if ST is 
considered independently as one single parameter in NashTest. The authors 
should make clearer how they combined such parameters. 
The alcohol consumption adopted in this article is higher than the accepted 
one for the NAFLD diagnosis, but the author’s arguments in the Discussion are convincing. 
There is sufficient number of patients and controls for statistical analysis 
and the data are extensively analyzed. The title and abstract are in accordance with the findings and the paper is very well written. Therefore, we think that this manuscript can be accepted with minor 
modifications 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
Please review this paper.
user
Reviewer's report 
 Diagnostic Value of Biochemical Markers (NashTest) for the prediction of NASH in Patients with Title: 
Non-Alcoholic Fatty Liver Disease 
 1  15 September 2006 Version: Date: 
 Edison Roberto R Parise Reviewer: 
Reviewer's report: 
General 
This article from Poynard et al. is another attempt to find a non-invasive 
marker to identify patients with NASH among those with NAFLD. In their 
previous work (Ratziu et al, 2006) the Fibrotest could identify advanced 
fibrosis in NAFLD but failed in differentiate patients with bland steatosis from those with steatohepatitis. In this study, they create a new panel of biomarkers, named NashTest. This new test according to the authors “ 
combined age, gender, the 6 parameters of Fibrotest, plus weight, height, 
AST, serum glucose, triglycerides, cholesterol and ST” . Since age, gender 
, BMI, AST, serum glucose, triglycerides and cholesterol are parameters 
from ST , the reader became confused in understanding whether there is a 
repetition of such parameters or (what seems to be the case) if ST is 
considered independently as one single parameter in NashTest. The authors 
should make clearer how they combined such parameters. 
The alcohol consumption adopted in this article is higher than the accepted 
one for the NAFLD diagnosis, but the author’s arguments in the Discussion are convincing. 
There is sufficient number of patients and controls for statistical analysis 
and the data are extensively analyzed. The title and abstract are in accordance with the findings and the paper is very well written. Therefore, we think that this manuscript can be accepted with minor 
modifications 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
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