Review for 10.1186/s12876-021-01660-5 (2021)

Reviewer’s report
Title: 
A Randomised Placebo Controlled Trial of VSL#3® Probiotic on
Biomarkers of Cardiovascular Risk and Liver Injury in Non-alcoholic Fatty
Liver Disease
Version: 
1 
Date: 
18 Sep 2020
Reviewer's report:
I am honored to review this manuscript. This study tried to investigate the effects
of VSL#3 
(Danisco Inc.) probiotic supplementation on markers of cardiovascular
risk and liver injury in patients with NAFLD. It is a randomized placebo
controlled trial. VSL#3 did not significantly improve markers of cardiovascular
risk and liver injury in patients with NAFLD. The sample size may not be
enough. It's a relatively small sample and a 10-week intervention may be
considered too short to achieve clinically meaningful results.
MAJOR COMMENTS
1. Statistical analysis of Table 2 is not appropriate. Four groups are
heterogeneity. It should be divided into two tables. One table is the comparison
between the two groups before treatment and the other is the comparison
between the two groups after treatment. 
MINOR COMMENTS
1. Recruitment began in May 2012 and ended in March 2014 when the study
closed. But this trail was registered 9 August 2012 as a retrospectively
registration.
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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