Title: Comparative diagnostic efficacy of two-dimensional shear wave and transient
elastography in predicting the risk of esophagogastric varices and histological staging in patients
with primary biliary cholangitis
Version: 0 Date: 12 Aug 2024
Reviewer:  Giuseppe Losurdo
Reviewer's report:
In the present prospective study on patients with primary biliary cholangitis (PBC), Meng et
al found that TE and SWE had similar diagnostic accuracy regarding liver fibrosis staging, but
SWE showed a slightly better accuracy for predicting varices. Main comments:
1) Page 2 last two lines, I assume that a value is missing (only 95% CI was reported).
2) By looking at fig 1, I assume that this is a 2D-SWE and not a point SWE. Please be more
precise in Methods section.
3) The main problem is that histological diagnosis was based on Ludwig system, which is
specific for PBC, but it does not focus on entity of fibrosis. Indeed, TE and SWE were validated
according to Metavir.
4) Page 7: details of patients enrolment according to exclusion criteria should be reported in a
figure/flow diagram.
5) A correlation analysis between TE and SWE should be added.
6) In Methods, please report the used thresholds for F in TE ans SWE.
7) Some authors found a non optimal correlation between TE and SWE in PBC (see Losurdo G
et al, Diagnostics 2024), a result in disagreement with this study. Please comment on.
Title: Comparative diagnostic efficacy of two-dimensional shear wave and transient
elastography in predicting the risk of esophagogastric varices and histological staging in patients
with primary biliary cholangitis
Version: 0 Date: 12 Aug 2024
Reviewer:  Giuseppe Losurdo
Reviewer's report:
In the present prospective study on patients with primary biliary cholangitis (PBC), Meng et
al found that TE and SWE had similar diagnostic accuracy regarding liver fibrosis staging, but
SWE showed a slightly better accuracy for predicting varices. Main comments:
1) Page 2 last two lines, I assume that a value is missing (only 95% CI was reported).
2) By looking at fig 1, I assume that this is a 2D-SWE and not a point SWE. Please be more
precise in Methods section.
3) The main problem is that histological diagnosis was based on Ludwig system, which is
specific for PBC, but it does not focus on entity of fibrosis. Indeed, TE and SWE were validated
according to Metavir.
4) Page 7: details of patients enrolment according to exclusion criteria should be reported in a
figure/flow diagram.
5) A correlation analysis between TE and SWE should be added.
6) In Methods, please report the used thresholds for F in TE ans SWE.
7) Some authors found a non optimal correlation between TE and SWE in PBC (see Losurdo G
et al, Diagnostics 2024), a result in disagreement with this study. Please comment on.
Please review this paper.
user
Title: Comparative diagnostic efficacy of two-dimensional shear wave and transient
elastography in predicting the risk of esophagogastric varices and histological staging in patients
with primary biliary cholangitis
Version: 0 Date: 12 Aug 2024
Reviewer:  Giuseppe Losurdo
Reviewer's report:
In the present prospective study on patients with primary biliary cholangitis (PBC), Meng et
al found that TE and SWE had similar diagnostic accuracy regarding liver fibrosis staging, but
SWE showed a slightly better accuracy for predicting varices. Main comments:
1) Page 2 last two lines, I assume that a value is missing (only 95% CI was reported).
2) By looking at fig 1, I assume that this is a 2D-SWE and not a point SWE. Please be more
precise in Methods section.
3) The main problem is that histological diagnosis was based on Ludwig system, which is
specific for PBC, but it does not focus on entity of fibrosis. Indeed, TE and SWE were validated
according to Metavir.
4) Page 7: details of patients enrolment according to exclusion criteria should be reported in a
figure/flow diagram.
5) A correlation analysis between TE and SWE should be added.
6) In Methods, please report the used thresholds for F in TE ans SWE.
7) Some authors found a non optimal correlation between TE and SWE in PBC (see Losurdo G
et al, Diagnostics 2024), a result in disagreement with this study. Please comment on.
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