Review for 10.1186/1471-230X-8-13 (2008)

Reviewer's report
Title:Prevalence and determinants of biochemical dysfunction of the liver in
Atayal aboriginal community of Taiwan: Is betel nut chewing a risk factor?
Version: 1Date:14 July 2007
Reviewer: Hans Lin
Reviewer's report:
General:
1. This paper deals with factors associated with abnormal biochemical tests for
liver diseases and focuses on betel quid chewing habit. This issue has been
discussed and published previously (Lin HH et al, J Formosan Med Assoc
101:826-834, 2002). The authors stressed the role of betel quit chewing,
however, as reflected from the data the authors provided, betel quid chewing is
not a major factor. Other factors had stronger association. The most important
ones are hepatitis virus infection and alcohol. The conclusions are misleading.
The authors can emphasize the role of betel quid chewing if they think it is so
important, which is not a new finding, but should state it in a milder tone.
2. The English was not well written and need some corrections and polishing.
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached):
1. In the Method section of Abstract, the readers may be falsely impressed to
think all the residents were aborigines. It should be mentioned that around 70%
of residents in this village were aborigines to avoid confusion.
2. All significant factors associated with abnormal AST/ALT or liver cirrhosis
should appear in the Result section of the Abstract, and expressed in the order of
relative importance.
3. In the Conclusion section of the Abstract, a phrase such as “among other
known factors,” should be added, to avoid misleading impression that only
aboriginal ethnicity and betel quid chewing were important.
4. Result: 1st paragraph, 12th line: What is the meaning of “…although there was
no significant difference in the proportion of people who were overweight.” The
association of overweight and abnormal liver function test is not so straight
forward.
5. Result: 1st paragraph, 13th line: “As expected” should be deleted. If it is as
expected, this manuscript is meaningless.
6. Page 10, the last sentence should be deleted or move to Discussion.
7. In Table 1: “BMI” should be in the rows rather than in the columns.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
1. There should be only one number after the decimal point for all numerals for
uniformity. In 1st line of the Result section of the Abstract: “…21.2% …” instead
of “…21% …”. In 5th line of the Result section of the Abstract: “…1.5 …” instead
of “…1.55 …”.
2. Page 10, 2nd paragraph, 5th line: “…46+14 years.…” should be “…46±14
years. …”.
3. Table 1: the 1st column: “Sex” should be replaced with “Gender” for uniformity,
and “HbsAg” should be replaced with “HBsAg”.
4. The 2nd row under HBV/HCV in Table 3 was mistyped as “-/-“, which should
be “+/-“.
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Discretionary Revisions (which the author can choose to ignore)
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.