Review for 10.1186/s12876-021-02007-w (2021)

Reviewer’s report
Title: 
A neutrophil-to-lymphocyte ratio-based prognostic model to predict
mortality in patients with HBV-related acute-on-chronic liver failure
Version: 
1 
Date: 
21 Jun 2021
Reviewer's report:
Major concerns:
1) The level of the English language is not appropriate for publication.
Throughout the text, there are numerous ambiguous expressions. The manuscript
should be rewritten and these expressions should be reformulated/avoided;
Eg: Page 3, line 51: "Using middle-long term and reliable prediction with
frequently-used variables, therefore, is important for patient classification and
therapeutic guidance"
2) The Child-Pugh score has been widely used and validated for the prognostic
of patients with liver cirrhosis. Please explain why you chose not to include the
Child-Pugh score in the analysis.
3) The MELD score has been validated for patients with liver cirrhosis.
Although it has been used to assess waitlist mortality in patients with ACLF the
utility of this score outside of the analysis of patients with liver cirrhosis is still
under debate. A subgroup analysis of the patients with and without cirrhosis
would be welcome in order to clarify this issue.
Minor concerns:
1) Regarding the statistical analysis, the distribution of the continuous variables
should have been analyzed. This is important as variables with a normal
distribution should be expressed as mean +/- SD. Please update the statistical
analysis accordingly.
2) Please clarify the statement: "Artificial liver support 
was utilized based on
clinical state of each patient." (page 4, line 51).
3) Please replace "Artificial liver history" with "Artificial liver support history"
(Page 15, Table 1,).
4) Please rephrase: "Baseline data was defined as the poorest result/score
obtained in the 24-hour period during hospitalization" at page 4 line 59. The
authors reffer to the first 24 hours of hospitalization?
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes