Title: Validation of a new simple scoring system to predict spontaneous bacterial peritonitis in
patients with cirrhosis and ascites
Version: 1 Date: 25 Apr 2023
Reviewer's report:
It is difficult to diagnose spontaneous bacterial peritonitis (SBP). This study was to externally
validate a diagnostic model for SBP in patients with cirrhosis and ascites, which had certain
clinical significance.
Comments:
1.In multivariate analysis, we found that NLR, MPV, and CRP were independent variables
related to the presence of SBP (Table 2). The performances of the variables are compared and
summarized in Fig. 1.
It was univariate analysis. The four variables, including age, NLR, MPV, and CRP from the
original study, should be brought into a logistic regression model at the same time in this
external validation data to figure out whether they still were all independent risk factors. The
OR (95%CI ) of the four variable alone and the Mansoura simple scoring system in this external
data should be disclosed.
2. Mansoura simple scoring system (Eur J Gastroenterol Hepatol. 2019 Aug;31(8):1017-1024.):
A scoring system including these four variables (age, MPV, and NLR with 1 point each, whereas
CRP with 2 points) achieves a specificity of 98.2% with a positive predictive value for the
diagnosis of SBP of 88.1% (score#4). At a threshold of 1 point, the negative predictive value
is 97.5% with a sensitivity of 92.9%.
As an external validation study, calibration (Calibration curve and Brier score) based on the two
cutoffs (1 for negative prediction, 4 for positive prediction) should be disclosed in addition to
providing discrimination (AUROC). 95% CI should be shown too.
3. The discussion is not in-depth. It does not bring much apart from repeating facts already stated
in the introduction and the original study proposed the Mansoura simple scoring system.
4. Several models predicting SBP could be retrieved in Pubmed. It would be more meaningful
to validate the Mansoura simple scoring system and the others.
Title: Validation of a new simple scoring system to predict spontaneous bacterial peritonitis in
patients with cirrhosis and ascites
Version: 1 Date: 25 Apr 2023
Reviewer's report:
It is difficult to diagnose spontaneous bacterial peritonitis (SBP). This study was to externally
validate a diagnostic model for SBP in patients with cirrhosis and ascites, which had certain
clinical significance.
Comments:
1.In multivariate analysis, we found that NLR, MPV, and CRP were independent variables
related to the presence of SBP (Table 2). The performances of the variables are compared and
summarized in Fig. 1.
It was univariate analysis. The four variables, including age, NLR, MPV, and CRP from the
original study, should be brought into a logistic regression model at the same time in this
external validation data to figure out whether they still were all independent risk factors. The
OR (95%CI ) of the four variable alone and the Mansoura simple scoring system in this external
data should be disclosed.
2. Mansoura simple scoring system (Eur J Gastroenterol Hepatol. 2019 Aug;31(8):1017-1024.):
A scoring system including these four variables (age, MPV, and NLR with 1 point each, whereas
CRP with 2 points) achieves a specificity of 98.2% with a positive predictive value for the
diagnosis of SBP of 88.1% (score#4). At a threshold of 1 point, the negative predictive value
is 97.5% with a sensitivity of 92.9%.
As an external validation study, calibration (Calibration curve and Brier score) based on the two
cutoffs (1 for negative prediction, 4 for positive prediction) should be disclosed in addition to
providing discrimination (AUROC). 95% CI should be shown too.
3. The discussion is not in-depth. It does not bring much apart from repeating facts already stated
in the introduction and the original study proposed the Mansoura simple scoring system.
4. Several models predicting SBP could be retrieved in Pubmed. It would be more meaningful
to validate the Mansoura simple scoring system and the others.
Please review this paper.
user
Title: Validation of a new simple scoring system to predict spontaneous bacterial peritonitis in
patients with cirrhosis and ascites
Version: 1 Date: 25 Apr 2023
Reviewer's report:
It is difficult to diagnose spontaneous bacterial peritonitis (SBP). This study was to externally
validate a diagnostic model for SBP in patients with cirrhosis and ascites, which had certain
clinical significance.
Comments:
1.In multivariate analysis, we found that NLR, MPV, and CRP were independent variables
related to the presence of SBP (Table 2). The performances of the variables are compared and
summarized in Fig. 1.
It was univariate analysis. The four variables, including age, NLR, MPV, and CRP from the
original study, should be brought into a logistic regression model at the same time in this
external validation data to figure out whether they still were all independent risk factors. The
OR (95%CI ) of the four variable alone and the Mansoura simple scoring system in this external
data should be disclosed.
2. Mansoura simple scoring system (Eur J Gastroenterol Hepatol. 2019 Aug;31(8):1017-1024.):
A scoring system including these four variables (age, MPV, and NLR with 1 point each, whereas
CRP with 2 points) achieves a specificity of 98.2% with a positive predictive value for the
diagnosis of SBP of 88.1% (score#4). At a threshold of 1 point, the negative predictive value
is 97.5% with a sensitivity of 92.9%.
As an external validation study, calibration (Calibration curve and Brier score) based on the two
cutoffs (1 for negative prediction, 4 for positive prediction) should be disclosed in addition to
providing discrimination (AUROC). 95% CI should be shown too.
3. The discussion is not in-depth. It does not bring much apart from repeating facts already stated
in the introduction and the original study proposed the Mansoura simple scoring system.
4. Several models predicting SBP could be retrieved in Pubmed. It would be more meaningful
to validate the Mansoura simple scoring system and the others.
assistant