Reviewer’s report
Title: Clinical implications with tolvaptan on monitored bioimpedance-defined fluid status in patients
with cirrhotic ascites: an observational study
Version: 1 Date: 08 Nov 2019
Reviewer: Cyriac Abby Philips
Reviewer's report:
Thank you for the opportunity to review the revised manuscript
The authors have painstakingly revised and tried to bring in decorum into the revised version.
The following may be addressed:
The use of the term hepatic edema may be reconsidered. Did the authors mean ascites? If so, cirrhotic
ascites could be a better term.
In Figure 3, the p value should be <0.001
The lack of a control group is still a major issue with this study. A historical control group matched to
liver disease severity and on diuretics without add on tolvaptan could still be considered. We do not
require  the  whole  of  BIA based  assessment  to  be  present,  but  only  outcomes,  such  as  weight
differences, survival and other liver and renal related events which could be easily retrieved from
patient and electronic files. This would be an important addition to the authors conclusions on their
work.
Other than these issues, the authors have revised the manuscript with attentiveness and also provided
reasonable limitations that need to be addressed in future trials on the same issue.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
None
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: Clinical implications with tolvaptan on monitored bioimpedance-defined fluid status in patients
with cirrhotic ascites: an observational study
Version: 1 Date: 08 Nov 2019
Reviewer: Cyriac Abby Philips
Reviewer's report:
Thank you for the opportunity to review the revised manuscript
The authors have painstakingly revised and tried to bring in decorum into the revised version.
The following may be addressed:
The use of the term hepatic edema may be reconsidered. Did the authors mean ascites? If so, cirrhotic
ascites could be a better term.
In Figure 3, the p value should be <0.001
The lack of a control group is still a major issue with this study. A historical control group matched to
liver disease severity and on diuretics without add on tolvaptan could still be considered. We do not
require  the  whole  of  BIA based  assessment  to  be  present,  but  only  outcomes,  such  as  weight
differences, survival and other liver and renal related events which could be easily retrieved from
patient and electronic files. This would be an important addition to the authors conclusions on their
work.
Other than these issues, the authors have revised the manuscript with attentiveness and also provided
reasonable limitations that need to be addressed in future trials on the same issue.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
None
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: Clinical implications with tolvaptan on monitored bioimpedance-defined fluid status in patients
with cirrhotic ascites: an observational study
Version: 1 Date: 08 Nov 2019
Reviewer: Cyriac Abby Philips
Reviewer's report:
Thank you for the opportunity to review the revised manuscript
The authors have painstakingly revised and tried to bring in decorum into the revised version.
The following may be addressed:
The use of the term hepatic edema may be reconsidered. Did the authors mean ascites? If so, cirrhotic
ascites could be a better term.
In Figure 3, the p value should be <0.001
The lack of a control group is still a major issue with this study. A historical control group matched to
liver disease severity and on diuretics without add on tolvaptan could still be considered. We do not
require  the  whole  of  BIA based  assessment  to  be  present,  but  only  outcomes,  such  as  weight
differences, survival and other liver and renal related events which could be easily retrieved from
patient and electronic files. This would be an important addition to the authors conclusions on their
work.
Other than these issues, the authors have revised the manuscript with attentiveness and also provided
reasonable limitations that need to be addressed in future trials on the same issue.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
None
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
assistant