Title: The Prognostic Value of Systemic Inflammation Response Index in Digestive System
Carcinomas: A Systematic Review and Meta-Analysis
Version: 2 Date: 01 Oct 2024
Reviewer's report:
The primary aim of this systematic review and meta-analysis is to investigate the prognostic
value of the Systemic Inflammation Response Index (SIRI) in patients with digestive system
carcinomas (DSC). The study evaluates the association between pre-treatment SIRI levels
and various clinical outcomes, such as overall survival (OS), progression-free survival (PFS),
disease-free survival (DFS), time to progression (TTP), and disease-specific survival (DSS).
The goal is to provide a comprehensive understanding of whether SIRI can be utilized as a
reliable and non-invasive biomarker to predict the prognosis of DSC patients, potentially aiding
in treatment planning and improving patient outcomes.
However, there exist some limitations:
Significant Heterogeneity: The meta-analysis for overall survival (OS) exhibited high
heterogeneity (I² = 76.5%), which may affect the reliability of the pooled results. Although the
meta-regression and subgroup analyses attempted to address this, heterogeneity remained in
some subgroups, particularly the non-metastatic subgroup.
Publication Bias: Egger's test indicated publication bias in the meta-analysis of OS, which
suggests that some negative results may have been underreported or unpublished. This could
skew the overall findings.
Language and Geographical Bias: The study only included English-language publications,
which may introduce a language bias. Additionally, the majority of the included studies
originated from China, limiting the generalizability of the findings to other populations.
Limited Data on Secondary Outcomes: Due to the small number of studies evaluating PFS, DFS,
TTP, and DSS, detailed subgroup analyses or sensitivity analyses could not be performed for
these outcomes.
Categorization of SIRI: The conversion of continuous SIRI values into categorical variables
based on an optimal cutoff may lead to loss of statistical power and residual confounding,
limiting the robustness of the results.
Proposed Improvement Methods:
Addressing Heterogeneity: Future studies should aim to standardize the cutoff values used for
SIRI to reduce heterogeneity. Additionally, individual patient data (IPD) meta-analysis could
be considered to adjust for patient-level factors and provide more accurate estimates.
Inclusion of Gray Literature: Incorporating gray literature and non-English publications may
reduce publication bias and provide a more comprehensive overview of SIRI’s prognostic value.
Expanding Geographical Representation: Conducting studies in diverse geographical settings
with varied population characteristics would enhance the generalizability of the findings.
Title: The Prognostic Value of Systemic Inflammation Response Index in Digestive System
Carcinomas: A Systematic Review and Meta-Analysis
Version: 2 Date: 01 Oct 2024
Reviewer's report:
The primary aim of this systematic review and meta-analysis is to investigate the prognostic
value of the Systemic Inflammation Response Index (SIRI) in patients with digestive system
carcinomas (DSC). The study evaluates the association between pre-treatment SIRI levels
and various clinical outcomes, such as overall survival (OS), progression-free survival (PFS),
disease-free survival (DFS), time to progression (TTP), and disease-specific survival (DSS).
The goal is to provide a comprehensive understanding of whether SIRI can be utilized as a
reliable and non-invasive biomarker to predict the prognosis of DSC patients, potentially aiding
in treatment planning and improving patient outcomes.
However, there exist some limitations:
Significant Heterogeneity: The meta-analysis for overall survival (OS) exhibited high
heterogeneity (I² = 76.5%), which may affect the reliability of the pooled results. Although the
meta-regression and subgroup analyses attempted to address this, heterogeneity remained in
some subgroups, particularly the non-metastatic subgroup.
Publication Bias: Egger's test indicated publication bias in the meta-analysis of OS, which
suggests that some negative results may have been underreported or unpublished. This could
skew the overall findings.
Language and Geographical Bias: The study only included English-language publications,
which may introduce a language bias. Additionally, the majority of the included studies
originated from China, limiting the generalizability of the findings to other populations.
Limited Data on Secondary Outcomes: Due to the small number of studies evaluating PFS, DFS,
TTP, and DSS, detailed subgroup analyses or sensitivity analyses could not be performed for
these outcomes.
Categorization of SIRI: The conversion of continuous SIRI values into categorical variables
based on an optimal cutoff may lead to loss of statistical power and residual confounding,
limiting the robustness of the results.
Proposed Improvement Methods:
Addressing Heterogeneity: Future studies should aim to standardize the cutoff values used for
SIRI to reduce heterogeneity. Additionally, individual patient data (IPD) meta-analysis could
be considered to adjust for patient-level factors and provide more accurate estimates.
Inclusion of Gray Literature: Incorporating gray literature and non-English publications may
reduce publication bias and provide a more comprehensive overview of SIRI’s prognostic value.
Expanding Geographical Representation: Conducting studies in diverse geographical settings
with varied population characteristics would enhance the generalizability of the findings.
Please review this paper.
user
Title: The Prognostic Value of Systemic Inflammation Response Index in Digestive System
Carcinomas: A Systematic Review and Meta-Analysis
Version: 2 Date: 01 Oct 2024
Reviewer's report:
The primary aim of this systematic review and meta-analysis is to investigate the prognostic
value of the Systemic Inflammation Response Index (SIRI) in patients with digestive system
carcinomas (DSC). The study evaluates the association between pre-treatment SIRI levels
and various clinical outcomes, such as overall survival (OS), progression-free survival (PFS),
disease-free survival (DFS), time to progression (TTP), and disease-specific survival (DSS).
The goal is to provide a comprehensive understanding of whether SIRI can be utilized as a
reliable and non-invasive biomarker to predict the prognosis of DSC patients, potentially aiding
in treatment planning and improving patient outcomes.
However, there exist some limitations:
Significant Heterogeneity: The meta-analysis for overall survival (OS) exhibited high
heterogeneity (I² = 76.5%), which may affect the reliability of the pooled results. Although the
meta-regression and subgroup analyses attempted to address this, heterogeneity remained in
some subgroups, particularly the non-metastatic subgroup.
Publication Bias: Egger's test indicated publication bias in the meta-analysis of OS, which
suggests that some negative results may have been underreported or unpublished. This could
skew the overall findings.
Language and Geographical Bias: The study only included English-language publications,
which may introduce a language bias. Additionally, the majority of the included studies
originated from China, limiting the generalizability of the findings to other populations.
Limited Data on Secondary Outcomes: Due to the small number of studies evaluating PFS, DFS,
TTP, and DSS, detailed subgroup analyses or sensitivity analyses could not be performed for
these outcomes.
Categorization of SIRI: The conversion of continuous SIRI values into categorical variables
based on an optimal cutoff may lead to loss of statistical power and residual confounding,
limiting the robustness of the results.
Proposed Improvement Methods:
Addressing Heterogeneity: Future studies should aim to standardize the cutoff values used for
SIRI to reduce heterogeneity. Additionally, individual patient data (IPD) meta-analysis could
be considered to adjust for patient-level factors and provide more accurate estimates.
Inclusion of Gray Literature: Incorporating gray literature and non-English publications may
reduce publication bias and provide a more comprehensive overview of SIRI’s prognostic value.
Expanding Geographical Representation: Conducting studies in diverse geographical settings
with varied population characteristics would enhance the generalizability of the findings.
assistant