Reviewer's report
Title:Severity of acute hepatitis and its outcome in patients with dengue fever in
a tertiary care hospital Karachi, Pakistan (South Asia):
Version: 5Date:25 February 2010
Reviewer: Dorothea Nitsch
Reviewer's report:
The authors have answered most of the points that were queried.
However, there are few final alterations that need to be made to the manuscript.
- Please add on page 5 ‘(n=6)’ as follows:
‘We had excluded all those patients who had underlying Chronic Liver Disease
(CLD) or known positive serology for viral hepatitis (HBsAg or HCVAb; n=6)
and those patients who had malaria.’
- Please delete Figure 1a (as discussed previously, these numbers do not allow
for length of follow-up)
- Please keep the survival curve for figure 1b as new Figure 1.
- Please delete cumulative hazard and log-survival (the old figure 1b) as they
contain essentially the same information.
- Please add numbers at risk in each group displayed below the new Figure 1
- Please clarify for the journal reader who looks at Figure II what the middle, the
top and the bottom of the box, and the whiskers indicate.
- Please add to the methods that Fisher's exact tests were used when numbers
were too small to perform chi-square testing
-Table 1 needs further amendments. Firstly, for a non-statistical reader it will be
hard to understand why percentages of death and survival for each group
(mild-moderate as opposed to severe hepatitis) are not adding up to 100 percent.
Because the authors have calculated column percentages (ignoring the
prognostic design of the study) it reads at present that 50 % of those with
mild-moderate hepatitis died whilst at the same time 85% survived! The crude
numbers for ‘surviving’ are wrong, as they ignore the censoring events and
difference of length of stay. This table should form part of the main manuscript.
The table columns that should be presented are as follows:
1. Diagnosis categories
2. Severity of hepatitis
3. Deaths (n)
4. Death rate (deaths/10 days)
5. (95%CI for death rate)
6. LOS(days) +SD
7. P value for difference in death rates (log-rank)
- Table 2 is also important. Again as it stands I don’t believe it – how can a
complication (renal failure) that occurs at the same frequency in both groups
(both times 50%) have a significant difference at p=0.002? There is something
seriously wrong here. Unless the authors come up with some crude original
numbers rather than some arbitrary percentages I don’t believe this table at all.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Severity of acute hepatitis and its outcome in patients with dengue fever in
a tertiary care hospital Karachi, Pakistan (South Asia):
Version: 5Date:25 February 2010
Reviewer: Dorothea Nitsch
Reviewer's report:
The authors have answered most of the points that were queried.
However, there are few final alterations that need to be made to the manuscript.
- Please add on page 5 ‘(n=6)’ as follows:
‘We had excluded all those patients who had underlying Chronic Liver Disease
(CLD) or known positive serology for viral hepatitis (HBsAg or HCVAb; n=6)
and those patients who had malaria.’
- Please delete Figure 1a (as discussed previously, these numbers do not allow
for length of follow-up)
- Please keep the survival curve for figure 1b as new Figure 1.
- Please delete cumulative hazard and log-survival (the old figure 1b) as they
contain essentially the same information.
- Please add numbers at risk in each group displayed below the new Figure 1
- Please clarify for the journal reader who looks at Figure II what the middle, the
top and the bottom of the box, and the whiskers indicate.
- Please add to the methods that Fisher's exact tests were used when numbers
were too small to perform chi-square testing
-Table 1 needs further amendments. Firstly, for a non-statistical reader it will be
hard to understand why percentages of death and survival for each group
(mild-moderate as opposed to severe hepatitis) are not adding up to 100 percent.
Because the authors have calculated column percentages (ignoring the
prognostic design of the study) it reads at present that 50 % of those with
mild-moderate hepatitis died whilst at the same time 85% survived! The crude
numbers for ‘surviving’ are wrong, as they ignore the censoring events and
difference of length of stay. This table should form part of the main manuscript.
The table columns that should be presented are as follows:
1. Diagnosis categories
2. Severity of hepatitis
3. Deaths (n)
4. Death rate (deaths/10 days)
5. (95%CI for death rate)
6. LOS(days) +SD
7. P value for difference in death rates (log-rank)
- Table 2 is also important. Again as it stands I don’t believe it – how can a
complication (renal failure) that occurs at the same frequency in both groups
(both times 50%) have a significant difference at p=0.002? There is something
seriously wrong here. Unless the authors come up with some crude original
numbers rather than some arbitrary percentages I don’t believe this table at all.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Severity of acute hepatitis and its outcome in patients with dengue fever in
a tertiary care hospital Karachi, Pakistan (South Asia):
Version: 5Date:25 February 2010
Reviewer: Dorothea Nitsch
Reviewer's report:
The authors have answered most of the points that were queried.
However, there are few final alterations that need to be made to the manuscript.
- Please add on page 5 ‘(n=6)’ as follows:
‘We had excluded all those patients who had underlying Chronic Liver Disease
(CLD) or known positive serology for viral hepatitis (HBsAg or HCVAb; n=6)
and those patients who had malaria.’
- Please delete Figure 1a (as discussed previously, these numbers do not allow
for length of follow-up)
- Please keep the survival curve for figure 1b as new Figure 1.
- Please delete cumulative hazard and log-survival (the old figure 1b) as they
contain essentially the same information.
- Please add numbers at risk in each group displayed below the new Figure 1
- Please clarify for the journal reader who looks at Figure II what the middle, the
top and the bottom of the box, and the whiskers indicate.
- Please add to the methods that Fisher's exact tests were used when numbers
were too small to perform chi-square testing
-Table 1 needs further amendments. Firstly, for a non-statistical reader it will be
hard to understand why percentages of death and survival for each group
(mild-moderate as opposed to severe hepatitis) are not adding up to 100 percent.
Because the authors have calculated column percentages (ignoring the
prognostic design of the study) it reads at present that 50 % of those with
mild-moderate hepatitis died whilst at the same time 85% survived! The crude
numbers for ‘surviving’ are wrong, as they ignore the censoring events and
difference of length of stay. This table should form part of the main manuscript.
The table columns that should be presented are as follows:
1. Diagnosis categories
2. Severity of hepatitis
3. Deaths (n)
4. Death rate (deaths/10 days)
5. (95%CI for death rate)
6. LOS(days) +SD
7. P value for difference in death rates (log-rank)
- Table 2 is also important. Again as it stands I don’t believe it – how can a
complication (renal failure) that occurs at the same frequency in both groups
(both times 50%) have a significant difference at p=0.002? There is something
seriously wrong here. Unless the authors come up with some crude original
numbers rather than some arbitrary percentages I don’t believe this table at all.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
assistant