Title: The association between inflammatory biomarkers and gallstones in Americans under 50
years old
Version: 1 Date: 21 Apr 2025
Reviewer's report:
This is a revised manuscript. Most of issues are solved.
Remaining Concerns
1. Self-Reported Gallstone Diagnosis
- While acknowledged, the potential for misclassification (asymptomatic cases) remains
unresolved. The authors could propose future validation with imaging data.
2. Small Subgroup Sizes
- The diabetic subgroup (n=29 gallstone cases) has limited statistical power. The discussion
mentions this but understates its impact on reliability.
3. Inconsistencies in Comparisons
- The stronger SII association compared to Meng et al. (OR=1.79 vs. 1.001) lacks mechanistic
exploration. A deeper discussion of methodological differences (e.g., sample size, covariate
adjustment) is needed.
4. Generalizability
- Restricting the analysis to individuals <50 years limits extrapolation to older populations. The
authors should emphasize this caveat in the conclusion.
5. Formatting Inconsistencies
- Table alignment issues (e.g., merged cells in Table S1) and inconsistent decimal places (e.g.,
p-values in Table 2) require proofreading.
The authors have satisfactorily addressed most reviewer concerns, particularly regarding
statistical methods, subgroup analyses, and limitations. However, residual issues related to
subgroup reliability, comparative interpretation, and data collection methods warrant minor
revisions. Overall, the manuscript is strengthened but would benefit from clearer emphasis on
remaining limitations and their implications.
Title: The association between inflammatory biomarkers and gallstones in Americans under 50
years old
Version: 1 Date: 21 Apr 2025
Reviewer's report:
This is a revised manuscript. Most of issues are solved.
Remaining Concerns
1. Self-Reported Gallstone Diagnosis
- While acknowledged, the potential for misclassification (asymptomatic cases) remains
unresolved. The authors could propose future validation with imaging data.
2. Small Subgroup Sizes
- The diabetic subgroup (n=29 gallstone cases) has limited statistical power. The discussion
mentions this but understates its impact on reliability.
3. Inconsistencies in Comparisons
- The stronger SII association compared to Meng et al. (OR=1.79 vs. 1.001) lacks mechanistic
exploration. A deeper discussion of methodological differences (e.g., sample size, covariate
adjustment) is needed.
4. Generalizability
- Restricting the analysis to individuals <50 years limits extrapolation to older populations. The
authors should emphasize this caveat in the conclusion.
5. Formatting Inconsistencies
- Table alignment issues (e.g., merged cells in Table S1) and inconsistent decimal places (e.g.,
p-values in Table 2) require proofreading.
The authors have satisfactorily addressed most reviewer concerns, particularly regarding
statistical methods, subgroup analyses, and limitations. However, residual issues related to
subgroup reliability, comparative interpretation, and data collection methods warrant minor
revisions. Overall, the manuscript is strengthened but would benefit from clearer emphasis on
remaining limitations and their implications.
Please review this paper.
user
Title: The association between inflammatory biomarkers and gallstones in Americans under 50
years old
Version: 1 Date: 21 Apr 2025
Reviewer's report:
This is a revised manuscript. Most of issues are solved.
Remaining Concerns
1. Self-Reported Gallstone Diagnosis
- While acknowledged, the potential for misclassification (asymptomatic cases) remains
unresolved. The authors could propose future validation with imaging data.
2. Small Subgroup Sizes
- The diabetic subgroup (n=29 gallstone cases) has limited statistical power. The discussion
mentions this but understates its impact on reliability.
3. Inconsistencies in Comparisons
- The stronger SII association compared to Meng et al. (OR=1.79 vs. 1.001) lacks mechanistic
exploration. A deeper discussion of methodological differences (e.g., sample size, covariate
adjustment) is needed.
4. Generalizability
- Restricting the analysis to individuals <50 years limits extrapolation to older populations. The
authors should emphasize this caveat in the conclusion.
5. Formatting Inconsistencies
- Table alignment issues (e.g., merged cells in Table S1) and inconsistent decimal places (e.g.,
p-values in Table 2) require proofreading.
The authors have satisfactorily addressed most reviewer concerns, particularly regarding
statistical methods, subgroup analyses, and limitations. However, residual issues related to
subgroup reliability, comparative interpretation, and data collection methods warrant minor
revisions. Overall, the manuscript is strengthened but would benefit from clearer emphasis on
remaining limitations and their implications.
assistant