Title: Title: Prospective randomized, placebo-controlled study: Role of branched-chain amino
acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit
Version: 6 Date: 28 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient 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 - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
No - manuscript has some fundamental flaw(s)
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have addressed two of the three main concerns raised
in the previous review of the manuscript. However, there are still doubts regarding one of the
main results, which is the reduction in transaminase and bilirubin levels.
REQUESTED REVISIONS:
Given the relevant difference in baseline values (albeit non-significant), the authors cannot
analyze the raw values without any adjustment. Instead, they could analyze the percentage of
reduction or a proportion. Indeed, AST transaminase values were reduced by 60% in the placebo
group and only 70% in the treatment group. Thus, although the impact on this biomarker may be
real, the authors must present the results in a way that addresses the prior baseline differences,
even if the result is non-significant. Additionally, the difference in PT at day 7 is very small
(12.5 (11–23.5) vs. 12.9 (11–27.9)) to justify a statistically significant difference.
Title: Title: Prospective randomized, placebo-controlled study: Role of branched-chain amino
acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit
Version: 6 Date: 28 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient 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 - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
No - manuscript has some fundamental flaw(s)
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have addressed two of the three main concerns raised
in the previous review of the manuscript. However, there are still doubts regarding one of the
main results, which is the reduction in transaminase and bilirubin levels.
REQUESTED REVISIONS:
Given the relevant difference in baseline values (albeit non-significant), the authors cannot
analyze the raw values without any adjustment. Instead, they could analyze the percentage of
reduction or a proportion. Indeed, AST transaminase values were reduced by 60% in the placebo
group and only 70% in the treatment group. Thus, although the impact on this biomarker may be
real, the authors must present the results in a way that addresses the prior baseline differences,
even if the result is non-significant. Additionally, the difference in PT at day 7 is very small
(12.5 (11–23.5) vs. 12.9 (11–27.9)) to justify a statistically significant difference.
Please review this paper.
user
Title: Title: Prospective randomized, placebo-controlled study: Role of branched-chain amino
acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit
Version: 6 Date: 28 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient 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 - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
No - manuscript has some fundamental flaw(s)
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have addressed two of the three main concerns raised
in the previous review of the manuscript. However, there are still doubts regarding one of the
main results, which is the reduction in transaminase and bilirubin levels.
REQUESTED REVISIONS:
Given the relevant difference in baseline values (albeit non-significant), the authors cannot
analyze the raw values without any adjustment. Instead, they could analyze the percentage of
reduction or a proportion. Indeed, AST transaminase values were reduced by 60% in the placebo
group and only 70% in the treatment group. Thus, although the impact on this biomarker may be
real, the authors must present the results in a way that addresses the prior baseline differences,
even if the result is non-significant. Additionally, the difference in PT at day 7 is very small
(12.5 (11–23.5) vs. 12.9 (11–27.9)) to justify a statistically significant difference.
assistant