Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 28 Apr 2022
Reviewer's report:
In the present manuscript the Authors report the results of a survey aimed at evaluating
the medical journey of patients with NASH and role of hepatologists/gastroenterologists in
diagnosing and treating patients with NASH. The manuscript is well written and easy to follow
and deals with an interesting topic.
I have the following comments:
- I would better specify how participants to the present survey were identified and contacted
(both doctors and patients)
- The Authors correctly point out in the introduction that NASH is a histological diagnosis,
which can only be made through liver biopsy. Nonetheless, most hepatologists argued that they
diagnose NASH based on fibroscan (which is a noninvasive proxy for fibrosis, not inflammation)
or even with liver function tests. I believe that the question was not well formulated and the
aspect dealing with a bit of confusion between steatosis, inflammation and fibrosis among
gastroenterologists /hepatologists deserves some comments.
- When discussing the prevalence of NAFLD in the United States, I would mention a recent study
performed using NHANES data and reporting the prevalence of both NAFLD and advanced
liver fibrosis in the general US population (see doi: 10.1111/liv.14828).
Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 28 Apr 2022
Reviewer's report:
In the present manuscript the Authors report the results of a survey aimed at evaluating
the medical journey of patients with NASH and role of hepatologists/gastroenterologists in
diagnosing and treating patients with NASH. The manuscript is well written and easy to follow
and deals with an interesting topic.
I have the following comments:
- I would better specify how participants to the present survey were identified and contacted
(both doctors and patients)
- The Authors correctly point out in the introduction that NASH is a histological diagnosis,
which can only be made through liver biopsy. Nonetheless, most hepatologists argued that they
diagnose NASH based on fibroscan (which is a noninvasive proxy for fibrosis, not inflammation)
or even with liver function tests. I believe that the question was not well formulated and the
aspect dealing with a bit of confusion between steatosis, inflammation and fibrosis among
gastroenterologists /hepatologists deserves some comments.
- When discussing the prevalence of NAFLD in the United States, I would mention a recent study
performed using NHANES data and reporting the prevalence of both NAFLD and advanced
liver fibrosis in the general US population (see doi: 10.1111/liv.14828).
Please review this paper.
user
Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 28 Apr 2022
Reviewer's report:
In the present manuscript the Authors report the results of a survey aimed at evaluating
the medical journey of patients with NASH and role of hepatologists/gastroenterologists in
diagnosing and treating patients with NASH. The manuscript is well written and easy to follow
and deals with an interesting topic.
I have the following comments:
- I would better specify how participants to the present survey were identified and contacted
(both doctors and patients)
- The Authors correctly point out in the introduction that NASH is a histological diagnosis,
which can only be made through liver biopsy. Nonetheless, most hepatologists argued that they
diagnose NASH based on fibroscan (which is a noninvasive proxy for fibrosis, not inflammation)
or even with liver function tests. I believe that the question was not well formulated and the
aspect dealing with a bit of confusion between steatosis, inflammation and fibrosis among
gastroenterologists /hepatologists deserves some comments.
- When discussing the prevalence of NAFLD in the United States, I would mention a recent study
performed using NHANES data and reporting the prevalence of both NAFLD and advanced
liver fibrosis in the general US population (see doi: 10.1111/liv.14828).
assistant