Review for 10.1186/s12876-020-01240-z (2020)

Reviewer’s report
Title: Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty
liver disease: The GOASIA study
Version: 0 Date: 28 Sep 2019
Reviewer: David Kleiner
Reviewer's report:
This study describes the utility of the generally accepted non-invasive fibrosis surrogates in identifying
which elderly patients with fatty liver disease have advanced fibrosis.  The study combines data from
multiple medical centers across Asia from cohorts collected at various times over the last 16 years.  The
main result is that the readily available calculated indices of fibrosis are not as useful in the elderly
Asian population, similar to results obtained from cohorts in other parts of the world.  There are only a
couple of issues that could be addressed that would be of benefit to readers.
1. Description of cohort - Given that the patients were drawn from different (but overlapping) time
periods and from multiple centers, were there any significant differences in patient demongraphics or in
the distribution of liver disease seen on biopsy that might affect interpretation of the results?
2. Methods - collection of laboratory data.  What was time interval between the laboratory test results
and the liver biopsy?  Was there an outer limit?
3. Results - The results are all expressed as summary data statistics.  It would be useful to include a
figure showing the distribution of non-invasive index results plotted against fibrosis stage comparing
the elderly to the younger patients. 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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