Reviewer's report
Title:Etiology of liver cirrhosis does not influence the severity of hepatic
encephalopathy: a cross-sectional study
Version: 1Date:26 August 2008
Reviewer: Stephen Harrison
Reviewer's report:
Kalaitzakis et al present an interesting study of 156 Swedish cirrhotic patients
with the aim of investigating the etiology of cirrhosis on the prevalence of hepatic
encephalopathy as well as any differences in quality of life and rates of diabetes.
Strengths of this study include the relatively large number of patients and good
study design with comprehensive data available to calculate MELD and C-P
scores as well as cognitive function testing with psychometric tests (number
connection) and HE scoring on a scale of 0-4.
The finding of diabetes mellitus being more common in patients with
hepatocellular rather than cholestatic cirrhosis support existing data and does not
represent a novel finding. However, the negative finding that hepatic
encephalopathy was equally found in all causes of cirrhosis as well as the
multivariate analysis that related cognitive impairment to age, liver disease
severity, and diabetes are all novel & clinically relevant findings.
Weaknesses of this paper include single center cross sectional nature of the trial
as well as lack of neurophysiologic tools to assess for HE (which is mentioned
appropriately by the authors). Also, on page #10, the statement diabetes mellitus
was "more common" should be changed to less common in the group of
cholestatic cirrhosis. The conclusion paragraph also has a small typographical
error in the first sentence.
In summary, a well conducted & interesting study with some clinically relevant
conclusions.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Etiology of liver cirrhosis does not influence the severity of hepatic
encephalopathy: a cross-sectional study
Version: 1Date:26 August 2008
Reviewer: Stephen Harrison
Reviewer's report:
Kalaitzakis et al present an interesting study of 156 Swedish cirrhotic patients
with the aim of investigating the etiology of cirrhosis on the prevalence of hepatic
encephalopathy as well as any differences in quality of life and rates of diabetes.
Strengths of this study include the relatively large number of patients and good
study design with comprehensive data available to calculate MELD and C-P
scores as well as cognitive function testing with psychometric tests (number
connection) and HE scoring on a scale of 0-4.
The finding of diabetes mellitus being more common in patients with
hepatocellular rather than cholestatic cirrhosis support existing data and does not
represent a novel finding. However, the negative finding that hepatic
encephalopathy was equally found in all causes of cirrhosis as well as the
multivariate analysis that related cognitive impairment to age, liver disease
severity, and diabetes are all novel & clinically relevant findings.
Weaknesses of this paper include single center cross sectional nature of the trial
as well as lack of neurophysiologic tools to assess for HE (which is mentioned
appropriately by the authors). Also, on page #10, the statement diabetes mellitus
was "more common" should be changed to less common in the group of
cholestatic cirrhosis. The conclusion paragraph also has a small typographical
error in the first sentence.
In summary, a well conducted & interesting study with some clinically relevant
conclusions.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Etiology of liver cirrhosis does not influence the severity of hepatic
encephalopathy: a cross-sectional study
Version: 1Date:26 August 2008
Reviewer: Stephen Harrison
Reviewer's report:
Kalaitzakis et al present an interesting study of 156 Swedish cirrhotic patients
with the aim of investigating the etiology of cirrhosis on the prevalence of hepatic
encephalopathy as well as any differences in quality of life and rates of diabetes.
Strengths of this study include the relatively large number of patients and good
study design with comprehensive data available to calculate MELD and C-P
scores as well as cognitive function testing with psychometric tests (number
connection) and HE scoring on a scale of 0-4.
The finding of diabetes mellitus being more common in patients with
hepatocellular rather than cholestatic cirrhosis support existing data and does not
represent a novel finding. However, the negative finding that hepatic
encephalopathy was equally found in all causes of cirrhosis as well as the
multivariate analysis that related cognitive impairment to age, liver disease
severity, and diabetes are all novel & clinically relevant findings.
Weaknesses of this paper include single center cross sectional nature of the trial
as well as lack of neurophysiologic tools to assess for HE (which is mentioned
appropriately by the authors). Also, on page #10, the statement diabetes mellitus
was "more common" should be changed to less common in the group of
cholestatic cirrhosis. The conclusion paragraph also has a small typographical
error in the first sentence.
In summary, a well conducted & interesting study with some clinically relevant
conclusions.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
assistant