Reviewer ’s report  
 
Title: Cost-comparison an alysis of FIB -4, ELF and fibroscan  in community pathways for Non - 
Alcoholic Fatty Liver Disease  
 
Version: 0 Date: 19 Feb 2019  
 
Reviewer: Reviewer  2 
 
Reviewer's report:  
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the curre nt approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
Statistics - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasona ble and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Yes - current version is techni cally sound  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The authors have undertaken a comprehensive analysis of the cost 
differences of using non -invasive liver fibrosis tests in primary care.  
 
The study is well designed and rigorously conducted. I have no major issues with the study.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
I'm not sure of the appropriateness of using a 0% discount rate. I would suggest a rate similar to 
that suggested by NICE is more appropriate.  
 
The authors have made several assumptions in their model, often informed by opinion only. I 
would expect to see a more comprehensive sensitivity analysis performed. Specifically, the 
authors should consider a probabilistic sensitivity analysis so all varia bles can be varied 
simultaneously.  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
Reviewer ’s report  
 
Title: Cost-comparison an alysis of FIB -4, ELF and fibroscan  in community pathways for Non - 
Alcoholic Fatty Liver Disease  
 
Version: 0 Date: 19 Feb 2019  
 
Reviewer: Reviewer  2 
 
Reviewer's report:  
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the curre nt approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
Statistics - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasona ble and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Yes - current version is techni cally sound  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The authors have undertaken a comprehensive analysis of the cost 
differences of using non -invasive liver fibrosis tests in primary care.  
 
The study is well designed and rigorously conducted. I have no major issues with the study.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
I'm not sure of the appropriateness of using a 0% discount rate. I would suggest a rate similar to 
that suggested by NICE is more appropriate.  
 
The authors have made several assumptions in their model, often informed by opinion only. I 
would expect to see a more comprehensive sensitivity analysis performed. Specifically, the 
authors should consider a probabilistic sensitivity analysis so all varia bles can be varied 
simultaneously.  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
Please review this paper.
user
Reviewer ’s report  
 
Title: Cost-comparison an alysis of FIB -4, ELF and fibroscan  in community pathways for Non - 
Alcoholic Fatty Liver Disease  
 
Version: 0 Date: 19 Feb 2019  
 
Reviewer: Reviewer  2 
 
Reviewer's report:  
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the curre nt approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
Statistics - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasona ble and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Yes - current version is techni cally sound  
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: The authors have undertaken a comprehensive analysis of the cost 
differences of using non -invasive liver fibrosis tests in primary care.  
 
The study is well designed and rigorously conducted. I have no major issues with the study.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
I'm not sure of the appropriateness of using a 0% discount rate. I would suggest a rate similar to 
that suggested by NICE is more appropriate.  
 
The authors have made several assumptions in their model, often informed by opinion only. I 
would expect to see a more comprehensive sensitivity analysis performed. Specifically, the 
authors should consider a probabilistic sensitivity analysis so all varia bles can be varied 
simultaneously.  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
assistant