Title: Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential
application dosages and strategies: a network meta-analysis
Version: 1 Date: 13 Jan 2024
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)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The current metananalysis demonstrates rifaximin's efficacy in
reducing the incidence and recurrence of HE, especially in primary prevention and for patients
with Minimal Hepatic Encephalopathy (MHE), while not significantly impacting mortality rates
and maintaining a safe profile. However, the field is already saturated with numerous meta-
analyses but lacks a corresponding depth of individual studies. This context places the study in
a domain where it struggles to offer substantial novelty or new insights into the treatment of HE.
REQUESTED REVISIONS:
the methodological concern of including a heterogeneous patient population in the primary
prophylaxis category, such as mixing patients with TIPS (some with prior HE) with those
having compensated cirrhosis, further complicates the interpretation of results and may affect
the validity of the conclusions drawn regarding primary prophylaxis.
Title: Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential
application dosages and strategies: a network meta-analysis
Version: 1 Date: 13 Jan 2024
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)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The current metananalysis demonstrates rifaximin's efficacy in
reducing the incidence and recurrence of HE, especially in primary prevention and for patients
with Minimal Hepatic Encephalopathy (MHE), while not significantly impacting mortality rates
and maintaining a safe profile. However, the field is already saturated with numerous meta-
analyses but lacks a corresponding depth of individual studies. This context places the study in
a domain where it struggles to offer substantial novelty or new insights into the treatment of HE.
REQUESTED REVISIONS:
the methodological concern of including a heterogeneous patient population in the primary
prophylaxis category, such as mixing patients with TIPS (some with prior HE) with those
having compensated cirrhosis, further complicates the interpretation of results and may affect
the validity of the conclusions drawn regarding primary prophylaxis.
Please review this paper.
user
Title: Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential
application dosages and strategies: a network meta-analysis
Version: 1 Date: 13 Jan 2024
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)?
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The current metananalysis demonstrates rifaximin's efficacy in
reducing the incidence and recurrence of HE, especially in primary prevention and for patients
with Minimal Hepatic Encephalopathy (MHE), while not significantly impacting mortality rates
and maintaining a safe profile. However, the field is already saturated with numerous meta-
analyses but lacks a corresponding depth of individual studies. This context places the study in
a domain where it struggles to offer substantial novelty or new insights into the treatment of HE.
REQUESTED REVISIONS:
the methodological concern of including a heterogeneous patient population in the primary
prophylaxis category, such as mixing patients with TIPS (some with prior HE) with those
having compensated cirrhosis, further complicates the interpretation of results and may affect
the validity of the conclusions drawn regarding primary prophylaxis.
assistant