Title: AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of liver
fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran
Version: 0 Date: 10 Feb 2023
Reviewer's report:
The study "AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of
liver fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran" aimed to
compare aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, AST to platelet
ratio index (APRI), and fibrosis-4 (FIB-4) with FibroScan results for the evaluation of hepatic
fibrosis in CHB patients. There are no elements of originality, and the study is not rigorous
enough.
The study has some important limits.
- The major limit of the study is the lack of gold standard (liver biopsy), all results being analyzed
compared to Fibroscan. Fibroscan is a method that estimates the stage of fibrosis and can be
subject to errors of interpretation. This aspect should be emphasized more in the discussion
chapter
- For the prediction of fibrosis using Fibroscan, certain cutoff values of liver stiffness were
chosen. Why were these values chosen and not others? There is no bibliographical quota inserted
in this respect.
- Between the Fibroscan examination and the moment of blood tests collection there is a time
interval of maximum one month, which is not correct. Fibroscan examination and laboratory
tests should have been performed on the same day or at a difference of one day in order to be
comparable
- How were the FIB4, APRI and AST/ALT/ratio cutoff values chosen for the assemenst of Se,
Sp, VPP and VPN?
- Is there a statistically significant difference between the values of FIB4, APRI and AST/ALT/
ratio depending on the stage of fibrosis estimated by Fibroscan?
- The statistical significance of the AUROC difference between Fibroscan, FIB 4, APRI and
AST/ALT ratio is not analyzed
- The article requires Corrections of English
Title: AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of liver
fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran
Version: 0 Date: 10 Feb 2023
Reviewer's report:
The study "AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of
liver fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran" aimed to
compare aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, AST to platelet
ratio index (APRI), and fibrosis-4 (FIB-4) with FibroScan results for the evaluation of hepatic
fibrosis in CHB patients. There are no elements of originality, and the study is not rigorous
enough.
The study has some important limits.
- The major limit of the study is the lack of gold standard (liver biopsy), all results being analyzed
compared to Fibroscan. Fibroscan is a method that estimates the stage of fibrosis and can be
subject to errors of interpretation. This aspect should be emphasized more in the discussion
chapter
- For the prediction of fibrosis using Fibroscan, certain cutoff values of liver stiffness were
chosen. Why were these values chosen and not others? There is no bibliographical quota inserted
in this respect.
- Between the Fibroscan examination and the moment of blood tests collection there is a time
interval of maximum one month, which is not correct. Fibroscan examination and laboratory
tests should have been performed on the same day or at a difference of one day in order to be
comparable
- How were the FIB4, APRI and AST/ALT/ratio cutoff values chosen for the assemenst of Se,
Sp, VPP and VPN?
- Is there a statistically significant difference between the values of FIB4, APRI and AST/ALT/
ratio depending on the stage of fibrosis estimated by Fibroscan?
- The statistical significance of the AUROC difference between Fibroscan, FIB 4, APRI and
AST/ALT ratio is not analyzed
- The article requires Corrections of English
Please review this paper.
user
Title: AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of liver
fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran
Version: 0 Date: 10 Feb 2023
Reviewer's report:
The study "AST/ALT ratio, APRI, and FIB-4 compared to FibroScan for the assessment of
liver fibrosis in patients with chronic hepatitis B in Bandar Abbas, Hormozgan, Iran" aimed to
compare aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, AST to platelet
ratio index (APRI), and fibrosis-4 (FIB-4) with FibroScan results for the evaluation of hepatic
fibrosis in CHB patients. There are no elements of originality, and the study is not rigorous
enough.
The study has some important limits.
- The major limit of the study is the lack of gold standard (liver biopsy), all results being analyzed
compared to Fibroscan. Fibroscan is a method that estimates the stage of fibrosis and can be
subject to errors of interpretation. This aspect should be emphasized more in the discussion
chapter
- For the prediction of fibrosis using Fibroscan, certain cutoff values of liver stiffness were
chosen. Why were these values chosen and not others? There is no bibliographical quota inserted
in this respect.
- Between the Fibroscan examination and the moment of blood tests collection there is a time
interval of maximum one month, which is not correct. Fibroscan examination and laboratory
tests should have been performed on the same day or at a difference of one day in order to be
comparable
- How were the FIB4, APRI and AST/ALT/ratio cutoff values chosen for the assemenst of Se,
Sp, VPP and VPN?
- Is there a statistically significant difference between the values of FIB4, APRI and AST/ALT/
ratio depending on the stage of fibrosis estimated by Fibroscan?
- The statistical significance of the AUROC difference between Fibroscan, FIB 4, APRI and
AST/ALT ratio is not analyzed
- The article requires Corrections of English
assistant