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: 1Date: 28 Oct 2019
Reviewer: Huadong Yan
Reviewer's report:
Li qiang and colleagues have written a paper finding that A model named RNTIC based on
inflammatory markers to assess the prognosis of patients with HBV-related acute-on chronic liverfailure in a retrospective cohort of 577 patients. However, there are many important details notincluded in this paper that need clarification.1) Patients and methodsa. Study cohort: The study retrospectively enrolled consecutive patients diagnosed with HBV-ACLF in the Affiliated Hospital of Southwest Medical University as a derivation cohort and theFirst People's Hospital of Neijiang and Second People's Hospital of Yibin as a validation cohort.APASL criteria was used to define ACLF patients.You only enrolled HBV ACLF patients fromChinese hospitals.So you should tell how many patients were diagnosed with Chinese criteria?b.Inclusion/exclusion: you lack a consort diagram.you excluded Patients with cardiac diseases,endocrinological disorders, hematological disease and other types of cancer were excluded. Co-infection with human immunodeficiency virus, hepatitis A, C, D, and E viruses or other hepatitisviruses, autoimmune diseases, alcoholic liver disease, drug-induced liver injury,coexistenthepatocellular carcinoma, and any other serious medical illness or patients who had received anyimmunotherapy, liver transplantation or artificial liver support were also excluded. How about the
numbers? How many patients with previous decompensation of cirrhosis were included in the
study? All patients with HCC were excluded in the study? All patients with artificial liver supportwere excluded in the study?We need information on if pts were lost to follow up. If so how many.What information was collected?c. management for patients :How about the management for patients during hospital? Anydifference between the derivation cohort and the validation cohort?d. Statistical analysis:We see you list many statistic methods like the Kaplan-Meier method andROC not seen in the paper.2) Results and discussiona. In table1 and table4,bacterial infection should be added as an important complication for ACLFpatients.CTP score and CLIF-SOFA score were now also important model for ACLF patients. Nodata of admission bacterial infection in this cohort was given. More details of infection atadmission and during hospital stay (if possible)including sites of infection, species of bacterialculture positive should be given.b. I can not see the figure1 and figure2.c. NLR was so low in the validation cohort(1.92 V 4.84),why?d. In table 3 validation cohort data also should be added.e. CTP score and CLIF-SOFA score and MELD-na score should also be compared to the new
RNTIC score.
In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-
ACLF patients.But many important details not included in this paper that need clarification.
Are the methods appropriate and well described?
If not, please specify what is required 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.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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.
no
I 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 commentsto 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: 1Date: 28 Oct 2019
Reviewer: Huadong Yan
Reviewer's report:
Li qiang and colleagues have written a paper finding that A model named RNTIC based on
inflammatory markers to assess the prognosis of patients with HBV-related acute-on chronic liverfailure in a retrospective cohort of 577 patients. However, there are many important details notincluded in this paper that need clarification.1) Patients and methodsa. Study cohort: The study retrospectively enrolled consecutive patients diagnosed with HBV-ACLF in the Affiliated Hospital of Southwest Medical University as a derivation cohort and theFirst People's Hospital of Neijiang and Second People's Hospital of Yibin as a validation cohort.APASL criteria was used to define ACLF patients.You only enrolled HBV ACLF patients fromChinese hospitals.So you should tell how many patients were diagnosed with Chinese criteria?b.Inclusion/exclusion: you lack a consort diagram.you excluded Patients with cardiac diseases,endocrinological disorders, hematological disease and other types of cancer were excluded. Co-infection with human immunodeficiency virus, hepatitis A, C, D, and E viruses or other hepatitisviruses, autoimmune diseases, alcoholic liver disease, drug-induced liver injury,coexistenthepatocellular carcinoma, and any other serious medical illness or patients who had received anyimmunotherapy, liver transplantation or artificial liver support were also excluded. How about the
numbers? How many patients with previous decompensation of cirrhosis were included in the
study? All patients with HCC were excluded in the study? All patients with artificial liver supportwere excluded in the study?We need information on if pts were lost to follow up. If so how many.What information was collected?c. management for patients :How about the management for patients during hospital? Anydifference between the derivation cohort and the validation cohort?d. Statistical analysis:We see you list many statistic methods like the Kaplan-Meier method andROC not seen in the paper.2) Results and discussiona. In table1 and table4,bacterial infection should be added as an important complication for ACLFpatients.CTP score and CLIF-SOFA score were now also important model for ACLF patients. Nodata of admission bacterial infection in this cohort was given. More details of infection atadmission and during hospital stay (if possible)including sites of infection, species of bacterialculture positive should be given.b. I can not see the figure1 and figure2.c. NLR was so low in the validation cohort(1.92 V 4.84),why?d. In table 3 validation cohort data also should be added.e. CTP score and CLIF-SOFA score and MELD-na score should also be compared to the new
RNTIC score.
In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-
ACLF patients.But many important details not included in this paper that need clarification.
Are the methods appropriate and well described?
If not, please specify what is required 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.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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.
no
I 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 commentsto 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: 1Date: 28 Oct 2019
Reviewer: Huadong Yan
Reviewer's report:
Li qiang and colleagues have written a paper finding that A model named RNTIC based on
inflammatory markers to assess the prognosis of patients with HBV-related acute-on chronic liverfailure in a retrospective cohort of 577 patients. However, there are many important details notincluded in this paper that need clarification.1) Patients and methodsa. Study cohort: The study retrospectively enrolled consecutive patients diagnosed with HBV-ACLF in the Affiliated Hospital of Southwest Medical University as a derivation cohort and theFirst People's Hospital of Neijiang and Second People's Hospital of Yibin as a validation cohort.APASL criteria was used to define ACLF patients.You only enrolled HBV ACLF patients fromChinese hospitals.So you should tell how many patients were diagnosed with Chinese criteria?b.Inclusion/exclusion: you lack a consort diagram.you excluded Patients with cardiac diseases,endocrinological disorders, hematological disease and other types of cancer were excluded. Co-infection with human immunodeficiency virus, hepatitis A, C, D, and E viruses or other hepatitisviruses, autoimmune diseases, alcoholic liver disease, drug-induced liver injury,coexistenthepatocellular carcinoma, and any other serious medical illness or patients who had received anyimmunotherapy, liver transplantation or artificial liver support were also excluded. How about the
numbers? How many patients with previous decompensation of cirrhosis were included in the
study? All patients with HCC were excluded in the study? All patients with artificial liver supportwere excluded in the study?We need information on if pts were lost to follow up. If so how many.What information was collected?c. management for patients :How about the management for patients during hospital? Anydifference between the derivation cohort and the validation cohort?d. Statistical analysis:We see you list many statistic methods like the Kaplan-Meier method andROC not seen in the paper.2) Results and discussiona. In table1 and table4,bacterial infection should be added as an important complication for ACLFpatients.CTP score and CLIF-SOFA score were now also important model for ACLF patients. Nodata of admission bacterial infection in this cohort was given. More details of infection atadmission and during hospital stay (if possible)including sites of infection, species of bacterialculture positive should be given.b. I can not see the figure1 and figure2.c. NLR was so low in the validation cohort(1.92 V 4.84),why?d. In table 3 validation cohort data also should be added.e. CTP score and CLIF-SOFA score and MELD-na score should also be compared to the new
RNTIC score.
In summary,the auther find RNTIC score was useful for prediction 90 day mortality in HBV-
ACLF patients.But many important details not included in this paper that need clarification.
Are the methods appropriate and well described?
If not, please specify what is required 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.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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.
no
I 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 commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant