Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 4 Date: 17 Mar 2025
Reviewer:  Erfan Arabpour
Reviewer's report:
I would like to thank the authors for addressing the revisions. My minor comments have been
fully addressed, with the exception of Figure 1, which requires a small correction: at the end
of the diagram, "gallbladder" should be replaced with "gallstone." The term "patients without
gallbladder" implies those who have undergone cholecystectomy, which is not accurate in this
context. However, my major concern regarding the clinical implications of the results remains
unresolved, as I believe the conclusions are still overstated. While the authors have addressed
some issues, I maintain that monitoring PHR for detection or risk stratification of patients is not
clinically useful. Additionally, another significant limitation of the study is its reliance on self-
reported data regarding the presence of gallstones. Although this is mentioned in the limitations
section, I recommend that the authors also highlight this issue in the methods section of the
abstract. This would provide readers with a clearer understanding of the study's results and their
potential limitations.
Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 4 Date: 17 Mar 2025
Reviewer:  Erfan Arabpour
Reviewer's report:
I would like to thank the authors for addressing the revisions. My minor comments have been
fully addressed, with the exception of Figure 1, which requires a small correction: at the end
of the diagram, "gallbladder" should be replaced with "gallstone." The term "patients without
gallbladder" implies those who have undergone cholecystectomy, which is not accurate in this
context. However, my major concern regarding the clinical implications of the results remains
unresolved, as I believe the conclusions are still overstated. While the authors have addressed
some issues, I maintain that monitoring PHR for detection or risk stratification of patients is not
clinically useful. Additionally, another significant limitation of the study is its reliance on self-
reported data regarding the presence of gallstones. Although this is mentioned in the limitations
section, I recommend that the authors also highlight this issue in the methods section of the
abstract. This would provide readers with a clearer understanding of the study's results and their
potential limitations.
Please review this paper.
user
Title: Association Between Platelet-to-High-Density Lipoprotein Cholesterol Ratio and
Gallstone Prevalence in the American Adult Population: A Cross-Sectional Study Analysis
Version: 4 Date: 17 Mar 2025
Reviewer:  Erfan Arabpour
Reviewer's report:
I would like to thank the authors for addressing the revisions. My minor comments have been
fully addressed, with the exception of Figure 1, which requires a small correction: at the end
of the diagram, "gallbladder" should be replaced with "gallstone." The term "patients without
gallbladder" implies those who have undergone cholecystectomy, which is not accurate in this
context. However, my major concern regarding the clinical implications of the results remains
unresolved, as I believe the conclusions are still overstated. While the authors have addressed
some issues, I maintain that monitoring PHR for detection or risk stratification of patients is not
clinically useful. Additionally, another significant limitation of the study is its reliance on self-
reported data regarding the presence of gallstones. Although this is mentioned in the limitations
section, I recommend that the authors also highlight this issue in the methods section of the
abstract. This would provide readers with a clearer understanding of the study's results and their
potential limitations.
assistant