Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 8 Date: 23 Jul 2022
Reviewer's report:
1. In table 4, the authors reported cut-offs of sTIM-3, BISAP, APACHE-II, MCTSI to predict
SAP. How did the authors acquire the cut-off values? By regression model or other methods
(e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses in the
methods.
2. On page 14, lines 8-9, in “BISAP…, while meta-analysis display it has low sensitivity for the
prediction of AP”, did the authors mean to predict the SAP rather than AP? Prediction of AP is
not needed while only patients with AP were included.
3. The sentence on page 14, lines 13-15, the sentence “However, peri-pancreatic necrosis and
pseudocysts are not generally present in the early stage of AP, which may delay the early
diagnosis of AP by the MCTSI scoring system.” What does the word,  "which', mean? Did it
mean “early stage of AP”? The sentence should be rewritten. Did the authors mean that MCTSI
mainly consists of pancreatic necrosis and pseudocysts as scoring elements, underestimating the
severity of AP in the early stage of the disease?
4. On page 15, lines 19-23, “There are also several limitations… We attempted to minimize
these limitations by using strict inclusion and exclusion criteria.” The authors need to explain
why strict inclusion and exclusion criteria can compensate for the specific limitation of sample
size. Or just reallocate the strict inclusion criteria to a new paragraph to show the “strength”
of this study.
5. On page 15, lines 21-23, “In addition, … exclude confounding factors.” This is the strength
and did not complement any of the mentioned limitations. Please consider relocating this content
to a strength paragraph (e.g., This study has strength…).
6. In the conclusion section, “…, the serum sTIM-3 was an objective, reliable, convenient, and
more sensitive parameter, which had different levels among MAP, MSAP, and SAP patients.”
This study did not confirm the utility of sTIM-3 in other hospitals and other countries, thus
limiting its validity as a “reliable” biomarker. In addition, unless the sTIM-3 could be efficiently
and economically tested within 12 hours (e.g., CRP, procalcitonin) instead of an ELISA kit, the
word “convenient” may not be literally true for sTIM-3.
The word “comparable” is more suitable because this biomarker was comparable with CRP,
procalcitonin, and BISAP scores.
Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 8 Date: 23 Jul 2022
Reviewer's report:
1. In table 4, the authors reported cut-offs of sTIM-3, BISAP, APACHE-II, MCTSI to predict
SAP. How did the authors acquire the cut-off values? By regression model or other methods
(e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses in the
methods.
2. On page 14, lines 8-9, in “BISAP…, while meta-analysis display it has low sensitivity for the
prediction of AP”, did the authors mean to predict the SAP rather than AP? Prediction of AP is
not needed while only patients with AP were included.
3. The sentence on page 14, lines 13-15, the sentence “However, peri-pancreatic necrosis and
pseudocysts are not generally present in the early stage of AP, which may delay the early
diagnosis of AP by the MCTSI scoring system.” What does the word,  "which', mean? Did it
mean “early stage of AP”? The sentence should be rewritten. Did the authors mean that MCTSI
mainly consists of pancreatic necrosis and pseudocysts as scoring elements, underestimating the
severity of AP in the early stage of the disease?
4. On page 15, lines 19-23, “There are also several limitations… We attempted to minimize
these limitations by using strict inclusion and exclusion criteria.” The authors need to explain
why strict inclusion and exclusion criteria can compensate for the specific limitation of sample
size. Or just reallocate the strict inclusion criteria to a new paragraph to show the “strength”
of this study.
5. On page 15, lines 21-23, “In addition, … exclude confounding factors.” This is the strength
and did not complement any of the mentioned limitations. Please consider relocating this content
to a strength paragraph (e.g., This study has strength…).
6. In the conclusion section, “…, the serum sTIM-3 was an objective, reliable, convenient, and
more sensitive parameter, which had different levels among MAP, MSAP, and SAP patients.”
This study did not confirm the utility of sTIM-3 in other hospitals and other countries, thus
limiting its validity as a “reliable” biomarker. In addition, unless the sTIM-3 could be efficiently
and economically tested within 12 hours (e.g., CRP, procalcitonin) instead of an ELISA kit, the
word “convenient” may not be literally true for sTIM-3.
The word “comparable” is more suitable because this biomarker was comparable with CRP,
procalcitonin, and BISAP scores.
Please review this paper.
user
Title: Serum Soluble T-Cell Immunoglobulin Mucin Domain-3 as an Early Predictive Marker
for Severity of Acute Pancreatitis This study was a retrospective analysis
Version: 8 Date: 23 Jul 2022
Reviewer's report:
1. In table 4, the authors reported cut-offs of sTIM-3, BISAP, APACHE-II, MCTSI to predict
SAP. How did the authors acquire the cut-off values? By regression model or other methods
(e.g., Younden index on ROC)? The authors need to describe it in the statistical analyses in the
methods.
2. On page 14, lines 8-9, in “BISAP…, while meta-analysis display it has low sensitivity for the
prediction of AP”, did the authors mean to predict the SAP rather than AP? Prediction of AP is
not needed while only patients with AP were included.
3. The sentence on page 14, lines 13-15, the sentence “However, peri-pancreatic necrosis and
pseudocysts are not generally present in the early stage of AP, which may delay the early
diagnosis of AP by the MCTSI scoring system.” What does the word,  "which', mean? Did it
mean “early stage of AP”? The sentence should be rewritten. Did the authors mean that MCTSI
mainly consists of pancreatic necrosis and pseudocysts as scoring elements, underestimating the
severity of AP in the early stage of the disease?
4. On page 15, lines 19-23, “There are also several limitations… We attempted to minimize
these limitations by using strict inclusion and exclusion criteria.” The authors need to explain
why strict inclusion and exclusion criteria can compensate for the specific limitation of sample
size. Or just reallocate the strict inclusion criteria to a new paragraph to show the “strength”
of this study.
5. On page 15, lines 21-23, “In addition, … exclude confounding factors.” This is the strength
and did not complement any of the mentioned limitations. Please consider relocating this content
to a strength paragraph (e.g., This study has strength…).
6. In the conclusion section, “…, the serum sTIM-3 was an objective, reliable, convenient, and
more sensitive parameter, which had different levels among MAP, MSAP, and SAP patients.”
This study did not confirm the utility of sTIM-3 in other hospitals and other countries, thus
limiting its validity as a “reliable” biomarker. In addition, unless the sTIM-3 could be efficiently
and economically tested within 12 hours (e.g., CRP, procalcitonin) instead of an ELISA kit, the
word “convenient” may not be literally true for sTIM-3.
The word “comparable” is more suitable because this biomarker was comparable with CRP,
procalcitonin, and BISAP scores.
assistant