Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 7 Date: 27 Dec 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have responded to most of the comments and concerns
raised in the previous revision. However, there is still a lack of information regarding patient
selection.
REQUESTED REVISIONS:
A major unanswered concern is still the selection of patients, since additional data and flowchart
in figure 1 do not provide enough information to clarify this point. Indeed, figure 1 should be
clarified or removed since it is very unclear how many patients were screened (either outpatient
visitors or clients with one or more signs and symptoms of liver disease), how the number of
388 patients was reached, and why 388 patients instead of 422 were interviewed. This point is
critical because a bias in the selection of patients greatly limits the potential generalization and
application of this manuscript.
In case the authors do not have additional data, apart from clarifying (or removing) figure 1,
they could provide general demographics of outpatient visitors or general population or compare
with other data available from other studies to analyze if their sample is representative of their
population.
Also, in my previous revision I pointed out that “The exclusion of patients with pre-existing liver
disease (n=16) is mentioned in the response document but should be more clearly explained in
the manuscript.” This has not been responded to by mistake.
Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 7 Date: 27 Dec 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have responded to most of the comments and concerns
raised in the previous revision. However, there is still a lack of information regarding patient
selection.
REQUESTED REVISIONS:
A major unanswered concern is still the selection of patients, since additional data and flowchart
in figure 1 do not provide enough information to clarify this point. Indeed, figure 1 should be
clarified or removed since it is very unclear how many patients were screened (either outpatient
visitors or clients with one or more signs and symptoms of liver disease), how the number of
388 patients was reached, and why 388 patients instead of 422 were interviewed. This point is
critical because a bias in the selection of patients greatly limits the potential generalization and
application of this manuscript.
In case the authors do not have additional data, apart from clarifying (or removing) figure 1,
they could provide general demographics of outpatient visitors or general population or compare
with other data available from other studies to analyze if their sample is representative of their
population.
Also, in my previous revision I pointed out that “The exclusion of patients with pre-existing liver
disease (n=16) is mentioned in the response document but should be more clearly explained in
the manuscript.” This has not been responded to by mistake.
Please review this paper.
user
Title: Magnitude, Patterns, and Factors Associated with Liver Disease among Clinically
Suspected Clients in Eastern Ethiopia: Hidden Public Health Tragedy
Version: 7 Date: 27 Dec 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors have responded to most of the comments and concerns
raised in the previous revision. However, there is still a lack of information regarding patient
selection.
REQUESTED REVISIONS:
A major unanswered concern is still the selection of patients, since additional data and flowchart
in figure 1 do not provide enough information to clarify this point. Indeed, figure 1 should be
clarified or removed since it is very unclear how many patients were screened (either outpatient
visitors or clients with one or more signs and symptoms of liver disease), how the number of
388 patients was reached, and why 388 patients instead of 422 were interviewed. This point is
critical because a bias in the selection of patients greatly limits the potential generalization and
application of this manuscript.
In case the authors do not have additional data, apart from clarifying (or removing) figure 1,
they could provide general demographics of outpatient visitors or general population or compare
with other data available from other studies to analyze if their sample is representative of their
population.
Also, in my previous revision I pointed out that “The exclusion of patients with pre-existing liver
disease (n=16) is mentioned in the response document but should be more clearly explained in
the manuscript.” This has not been responded to by mistake.
assistant