Reviewer's report
Title:A comparison of four fibrosis indexes in chronic HCV: Development of new
fibrosis-cirrhosis index (FCI)
Version: 1Date:6 January 2011
Reviewer: Guillaume PENARANDA
Reviewer's report:
Ahmad et al. aimed to create a new fibrosis-cirrhosis index (FCI)which would be
accurate in predicting fibrosis stages in HCV infected patients, and also more
efficient than frequently used serum indexes.
Major Compulsory Revisions
1-This study suffers from a poor statistical power. Usually, a study that aim in
creating a predictive score should be separated in two data sets: an estimation
set, and a validation set. The estimation set is the one used to assess the score;
the validation set is the one used to validate that score. It is common to separate
the cohort in 2/3 - 1/3 (Estimation - Validation). This means that there would be
100 patients for estimating the model, and 57 to validate the model. That sounds
too small.
Although the authors seems aware about that (i.e. las sentence of discussion),
they should improve their study before publication.
2-It is not well defined why the authors used AAR, APRI, FI, and FIB-4 and no
others. What about Fibrotest, Fibrometer, Hepascore....?
3-Table 5: Using FCI score does not improve accuracy compared to Platelets
alone in predicting F0F1(AUC=0.932 and 0.935 respectively, sens 81% and 98%
respectively). For cirrhosis prediction, the increase is not as high as expected
compared with Platelets alone (AUC=0.996 and 0.990, and sens 86% and 81%
respectively). Again, using a validation set would give the real power of the FCI
score.
Minor Essential Revisions
1-Table 4: Please give the Odds Ratio [95% CI] for each variables.
Discretionary Revisions
1-authors considered a p-value of 0.005 to be significant. Why did they used a
such small cut-off ? (Usually the commonly p of 0.05 is used).
2-Authors should changed the reporting of p-values all over the manuscript and
tables; replace p=0.000 with p=0.000x or p<0.005 (or p<0.05 ??).
3-Table 2: Replace Sig with P value
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that i have no competing interests
Reviewer's report
Title:A comparison of four fibrosis indexes in chronic HCV: Development of new
fibrosis-cirrhosis index (FCI)
Version: 1Date:6 January 2011
Reviewer: Guillaume PENARANDA
Reviewer's report:
Ahmad et al. aimed to create a new fibrosis-cirrhosis index (FCI)which would be
accurate in predicting fibrosis stages in HCV infected patients, and also more
efficient than frequently used serum indexes.
Major Compulsory Revisions
1-This study suffers from a poor statistical power. Usually, a study that aim in
creating a predictive score should be separated in two data sets: an estimation
set, and a validation set. The estimation set is the one used to assess the score;
the validation set is the one used to validate that score. It is common to separate
the cohort in 2/3 - 1/3 (Estimation - Validation). This means that there would be
100 patients for estimating the model, and 57 to validate the model. That sounds
too small.
Although the authors seems aware about that (i.e. las sentence of discussion),
they should improve their study before publication.
2-It is not well defined why the authors used AAR, APRI, FI, and FIB-4 and no
others. What about Fibrotest, Fibrometer, Hepascore....?
3-Table 5: Using FCI score does not improve accuracy compared to Platelets
alone in predicting F0F1(AUC=0.932 and 0.935 respectively, sens 81% and 98%
respectively). For cirrhosis prediction, the increase is not as high as expected
compared with Platelets alone (AUC=0.996 and 0.990, and sens 86% and 81%
respectively). Again, using a validation set would give the real power of the FCI
score.
Minor Essential Revisions
1-Table 4: Please give the Odds Ratio [95% CI] for each variables.
Discretionary Revisions
1-authors considered a p-value of 0.005 to be significant. Why did they used a
such small cut-off ? (Usually the commonly p of 0.05 is used).
2-Authors should changed the reporting of p-values all over the manuscript and
tables; replace p=0.000 with p=0.000x or p<0.005 (or p<0.05 ??).
3-Table 2: Replace Sig with P value
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that i have no competing interests
Please review this paper.
user
Reviewer's report
Title:A comparison of four fibrosis indexes in chronic HCV: Development of new
fibrosis-cirrhosis index (FCI)
Version: 1Date:6 January 2011
Reviewer: Guillaume PENARANDA
Reviewer's report:
Ahmad et al. aimed to create a new fibrosis-cirrhosis index (FCI)which would be
accurate in predicting fibrosis stages in HCV infected patients, and also more
efficient than frequently used serum indexes.
Major Compulsory Revisions
1-This study suffers from a poor statistical power. Usually, a study that aim in
creating a predictive score should be separated in two data sets: an estimation
set, and a validation set. The estimation set is the one used to assess the score;
the validation set is the one used to validate that score. It is common to separate
the cohort in 2/3 - 1/3 (Estimation - Validation). This means that there would be
100 patients for estimating the model, and 57 to validate the model. That sounds
too small.
Although the authors seems aware about that (i.e. las sentence of discussion),
they should improve their study before publication.
2-It is not well defined why the authors used AAR, APRI, FI, and FIB-4 and no
others. What about Fibrotest, Fibrometer, Hepascore....?
3-Table 5: Using FCI score does not improve accuracy compared to Platelets
alone in predicting F0F1(AUC=0.932 and 0.935 respectively, sens 81% and 98%
respectively). For cirrhosis prediction, the increase is not as high as expected
compared with Platelets alone (AUC=0.996 and 0.990, and sens 86% and 81%
respectively). Again, using a validation set would give the real power of the FCI
score.
Minor Essential Revisions
1-Table 4: Please give the Odds Ratio [95% CI] for each variables.
Discretionary Revisions
1-authors considered a p-value of 0.005 to be significant. Why did they used a
such small cut-off ? (Usually the commonly p of 0.05 is used).
2-Authors should changed the reporting of p-values all over the manuscript and
tables; replace p=0.000 with p=0.000x or p<0.005 (or p<0.05 ??).
3-Table 2: Replace Sig with P value
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that i have no competing interests
assistant