Review for 10.1186/s12876-022-02111-5 (2022)

Reviewer’s report
Title: 
Nonthyroidal illness syndrome in acute pancreatitis patients: an 8-year
cohort study
Version: 
0 
Date: 
30 May 2021
Reviewer's report:
This manuscript evaluated the clinical impact of free triiodothyronine (FT3) to
predict mortality in acute pancreatitis. This manuscript states some important
issues regarding risk factors of mortality in acute pancreatitis. However further
discussion would be required to confirm this conclusion. Therefore, authors
would clarify several matters that mentioned below.
1. Authors focus on nonthyroidal illness syndrome in acute pancreatitis.
Therefore, the subject of multivariate analysis for risk factors of mortality in
Table 4 should be acute pancreatitis with nonthyroidal illness syndrome.
However, it is unclear which was the subjects in Table 4, just acute pancreatitis
patients with nonthyroidal illness syndrome or all patients with acute
pancreatitis. Authors could clearly describe the subjects in Table 4. 
2. Which of categorical variable or continuous variable in multivariate analysis
was used for each variable such as FT3, FT4, and so on, in Table 4? Authors
could describe about this in Statistical analysis. 
3. Several studies have reported that higher APACHE II score, SOFA score,
Balthazar's CT score predicted severity, organ failure, and complications leading
to mortality in acute pancreatitis. However, in this study, these scoring systems
were not analyzed for multivariate analysis in Table 4. Authors could reevaluate
risk factors of mortality after adding these scoring systems as variables. 
4. Author reported that lower FT3 predicted mortality in acute pancreatitis.
Authors could evaluate whether FT3 was correlated with APACHE II score or
SOFA score by calculating correlation coefficient to confirm this conclusion.
5. In this study, nonthyroidal illness syndrome contains both low FT3 with
normal TSH and low FT3 with low TSH. How did the value of TSH in
nonthyroidal illness syndrome affect severity of acute pancreatitis? Authors
could discuss about the clinical impact of TSH in nonthyroidal illness syndrome.
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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
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No
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No
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from apparent manipulation?
Yes