Title: Macrophage migration inhibitory factor is an early marker of severe acute pancreatitis
based on the revised Atlanta classification
Version: 2 Date: 14 Nov 2020
Reviewer's report:
The authors investigated the diagnostic yield of serum MIF in predicting occurrence of SAP.
The paper is overall well written, and this biomarker has poorly been investigated before, so the
manuscript has some potential interest.
I have some major concerns regarding the study design:
1. There is no need of healthy controls in this study and they should not be included in all the
analyses. Potentially, the authors may leave the data on controls at the beginning, just to show
that MIF is not elevated in healthy controls, but these subjects should not be included in all the
following calculations.
2. Please check statistics. For continious variables is distribution normal or skewed? were
appropriate tests chosen accordingly? Are your  reporting mean (SD) or median (IQR)? this is
unclear to me.
3. As for the regression analysis, the authors state that "increased MIF" has an OR of....
What do the authors mean by "increased"? is it above normal values?
They should perform a ROC analysis to find the best cut-off of MIF and then use it in the logistic
regression analsysis.
4. The BISAP and APACHE score may well be colinear variables as they investigate similar
factors. Please check for the logistic regression analysis.
5. For all tables and figures make clear which data are presented (mean, SD, median, range...).
6. Report data on correlation between timepoint (aparently it is "whitin 48 hours") blood
sampling and MIF levels. This may well skrew-up the results.
7. The quote of "HTG-AP" is far too high compared to what is normally expected, please explain.
Also, try a separate analysis without these patients.
Title: Macrophage migration inhibitory factor is an early marker of severe acute pancreatitis
based on the revised Atlanta classification
Version: 2 Date: 14 Nov 2020
Reviewer's report:
The authors investigated the diagnostic yield of serum MIF in predicting occurrence of SAP.
The paper is overall well written, and this biomarker has poorly been investigated before, so the
manuscript has some potential interest.
I have some major concerns regarding the study design:
1. There is no need of healthy controls in this study and they should not be included in all the
analyses. Potentially, the authors may leave the data on controls at the beginning, just to show
that MIF is not elevated in healthy controls, but these subjects should not be included in all the
following calculations.
2. Please check statistics. For continious variables is distribution normal or skewed? were
appropriate tests chosen accordingly? Are your  reporting mean (SD) or median (IQR)? this is
unclear to me.
3. As for the regression analysis, the authors state that "increased MIF" has an OR of....
What do the authors mean by "increased"? is it above normal values?
They should perform a ROC analysis to find the best cut-off of MIF and then use it in the logistic
regression analsysis.
4. The BISAP and APACHE score may well be colinear variables as they investigate similar
factors. Please check for the logistic regression analysis.
5. For all tables and figures make clear which data are presented (mean, SD, median, range...).
6. Report data on correlation between timepoint (aparently it is "whitin 48 hours") blood
sampling and MIF levels. This may well skrew-up the results.
7. The quote of "HTG-AP" is far too high compared to what is normally expected, please explain.
Also, try a separate analysis without these patients.
Please review this paper.
user
Title: Macrophage migration inhibitory factor is an early marker of severe acute pancreatitis
based on the revised Atlanta classification
Version: 2 Date: 14 Nov 2020
Reviewer's report:
The authors investigated the diagnostic yield of serum MIF in predicting occurrence of SAP.
The paper is overall well written, and this biomarker has poorly been investigated before, so the
manuscript has some potential interest.
I have some major concerns regarding the study design:
1. There is no need of healthy controls in this study and they should not be included in all the
analyses. Potentially, the authors may leave the data on controls at the beginning, just to show
that MIF is not elevated in healthy controls, but these subjects should not be included in all the
following calculations.
2. Please check statistics. For continious variables is distribution normal or skewed? were
appropriate tests chosen accordingly? Are your  reporting mean (SD) or median (IQR)? this is
unclear to me.
3. As for the regression analysis, the authors state that "increased MIF" has an OR of....
What do the authors mean by "increased"? is it above normal values?
They should perform a ROC analysis to find the best cut-off of MIF and then use it in the logistic
regression analsysis.
4. The BISAP and APACHE score may well be colinear variables as they investigate similar
factors. Please check for the logistic regression analysis.
5. For all tables and figures make clear which data are presented (mean, SD, median, range...).
6. Report data on correlation between timepoint (aparently it is "whitin 48 hours") blood
sampling and MIF levels. This may well skrew-up the results.
7. The quote of "HTG-AP" is far too high compared to what is normally expected, please explain.
Also, try a separate analysis without these patients.
assistant