Reviewer ’s report  
 
Title: VALIDATION OF A NEW PROGNOSTIC MODEL TO PREDICT SHORT AND  
MEDIUM -TERM SURVIVAL IN PATIENTS WITH LIVER CIRRHOSIS  
 
Version: 1 Date: 12 Oct 2019  
 
Reviewer's report:  
 
Overall this paper is interesting, and deserves the publication in this journal. I have reviewed the 
paper based on my personal experiences. Some comments are listed.  
 
The authors are exploring a new method  for evaluating prognosis of liver cirrhosis. So previous 
and recent prognostic models should be fully reviewed and compared. Frist, MELD and Child -
Pugh scores are the most commmonly used models for prognostic evaluation of liver cirrhosis. 
Indeed, the two  scores have their own advantages in different settings of prognostic evaluation of 
liver cirhosis. Please see and discuss the recent systematic review paper (PMID: 26937922). 
Second, a new model, CAGIB, seems to have a better predictive ability than MELD and MELD -
Na in cirrhosis with gastrointestinal bleeding. It has lots of components for predicting the 
outcomes. Please compare your model with CAGIB (PMID: 31512140). Please compare with 
CAGIB score.  
 
An important issue is how to deal with the death unrela ted to liver diseases. When you did the 
ROC analyses, did the authors put these patients who died of non -liver events into the surviors or 
exclude them? From my point of view, the deaths unrelated to liver cannot be considered as 
survivors.  
 
Do not cite an y references in the Results sections. Any introduction regarding how to deal with 
your data should be put int the Methods.  
 
Please give us some information regarding cost of LiMAx® test.  
 
Language and format should be refined.  
 
Are the methods appropriate and well described?  
If not, please specify what is requi red in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
 
 
 
Are 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of co mpeting interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you ho ld 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 y es to any, please give details below.  
 
I declare that I have no competing interests  
 
 
 
 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including 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 Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded 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: VALIDATION OF A NEW PROGNOSTIC MODEL TO PREDICT SHORT AND  
MEDIUM -TERM SURVIVAL IN PATIENTS WITH LIVER CIRRHOSIS  
 
Version: 1 Date: 12 Oct 2019  
 
Reviewer's report:  
 
Overall this paper is interesting, and deserves the publication in this journal. I have reviewed the 
paper based on my personal experiences. Some comments are listed.  
 
The authors are exploring a new method  for evaluating prognosis of liver cirrhosis. So previous 
and recent prognostic models should be fully reviewed and compared. Frist, MELD and Child -
Pugh scores are the most commmonly used models for prognostic evaluation of liver cirrhosis. 
Indeed, the two  scores have their own advantages in different settings of prognostic evaluation of 
liver cirhosis. Please see and discuss the recent systematic review paper (PMID: 26937922). 
Second, a new model, CAGIB, seems to have a better predictive ability than MELD and MELD -
Na in cirrhosis with gastrointestinal bleeding. It has lots of components for predicting the 
outcomes. Please compare your model with CAGIB (PMID: 31512140). Please compare with 
CAGIB score.  
 
An important issue is how to deal with the death unrela ted to liver diseases. When you did the 
ROC analyses, did the authors put these patients who died of non -liver events into the surviors or 
exclude them? From my point of view, the deaths unrelated to liver cannot be considered as 
survivors.  
 
Do not cite an y references in the Results sections. Any introduction regarding how to deal with 
your data should be put int the Methods.  
 
Please give us some information regarding cost of LiMAx® test.  
 
Language and format should be refined.  
 
Are the methods appropriate and well described?  
If not, please specify what is requi red in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
 
 
 
Are 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of co mpeting interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you ho ld 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 y es to any, please give details below.  
 
I declare that I have no competing interests  
 
 
 
 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including 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 Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded 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: VALIDATION OF A NEW PROGNOSTIC MODEL TO PREDICT SHORT AND  
MEDIUM -TERM SURVIVAL IN PATIENTS WITH LIVER CIRRHOSIS  
 
Version: 1 Date: 12 Oct 2019  
 
Reviewer's report:  
 
Overall this paper is interesting, and deserves the publication in this journal. I have reviewed the 
paper based on my personal experiences. Some comments are listed.  
 
The authors are exploring a new method  for evaluating prognosis of liver cirrhosis. So previous 
and recent prognostic models should be fully reviewed and compared. Frist, MELD and Child -
Pugh scores are the most commmonly used models for prognostic evaluation of liver cirrhosis. 
Indeed, the two  scores have their own advantages in different settings of prognostic evaluation of 
liver cirhosis. Please see and discuss the recent systematic review paper (PMID: 26937922). 
Second, a new model, CAGIB, seems to have a better predictive ability than MELD and MELD -
Na in cirrhosis with gastrointestinal bleeding. It has lots of components for predicting the 
outcomes. Please compare your model with CAGIB (PMID: 31512140). Please compare with 
CAGIB score.  
 
An important issue is how to deal with the death unrela ted to liver diseases. When you did the 
ROC analyses, did the authors put these patients who died of non -liver events into the surviors or 
exclude them? From my point of view, the deaths unrelated to liver cannot be considered as 
survivors.  
 
Do not cite an y references in the Results sections. Any introduction regarding how to deal with 
your data should be put int the Methods.  
 
Please give us some information regarding cost of LiMAx® test.  
 
Language and format should be refined.  
 
Are the methods appropriate and well described?  
If not, please specify what is requi red in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
 
 
 
Are 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of co mpeting interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you ho ld 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 y es to any, please give details below.  
 
I declare that I have no competing interests  
 
 
 
 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including 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 Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant