Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 2 Date: 17 Jul 2022
Reviewer's report:
The aim of this work was to assess the burden of NASH on quality of life, productivity, and use
of healthcare resources in the United States . People diagnosed with NASH were compared on
these outcomes with the general population and people with type 2 diabetes.
Overall, the work is interesting and well written, however NASH and type 2 diabetes are
intimately related diseases, and the prevalence of NASH is high in patients with T2D.
Furthermore, NASH that has not yet evolved into cirrhosis is usually an asymptomatic condition.
This likely means that a high percentage of NASH may not have been identified among diabetics,
and the negative impact on the lives of people with NASH is likely highly conditioned by
comorbidities, including diabetes. For these reasons, a realistic comparison between the burden
of diabetes and that of NASH would seem difficult and uncertain to interpret for me.
Since it is difficult to quantify the true burden specifically related to the presence of NASH, at
most the authors can derive information on the burden of diagnosing NASH, but as the authors
themselves point out, the consequences of the diagnosis of NASH can also differ depending on
where the people receive such diagnosis.
The authors, in addition to the comparison with the general population, may consider comparing
the impact of NASH with that of diseases less intimately related to this condition and which
are known to have a negative effect on quality of life and productivity (e.g., chronic obstructive
pulmonary disease, asthma, migraine, psoriasis, etc.).
Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 2 Date: 17 Jul 2022
Reviewer's report:
The aim of this work was to assess the burden of NASH on quality of life, productivity, and use
of healthcare resources in the United States . People diagnosed with NASH were compared on
these outcomes with the general population and people with type 2 diabetes.
Overall, the work is interesting and well written, however NASH and type 2 diabetes are
intimately related diseases, and the prevalence of NASH is high in patients with T2D.
Furthermore, NASH that has not yet evolved into cirrhosis is usually an asymptomatic condition.
This likely means that a high percentage of NASH may not have been identified among diabetics,
and the negative impact on the lives of people with NASH is likely highly conditioned by
comorbidities, including diabetes. For these reasons, a realistic comparison between the burden
of diabetes and that of NASH would seem difficult and uncertain to interpret for me.
Since it is difficult to quantify the true burden specifically related to the presence of NASH, at
most the authors can derive information on the burden of diagnosing NASH, but as the authors
themselves point out, the consequences of the diagnosis of NASH can also differ depending on
where the people receive such diagnosis.
The authors, in addition to the comparison with the general population, may consider comparing
the impact of NASH with that of diseases less intimately related to this condition and which
are known to have a negative effect on quality of life and productivity (e.g., chronic obstructive
pulmonary disease, asthma, migraine, psoriasis, etc.).
Please review this paper.
user
Title: The burden of nonalcoholic steatohepatitis (NASH) in the United States
Version: 2 Date: 17 Jul 2022
Reviewer's report:
The aim of this work was to assess the burden of NASH on quality of life, productivity, and use
of healthcare resources in the United States . People diagnosed with NASH were compared on
these outcomes with the general population and people with type 2 diabetes.
Overall, the work is interesting and well written, however NASH and type 2 diabetes are
intimately related diseases, and the prevalence of NASH is high in patients with T2D.
Furthermore, NASH that has not yet evolved into cirrhosis is usually an asymptomatic condition.
This likely means that a high percentage of NASH may not have been identified among diabetics,
and the negative impact on the lives of people with NASH is likely highly conditioned by
comorbidities, including diabetes. For these reasons, a realistic comparison between the burden
of diabetes and that of NASH would seem difficult and uncertain to interpret for me.
Since it is difficult to quantify the true burden specifically related to the presence of NASH, at
most the authors can derive information on the burden of diagnosing NASH, but as the authors
themselves point out, the consequences of the diagnosis of NASH can also differ depending on
where the people receive such diagnosis.
The authors, in addition to the comparison with the general population, may consider comparing
the impact of NASH with that of diseases less intimately related to this condition and which
are known to have a negative effect on quality of life and productivity (e.g., chronic obstructive
pulmonary disease, asthma, migraine, psoriasis, etc.).
assistant