Review for 10.1186/s12876-025-04095-4 (2025)

Title: Long-term Quality of Life After Acute Pancreatitis: A Systematic Review and Meta-
Analysis
Version: 0 Date: 19 Feb 2025
Reviewer's report:
The manuscript presents a systematic review and meta-analysis on [insert specific topic based
on the study’s focus], offering a critical synthesis of the existing literature. The study is relevant
and addresses an important gap in the field. However, several aspects require improvement to
ensure rigor, clarity, and scientific quality.
As a systematic review and meta-analysis, this study does not require approval from an
Institutional Review Board (IRB) or Ethics Committee, as it does not involve direct human
participant research or new data collection. However, it is recommended that the authors
explicitly state this in the Methods section to clarify this for readers and reviewers.
Specific Review Sections
1. Methodology
PRISMA Guidelines Compliance: The study should strictly adhere to PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Ensure that all
checklist items are fully addressed, including search strategy, study selection, and risk of bias
assessment.
Eligibility Criteria: Inclusion and exclusion criteria should be explicitly detailed, with
justifications to improve transparency and reproducibility.
Search Strategy and Databases: The manuscript should specify which databases were searched
(e.g., PubMed, Embase, Scopus, Web of Science, Cochrane Library), the timeframe of the
search, and whether gray literature or manual searches were conducted to minimize publication
bias.
Data Extraction and Synthesis: Authors should clearly describe:
How data were independently extracted by multiple reviewers.
How disagreements in study selection were resolved.
Whether automation tools (e.g., Covidence, Rayyan) were used for systematic screening.
Risk of Bias Assessment: The manuscript should specify which tool was used to assess the risk
of bias (e.g., Cochrane Risk of Bias 2 for RCTs, ROBINS-I for observational studies). Results
should be presented systematically.
2. Statistical Analysis (Meta-Analysis)
Heterogeneity Assessment: Authors should report measures of statistical heterogeneity:
I² statistics (low: <25%, moderate: 25–50%, high: >50%).
Cochran’s Q-test to evaluate heterogeneity across studies.
Choice of Meta-Analytic Model: Justification should be provided for using either a random-
effects model (e.g., DerSimonian and Laird) or a fixed-effects model (e.g., Mantel-Haenszel)
based on heterogeneity levels.
Publication Bias: Funnel plots and Egger’s regression test should be performed to evaluate
potential publication bias.
Sensitivity Analysis: Sensitivity analyses should be conducted to test the robustness of findings,
particularly if substantial heterogeneity is present.
3. Results & Data Presentation
Forest Plots: Ensure all forest plots are clearly labeled, include effect sizes (OR, RR, HR, SMD),
and display 95% confidence intervals (CIs).
Subgroup Analyses: If applicable, subgroup analyses should be performed based on study
characteristics (e.g., intervention type, study design, population) to explore potential sources of
heterogeneity.
Data Consistency: Effect sizes should be consistently reported and correctly interpreted across
the manuscript.
4. Discussion
Contextualization with Literature: While the discussion presents key findings, it should be
expanded to include comparisons with prior systematic reviews and meta-analyses on the
same topic. Additionally, authors should contrast their findings with observational studies,
randomized controlled trials (RCTs), and other research methodologies that have explored
similar research questions. This will:
Provide a comprehensive perspective on the topic.
Highlight differences in findings due to variations in methodology, population, and
interventions.
Discuss the advantages and limitations of systematic reviews and meta-analyses compared to
primary research studies.
Clinical and Research Implications: The discussion should explicitly detail how findings
contribute to clinical practice or future research.
Causal Interpretation: If the study includes observational data, causal claims should be carefully
framed, considering potential biases.
5. Conclusion
The conclusion should align with key findings without overstating significance.
Authors should suggest directions for future research, particularly in areas where existing studies
show inconsistency or where high-quality trials are needed.
6. Ethical Considerations
Ethical Approval Not Required: As this is a systematic review and meta-analysis, it does not
require ethical committee approval. However, authors should explicitly state this in the Methods
section for clarity.
Conflict of Interest Disclosure: Authors should clearly disclose any funding sources or conflicts
of interest.
Final Recommendation
Major Revision Required: The study requires significant improvements in methodology,
statistical justification, and comparative contextualization with different study types before
being considered for publication.
Suggested Actions for Authors:
Ensure full PRISMA compliance, including transparency in study selection and bias assessment.
Strengthen statistical analysis by justifying model selection and addressing heterogeneity
concerns.
Clarify methodological aspects, including data extraction, eligibility criteria, and analytical
approaches.
Revise figures and tables to improve clarity and interpretability.
Expand the discussion to compare findings with other systematic reviews, meta-analyses,
observational studies, and randomized trials.
Explicitly state that ethical approval is not required.
Once these revisions are made, the manuscript will be substantially strengthened for potential
acceptance.
This review aims to constructively enhance the manuscript’s scientific quality and impact. I look
forward to reviewing a revised version that incorporates these recommendations.