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Author’s response to reviews Title: Accuracy of real-time shear wave elastography in staging hepatic fibrosis: A meta-analysis Authors:
| Content Provider | Semantic Scholar |
|---|---|
| Author | Fu, Juan Wu, Biao Wu, Hua-Zhi Lin, Feng Deng, Wei |
| Copyright Year | 2020 |
| Abstract | line 7: "this study was to perform"; the purpose/the aim of this study was to perform? Response: Not appropriate indeed. Revised. Thanks. Background line 18: "the causes of this injury include the infection of liver virus..". I think it should be something like "the causes of this condition include the infection with hepatitis viruses, autoimmune diseases.... Response: Revised. Thanks. Results: Meta-analysis line 50: what does it means that studies that reported F1 was considered inappropriate for metaanalysis? This studies was excluded from meta-analysis? (In this case this must be included among the exclusion criteria in "material and methods") Or only the data about the F1 stage was excluded from the meta analysis while the F2-F4 data was included? Response: We really mean that studies reporting hepatic fibrosis at stage F0F1 were excluded due to insufficient number of study and number of patients. This is corrected in the revised paper. We also revised the exclusion criteria in "material and methods" to reflect this. Thanks. Discussion: last line: "studies with F0-F1 were not included due to unavailability". See the previous comment. Response: This is further clarified as in the response to above comment. Thanks. Takahito Nakajima, M.D., Ph.D (Reviewer 2): The authors performed a meta-analysis to assess the overall performance of shear wave elastography (SWE) in the diagnosis of liver fibrosis. The manuscript was well written. However, their discussion felt to be a little different in scope from their investigation. Major issues: #1 Comparison among TE, RTE and ARFI As the authors mentioned it in the manuscript, several noninvasive quantitative techniques have become available for measurements of liver stiffness. They introduced real-time tissue elastography (RTE), transient elastography (TE), and real-time shear wave elastography (SWE). Although the comparison among these three methods would be interesting, they did not analyze such comparison. However, they discussed the difference among them. These kinds of discussion should be placed in the limitation section. Response: We have revised the discussion to enhance the comparison of these methods. However, we believe that including these comparison in the limitation section, as the reviewer suggested, appears to be inappropriate and we therefore leave these comparisons in other parts of Discussion. Thanks. #2 Main discussion points: What are the main factors that affect the evaluation performance for the liver stiffness. The main discussion point is not #1 but factors that affect the sensitivity or staging. The authors should discuss the factors and their effects on classifications or performances. The "diagnosis cutoff threshold" should be discussed as the authors noted. Response: We have revised the discussion to address the factors that affect the evaluation performance of SWE, as well as the diagnosis cutoff threshold. #3 Definition or difference of the term: "SWE" and "ARFI" In this manuscript, some confusions are noticed, especially between SWE and ARFI. These terms would be almost the same, but the authors should define the difference and the usage of these technical terms. Minor issues: p11L3, ...staging early cirrhosis (F4) > ..staging early cirrhosis (F1) Table 1, averaged age: add the range of ages. Figure 3, What do the dots in SROC graphs indicate? > The definition or explanation of the ROC curves and the dots should be noted in a figure legend or a manuscript. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://static-content.springer.com/openpeerreview/art:10.1186%2Fs12880-020-0414-5/12880_2020_414_AuthorComment_V2.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
