Reviewer's report
Title:Prevalence of liver fibrosis and risk factors in a general population using
non-invasive biomarkers (FibroTest)
Version: 1Date:22 March 2010
Reviewer: Laurent Castera
Reviewer's report:
In the present study, the authors estimated the prevalence of significant fibrosis
using biomarkers (Fibrotest, FT) as first line and transient elastography (TE) as
confirmation in 7463 subjects older than 40 seen for a free medical screening in
France as well as different screening strategies (non selective versus selective
and oriented).
Their results show that significant fibrosis could be suspected in 209 (2.8%)
including cirrhosis in 25 (0.3%) but could be confirmed (using the concordance
between FT >0.48 and TE >7.1 kPa) in only 52 patients (0.7%) (4 liver biopsies
performed).
The leading cause, as could be expected, was NAFLD and the most sensitive
selective screening strategy was the metabolic factor-oriented one.
major comments:
The authors should be congratulated for performing this pilot study in such a
large community based-population. Screening of the general population for liver
diseases is an important and challenging issue and using non invasive methods
is a very attractive strategy.
This study has however several methodological limitations (only half of the 209
patients with presumed fibrosis were reinvestigated, fibrosis was “confirmed” (on
the basis on the agreement between non invasive methods) in only 52 patients,
and finally histological characterization and confirmation was obtained in only 4
patients) that should be acknowledged and discussed in more details by the
authors.
minor comments
I would suggest adding an updated reference on the applicability of transient
elastography (Castera et al. Hepatology 2010).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Prevalence of liver fibrosis and risk factors in a general population using
non-invasive biomarkers (FibroTest)
Version: 1Date:22 March 2010
Reviewer: Laurent Castera
Reviewer's report:
In the present study, the authors estimated the prevalence of significant fibrosis
using biomarkers (Fibrotest, FT) as first line and transient elastography (TE) as
confirmation in 7463 subjects older than 40 seen for a free medical screening in
France as well as different screening strategies (non selective versus selective
and oriented).
Their results show that significant fibrosis could be suspected in 209 (2.8%)
including cirrhosis in 25 (0.3%) but could be confirmed (using the concordance
between FT >0.48 and TE >7.1 kPa) in only 52 patients (0.7%) (4 liver biopsies
performed).
The leading cause, as could be expected, was NAFLD and the most sensitive
selective screening strategy was the metabolic factor-oriented one.
major comments:
The authors should be congratulated for performing this pilot study in such a
large community based-population. Screening of the general population for liver
diseases is an important and challenging issue and using non invasive methods
is a very attractive strategy.
This study has however several methodological limitations (only half of the 209
patients with presumed fibrosis were reinvestigated, fibrosis was “confirmed” (on
the basis on the agreement between non invasive methods) in only 52 patients,
and finally histological characterization and confirmation was obtained in only 4
patients) that should be acknowledged and discussed in more details by the
authors.
minor comments
I would suggest adding an updated reference on the applicability of transient
elastography (Castera et al. Hepatology 2010).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Prevalence of liver fibrosis and risk factors in a general population using
non-invasive biomarkers (FibroTest)
Version: 1Date:22 March 2010
Reviewer: Laurent Castera
Reviewer's report:
In the present study, the authors estimated the prevalence of significant fibrosis
using biomarkers (Fibrotest, FT) as first line and transient elastography (TE) as
confirmation in 7463 subjects older than 40 seen for a free medical screening in
France as well as different screening strategies (non selective versus selective
and oriented).
Their results show that significant fibrosis could be suspected in 209 (2.8%)
including cirrhosis in 25 (0.3%) but could be confirmed (using the concordance
between FT >0.48 and TE >7.1 kPa) in only 52 patients (0.7%) (4 liver biopsies
performed).
The leading cause, as could be expected, was NAFLD and the most sensitive
selective screening strategy was the metabolic factor-oriented one.
major comments:
The authors should be congratulated for performing this pilot study in such a
large community based-population. Screening of the general population for liver
diseases is an important and challenging issue and using non invasive methods
is a very attractive strategy.
This study has however several methodological limitations (only half of the 209
patients with presumed fibrosis were reinvestigated, fibrosis was “confirmed” (on
the basis on the agreement between non invasive methods) in only 52 patients,
and finally histological characterization and confirmation was obtained in only 4
patients) that should be acknowledged and discussed in more details by the
authors.
minor comments
I would suggest adding an updated reference on the applicability of transient
elastography (Castera et al. Hepatology 2010).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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