Reviewer's report
Title:Comparison of ELF, FibroTest and FibroScan for the non-invasive
assessment of liver fibrosis
Version: 2Date:21 April 2010
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
The study by Friedrich-Rust et al. evaluated the diagnostic performances of
serum markers (FibroTest and ELF) and FibroScan in the diagnosis of significant
hepatic fibrosis or cirrhosis in a cohort of 74 patients with chronic viral hepatitis or
PBC. The study made a direct comparison among fibrosis markers and
FibroScan and concluded that there are comparable diagnostic accuracies
among indirect, direct fibrosis markers and FibroScan. The main limitation of this
study was small patient population with different etiologies of hepatic fibrosis,
which weakens the result and its conclusion.
Major comments
1. For clinical practice, it is favorable to have the diagnostic validity and yield for
each test. These data are available for chronic hepatitis C and PBC in previous
studies. The authors should give the information of cut-offs and their diagnostic
validities and yields in patients as a whole, patients with chronic hepatitis C and
PBC.
2. Combined use of various non-invasive tests might increase the diagnostic
accuracy. The authors could try to combine direct serum marker with indirect
serum marker or with FibroScan to increase the diagnosis of minor to moderate
hepatic fibrosis.
3. In the conclusion, the author stated that serum markers are informative in
higher proportions of patients than FibroScan. The conclusion was made due to
8 patients in the study population had unreliable results of FibroScan. To make
this conclusion, it should be cautious considering small study population without
prospectively consecutive enrollment.
Minor comment
1. The references should be arranged in the same format.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Comparison of ELF, FibroTest and FibroScan for the non-invasive
assessment of liver fibrosis
Version: 2Date:21 April 2010
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
The study by Friedrich-Rust et al. evaluated the diagnostic performances of
serum markers (FibroTest and ELF) and FibroScan in the diagnosis of significant
hepatic fibrosis or cirrhosis in a cohort of 74 patients with chronic viral hepatitis or
PBC. The study made a direct comparison among fibrosis markers and
FibroScan and concluded that there are comparable diagnostic accuracies
among indirect, direct fibrosis markers and FibroScan. The main limitation of this
study was small patient population with different etiologies of hepatic fibrosis,
which weakens the result and its conclusion.
Major comments
1. For clinical practice, it is favorable to have the diagnostic validity and yield for
each test. These data are available for chronic hepatitis C and PBC in previous
studies. The authors should give the information of cut-offs and their diagnostic
validities and yields in patients as a whole, patients with chronic hepatitis C and
PBC.
2. Combined use of various non-invasive tests might increase the diagnostic
accuracy. The authors could try to combine direct serum marker with indirect
serum marker or with FibroScan to increase the diagnosis of minor to moderate
hepatic fibrosis.
3. In the conclusion, the author stated that serum markers are informative in
higher proportions of patients than FibroScan. The conclusion was made due to
8 patients in the study population had unreliable results of FibroScan. To make
this conclusion, it should be cautious considering small study population without
prospectively consecutive enrollment.
Minor comment
1. The references should be arranged in the same format.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Comparison of ELF, FibroTest and FibroScan for the non-invasive
assessment of liver fibrosis
Version: 2Date:21 April 2010
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
The study by Friedrich-Rust et al. evaluated the diagnostic performances of
serum markers (FibroTest and ELF) and FibroScan in the diagnosis of significant
hepatic fibrosis or cirrhosis in a cohort of 74 patients with chronic viral hepatitis or
PBC. The study made a direct comparison among fibrosis markers and
FibroScan and concluded that there are comparable diagnostic accuracies
among indirect, direct fibrosis markers and FibroScan. The main limitation of this
study was small patient population with different etiologies of hepatic fibrosis,
which weakens the result and its conclusion.
Major comments
1. For clinical practice, it is favorable to have the diagnostic validity and yield for
each test. These data are available for chronic hepatitis C and PBC in previous
studies. The authors should give the information of cut-offs and their diagnostic
validities and yields in patients as a whole, patients with chronic hepatitis C and
PBC.
2. Combined use of various non-invasive tests might increase the diagnostic
accuracy. The authors could try to combine direct serum marker with indirect
serum marker or with FibroScan to increase the diagnosis of minor to moderate
hepatic fibrosis.
3. In the conclusion, the author stated that serum markers are informative in
higher proportions of patients than FibroScan. The conclusion was made due to
8 patients in the study population had unreliable results of FibroScan. To make
this conclusion, it should be cautious considering small study population without
prospectively consecutive enrollment.
Minor comment
1. The references should be arranged in the same format.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Declaration of competing interests:
I declare that I have no competing interests
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