Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 4 Date: 08 May 2022
Reviewer's report:
1. The authors need to mention the primary outcome and how long the outcomes are followed.
For example, the primary outcome is SAP and we followed every individual data until discharge
or up to 30 days. If the follow-up period is only 48 hours for outcomes, insufficient follow-up
time should be mentioned in the limitation.
2. On page 5, line 21, the statistical analyses: “ …the measurement data with skewed distribution
were expressed by M (Q1-Q3)”. So I guess it meant median. Please show the full term.
3. On page 6, line 4, the authors mentioned the usage of GLM with a logit link. However,
according to table 3, the authors used multivariate linear regression (not logistic regression).
In your methods, the dependent variable (response vector) is still a continuous variable (e.g.
APACHE II, sTIM-3). So it is not a logit link GLM (logistic regression) in which the dependent
variables are of the binomial distribution (e.g. 0 or 1, SAP or not). If you insisted to use the
APACHE II or the sTIM-3 as the dependent variable (the Y variable) in your regression model,
that is fine. Just need to be careful if you adjusted too many covariates in the model to end
in overfitting. In a cohort of up to 80 patients, eight covariates are the maximum number of
covariables to be appropriate. If the authors want to perform logistic regression on the outcomes
(SAP or not), please consult the statistician.
4. In Table 2, the mean and SD of the direct bilirubin were much higher than the total bilirubin.
Total bilirubin value equals direct plus indirct bilirubin. Logically, the mean + s(standard
deviation) of total bilirubin is higher than that of the direct bilirubin.
5. In the first paragraph of the discussion, “Additionally, compared with the BISAP, APACHE
II, and MCTSI score, the predictive value of sTim-3 did not weaker.” Suppose the authors
concluded that the sTim-3 was not inferior to APACHE II or MCTSI. Then, it will be perfect
for comparing the AUC of ROC between sTIM-3 and APACHE II or MCTSI in the statistical
test and show the P-value.
6. On page 13, lines 7-8, the author suggests a cut-off of APACHE II of more than 12 to
determine SAP. How did the authors acquire the cut-off value? By regression model or other
methods (e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses
in the methods.
7. In the conclusion section, “In summary, the serum sTIM-3 was an objective, quantitative, and
more sensitive parameter…”. The author should be more specific to inform readers of the kind of
outcome (e.g., SAP or mortality or local complications?) sTIM-3 outperformed other measures.
8. Please also check some spelling and grammar details in this article. For example there was
“a” significant difference; in IL-6 cytokine level“s” between SAP and MSAP patients
Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 4 Date: 08 May 2022
Reviewer's report:
1. The authors need to mention the primary outcome and how long the outcomes are followed.
For example, the primary outcome is SAP and we followed every individual data until discharge
or up to 30 days. If the follow-up period is only 48 hours for outcomes, insufficient follow-up
time should be mentioned in the limitation.
2. On page 5, line 21, the statistical analyses: “ …the measurement data with skewed distribution
were expressed by M (Q1-Q3)”. So I guess it meant median. Please show the full term.
3. On page 6, line 4, the authors mentioned the usage of GLM with a logit link. However,
according to table 3, the authors used multivariate linear regression (not logistic regression).
In your methods, the dependent variable (response vector) is still a continuous variable (e.g.
APACHE II, sTIM-3). So it is not a logit link GLM (logistic regression) in which the dependent
variables are of the binomial distribution (e.g. 0 or 1, SAP or not). If you insisted to use the
APACHE II or the sTIM-3 as the dependent variable (the Y variable) in your regression model,
that is fine. Just need to be careful if you adjusted too many covariates in the model to end
in overfitting. In a cohort of up to 80 patients, eight covariates are the maximum number of
covariables to be appropriate. If the authors want to perform logistic regression on the outcomes
(SAP or not), please consult the statistician.
4. In Table 2, the mean and SD of the direct bilirubin were much higher than the total bilirubin.
Total bilirubin value equals direct plus indirct bilirubin. Logically, the mean + s(standard
deviation) of total bilirubin is higher than that of the direct bilirubin.
5. In the first paragraph of the discussion, “Additionally, compared with the BISAP, APACHE
II, and MCTSI score, the predictive value of sTim-3 did not weaker.” Suppose the authors
concluded that the sTim-3 was not inferior to APACHE II or MCTSI. Then, it will be perfect
for comparing the AUC of ROC between sTIM-3 and APACHE II or MCTSI in the statistical
test and show the P-value.
6. On page 13, lines 7-8, the author suggests a cut-off of APACHE II of more than 12 to
determine SAP. How did the authors acquire the cut-off value? By regression model or other
methods (e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses
in the methods.
7. In the conclusion section, “In summary, the serum sTIM-3 was an objective, quantitative, and
more sensitive parameter…”. The author should be more specific to inform readers of the kind of
outcome (e.g., SAP or mortality or local complications?) sTIM-3 outperformed other measures.
8. Please also check some spelling and grammar details in this article. For example there was
“a” significant difference; in IL-6 cytokine level“s” between SAP and MSAP patients
Please review this paper.
user
Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 4 Date: 08 May 2022
Reviewer's report:
1. The authors need to mention the primary outcome and how long the outcomes are followed.
For example, the primary outcome is SAP and we followed every individual data until discharge
or up to 30 days. If the follow-up period is only 48 hours for outcomes, insufficient follow-up
time should be mentioned in the limitation.
2. On page 5, line 21, the statistical analyses: “ …the measurement data with skewed distribution
were expressed by M (Q1-Q3)”. So I guess it meant median. Please show the full term.
3. On page 6, line 4, the authors mentioned the usage of GLM with a logit link. However,
according to table 3, the authors used multivariate linear regression (not logistic regression).
In your methods, the dependent variable (response vector) is still a continuous variable (e.g.
APACHE II, sTIM-3). So it is not a logit link GLM (logistic regression) in which the dependent
variables are of the binomial distribution (e.g. 0 or 1, SAP or not). If you insisted to use the
APACHE II or the sTIM-3 as the dependent variable (the Y variable) in your regression model,
that is fine. Just need to be careful if you adjusted too many covariates in the model to end
in overfitting. In a cohort of up to 80 patients, eight covariates are the maximum number of
covariables to be appropriate. If the authors want to perform logistic regression on the outcomes
(SAP or not), please consult the statistician.
4. In Table 2, the mean and SD of the direct bilirubin were much higher than the total bilirubin.
Total bilirubin value equals direct plus indirct bilirubin. Logically, the mean + s(standard
deviation) of total bilirubin is higher than that of the direct bilirubin.
5. In the first paragraph of the discussion, “Additionally, compared with the BISAP, APACHE
II, and MCTSI score, the predictive value of sTim-3 did not weaker.” Suppose the authors
concluded that the sTim-3 was not inferior to APACHE II or MCTSI. Then, it will be perfect
for comparing the AUC of ROC between sTIM-3 and APACHE II or MCTSI in the statistical
test and show the P-value.
6. On page 13, lines 7-8, the author suggests a cut-off of APACHE II of more than 12 to
determine SAP. How did the authors acquire the cut-off value? By regression model or other
methods (e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses
in the methods.
7. In the conclusion section, “In summary, the serum sTIM-3 was an objective, quantitative, and
more sensitive parameter…”. The author should be more specific to inform readers of the kind of
outcome (e.g., SAP or mortality or local complications?) sTIM-3 outperformed other measures.
8. Please also check some spelling and grammar details in this article. For example there was
“a” significant difference; in IL-6 cytokine level“s” between SAP and MSAP patients
assistant