Reviewer’ s report
Title: A novel predictive model based on inflammatory markers to assess the prognosis of patients
with HBV-related acute-on-chronic liver failure:a retrospective cohort study
Version: 2Date: 24 Feb 2020
Reviewer: Huadong Yan
Reviewer's report:
1) Patients and methods
a. Study cohort: APASL criteria was used to define ACLF patients in the derivation cohort andvalidation cohort(TBIL≥85μ mol/L and INR≥1.5 and complicated with ascites and/or hepatic
encephalopathy within 4 weeks).In such a cohort, with 70% patients having cirrhosis, but grade 2to 3 ascites were only 52 (12.4%),then bacterical infection were very high (307,72.92%).Of coursethe ascites were severely underestimated due to retrospective assessment. I think you only needput baseline bacterical infection in table1.b. Statistical analysis: As a paper to develop and validation a model,you need to compare thepresent model with classic model, P value should be present.C index or AUROC should bepresent.In this paper, do you evaluate CLIF SOFA score carefully especially in validation cohort?If it is difficult for you to do it ,you can not put it in the paper,because inaccurate assessment willreduce article quality.KM curve was not necessary.You can draw KM curve according to cutoffvalue of RDW and NLR to intuitively reflect their value.2) Results and discussiona. In table1,you can add one column for total patient in training cohort.Only baseline bacterialinfection should be added in table1.
b. NLR was so low in the validation cohort(1.92 V 4.84), can you show the comparing of RDW
,NLR and other biomark using scatter dot plot.c. Z value and P value should be added to the table3.In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-ACLF patients.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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 furtherassessment 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 publishedDeclaration 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 thismanuscript, 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.
I declare that I have no competing interestsI 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 reportincluding 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 CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich 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: A novel predictive model based on inflammatory markers to assess the prognosis of patients
with HBV-related acute-on-chronic liver failure:a retrospective cohort study
Version: 2Date: 24 Feb 2020
Reviewer: Huadong Yan
Reviewer's report:
1) Patients and methods
a. Study cohort: APASL criteria was used to define ACLF patients in the derivation cohort andvalidation cohort(TBIL≥85μ mol/L and INR≥1.5 and complicated with ascites and/or hepatic
encephalopathy within 4 weeks).In such a cohort, with 70% patients having cirrhosis, but grade 2to 3 ascites were only 52 (12.4%),then bacterical infection were very high (307,72.92%).Of coursethe ascites were severely underestimated due to retrospective assessment. I think you only needput baseline bacterical infection in table1.b. Statistical analysis: As a paper to develop and validation a model,you need to compare thepresent model with classic model, P value should be present.C index or AUROC should bepresent.In this paper, do you evaluate CLIF SOFA score carefully especially in validation cohort?If it is difficult for you to do it ,you can not put it in the paper,because inaccurate assessment willreduce article quality.KM curve was not necessary.You can draw KM curve according to cutoffvalue of RDW and NLR to intuitively reflect their value.2) Results and discussiona. In table1,you can add one column for total patient in training cohort.Only baseline bacterialinfection should be added in table1.
b. NLR was so low in the validation cohort(1.92 V 4.84), can you show the comparing of RDW
,NLR and other biomark using scatter dot plot.c. Z value and P value should be added to the table3.In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-ACLF patients.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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 furtherassessment 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 publishedDeclaration 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 thismanuscript, 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.
I declare that I have no competing interestsI 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 reportincluding 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 CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich 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: A novel predictive model based on inflammatory markers to assess the prognosis of patients
with HBV-related acute-on-chronic liver failure:a retrospective cohort study
Version: 2Date: 24 Feb 2020
Reviewer: Huadong Yan
Reviewer's report:
1) Patients and methods
a. Study cohort: APASL criteria was used to define ACLF patients in the derivation cohort andvalidation cohort(TBIL≥85μ mol/L and INR≥1.5 and complicated with ascites and/or hepatic
encephalopathy within 4 weeks).In such a cohort, with 70% patients having cirrhosis, but grade 2to 3 ascites were only 52 (12.4%),then bacterical infection were very high (307,72.92%).Of coursethe ascites were severely underestimated due to retrospective assessment. I think you only needput baseline bacterical infection in table1.b. Statistical analysis: As a paper to develop and validation a model,you need to compare thepresent model with classic model, P value should be present.C index or AUROC should bepresent.In this paper, do you evaluate CLIF SOFA score carefully especially in validation cohort?If it is difficult for you to do it ,you can not put it in the paper,because inaccurate assessment willreduce article quality.KM curve was not necessary.You can draw KM curve according to cutoffvalue of RDW and NLR to intuitively reflect their value.2) Results and discussiona. In table1,you can add one column for total patient in training cohort.Only baseline bacterialinfection should be added in table1.
b. NLR was so low in the validation cohort(1.92 V 4.84), can you show the comparing of RDW
,NLR and other biomark using scatter dot plot.c. Z value and P value should be added to the table3.In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-ACLF patients.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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 furtherassessment 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 publishedDeclaration 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 thismanuscript, 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.
I declare that I have no competing interestsI 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 reportincluding 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 CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich 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