Reviewer ’s report  
Title: Diminished Accuracy of Biomarkers of Fibrosis in Low Replicative Chronic Hepatitis B  
 
Version:  0 Date: 25 May 2017  
 
Reviewer: Chang Seok Bang  
 
Reviewer's report:  
Thanks to authors for submitting interesting article to BMC gastroenterology.  
Although this manuscript did not show any statistical errors and methodological pitfalls, the 
unmeasured bias is the most important barrier for the generalization of the results of this study.  
This kind of study is influenced by the spectrum bias (ex, how much significant fibrosis is 
included in the entire cohort). Therefore, sufficient number of participants and val idation is 
needed.  
Due to the retrospective nature of this study, I can only find statistical trend or association, not 
suitable for the generalization.  
Liver fibrosis is the dynamic process and arbitrarily dividing patients into low replicative state 
and high replicative state with DNA level 20000 IU/mL might not correctly reflect the low 
viremia level.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supporte d by the data shown?  
If not, please explain in your comments to the authors.  
No 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further  
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please compl ete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of th is 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applyi ng for any patents relating to the content of the  
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details bel ow. 
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any commen ts 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Diminished Accuracy of Biomarkers of Fibrosis in Low Replicative Chronic Hepatitis B  
 
Version:  0 Date: 25 May 2017  
 
Reviewer: Chang Seok Bang  
 
Reviewer's report:  
Thanks to authors for submitting interesting article to BMC gastroenterology.  
Although this manuscript did not show any statistical errors and methodological pitfalls, the 
unmeasured bias is the most important barrier for the generalization of the results of this study.  
This kind of study is influenced by the spectrum bias (ex, how much significant fibrosis is 
included in the entire cohort). Therefore, sufficient number of participants and val idation is 
needed.  
Due to the retrospective nature of this study, I can only find statistical trend or association, not 
suitable for the generalization.  
Liver fibrosis is the dynamic process and arbitrarily dividing patients into low replicative state 
and high replicative state with DNA level 20000 IU/mL might not correctly reflect the low 
viremia level.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supporte d by the data shown?  
If not, please explain in your comments to the authors.  
No 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further  
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please compl ete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of th is 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applyi ng for any patents relating to the content of the  
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details bel ow. 
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any commen ts 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Diminished Accuracy of Biomarkers of Fibrosis in Low Replicative Chronic Hepatitis B  
 
Version:  0 Date: 25 May 2017  
 
Reviewer: Chang Seok Bang  
 
Reviewer's report:  
Thanks to authors for submitting interesting article to BMC gastroenterology.  
Although this manuscript did not show any statistical errors and methodological pitfalls, the 
unmeasured bias is the most important barrier for the generalization of the results of this study.  
This kind of study is influenced by the spectrum bias (ex, how much significant fibrosis is 
included in the entire cohort). Therefore, sufficient number of participants and val idation is 
needed.  
Due to the retrospective nature of this study, I can only find statistical trend or association, not 
suitable for the generalization.  
Liver fibrosis is the dynamic process and arbitrarily dividing patients into low replicative state 
and high replicative state with DNA level 20000 IU/mL might not correctly reflect the low 
viremia level.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supporte d by the data shown?  
If not, please explain in your comments to the authors.  
No 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further  
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please compl ete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of th is 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applyi ng for any patents relating to the content of the  
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details bel ow. 
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any commen ts 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant