Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 1 Date: 07 Jan 2025
Reviewer:  Amira A A Othman
Reviewer's report:
The authors' efforts to improve the manuscript and address the reviewers' comments are
praiseworthy. In general, their answers are adequate, and the work has been strengthened by
the changes. Nonetheless, there are a few places where the manuscript's quality may be further
improved with further explanation or polish. The study would be even stronger if it addressed
the proportional risks assumption, elaborated on the DAGs, and clarified the topic.
1. To guarantee the validity of longitudinal analysis, test and report the proportional hazards
assumption for Cox regression models.
2. Give further information about Directed Acyclic Graphs (DAGs), such as the methods used
to find confounders and the rationale behind the inclusion of covariates.
3. Explain how missing data was handled; indicate whether imputation techniques or thorough
case analysis were applied and provide justification for the strategy.
4. Describe preprocessing in more detail, including how datasets were normalized and how
alcohol intake was measured.
5. Include Hosmer-Lemeshow test results (e.g., p-values) in the main text or supplementary
material to demonstrate model calibration.
6. Provide specific clinical recommendations tailored to different patient subgroups (e.g., by sex
or disease severity).
7. Propose detailed future research questions, such as investigating molecular mechanisms of
MetALD or developing risk prediction models.
8. Avoid repetition in responses to reviewers’ comments by cross-referencing earlier responses
where applicable.
9. Summarize key supplementary findings in the main text to improve accessibility for readers.
10. Consolidate epidemiological data into one section to avoid redundancy and improve flow.
11. Simplify the discussion to prevent duplication, particularly in the parts on future research
and clinical implications.
12. To improve the discussion of MetALD's causes and clinical relevance, incorporate more
recent research.
Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 1 Date: 07 Jan 2025
Reviewer:  Amira A A Othman
Reviewer's report:
The authors' efforts to improve the manuscript and address the reviewers' comments are
praiseworthy. In general, their answers are adequate, and the work has been strengthened by
the changes. Nonetheless, there are a few places where the manuscript's quality may be further
improved with further explanation or polish. The study would be even stronger if it addressed
the proportional risks assumption, elaborated on the DAGs, and clarified the topic.
1. To guarantee the validity of longitudinal analysis, test and report the proportional hazards
assumption for Cox regression models.
2. Give further information about Directed Acyclic Graphs (DAGs), such as the methods used
to find confounders and the rationale behind the inclusion of covariates.
3. Explain how missing data was handled; indicate whether imputation techniques or thorough
case analysis were applied and provide justification for the strategy.
4. Describe preprocessing in more detail, including how datasets were normalized and how
alcohol intake was measured.
5. Include Hosmer-Lemeshow test results (e.g., p-values) in the main text or supplementary
material to demonstrate model calibration.
6. Provide specific clinical recommendations tailored to different patient subgroups (e.g., by sex
or disease severity).
7. Propose detailed future research questions, such as investigating molecular mechanisms of
MetALD or developing risk prediction models.
8. Avoid repetition in responses to reviewers’ comments by cross-referencing earlier responses
where applicable.
9. Summarize key supplementary findings in the main text to improve accessibility for readers.
10. Consolidate epidemiological data into one section to avoid redundancy and improve flow.
11. Simplify the discussion to prevent duplication, particularly in the parts on future research
and clinical implications.
12. To improve the discussion of MetALD's causes and clinical relevance, incorporate more
recent research.
Please review this paper.
user
Title: Metabolic Outcomes in Non-Alcoholic and Alcoholic Steatotic Liver Disease among
Korean and American Adults
Version: 1 Date: 07 Jan 2025
Reviewer:  Amira A A Othman
Reviewer's report:
The authors' efforts to improve the manuscript and address the reviewers' comments are
praiseworthy. In general, their answers are adequate, and the work has been strengthened by
the changes. Nonetheless, there are a few places where the manuscript's quality may be further
improved with further explanation or polish. The study would be even stronger if it addressed
the proportional risks assumption, elaborated on the DAGs, and clarified the topic.
1. To guarantee the validity of longitudinal analysis, test and report the proportional hazards
assumption for Cox regression models.
2. Give further information about Directed Acyclic Graphs (DAGs), such as the methods used
to find confounders and the rationale behind the inclusion of covariates.
3. Explain how missing data was handled; indicate whether imputation techniques or thorough
case analysis were applied and provide justification for the strategy.
4. Describe preprocessing in more detail, including how datasets were normalized and how
alcohol intake was measured.
5. Include Hosmer-Lemeshow test results (e.g., p-values) in the main text or supplementary
material to demonstrate model calibration.
6. Provide specific clinical recommendations tailored to different patient subgroups (e.g., by sex
or disease severity).
7. Propose detailed future research questions, such as investigating molecular mechanisms of
MetALD or developing risk prediction models.
8. Avoid repetition in responses to reviewers’ comments by cross-referencing earlier responses
where applicable.
9. Summarize key supplementary findings in the main text to improve accessibility for readers.
10. Consolidate epidemiological data into one section to avoid redundancy and improve flow.
11. Simplify the discussion to prevent duplication, particularly in the parts on future research
and clinical implications.
12. To improve the discussion of MetALD's causes and clinical relevance, incorporate more
recent research.
assistant