Review for 10.1186/s12876-020-01573-9 (2020)

Reviewer’s report
Title: 
Lusutrombopag is Effective and Safe in Patients with Chronic Liver
Disease and Severe Thrombocytopenia: A multicenter retrospective study
Version: 
1 
Date: 
26 Oct 2020
Reviewer's report:
The authors investigated the efficacy and safety of lusutrombopag treatment
before invasive procedures in the real-world setting among patients with chronic
liver disease whose platelet counts were no more than 50,000/μL. The design and
the methods of analysis of this study are reasonable. However, although it is a
multicenter study, the number of cases is small and the novelty of the study is
small compared to previous reports. 
Major comments:
1) The authors should clarify the date of the last measurement of platelet count
before procedure. The previous day of the procedure or the day of procedure ?
2) The authors divided the patients into two groups based on whether their
platelet count was below or above 50,000/
μ
L. Please clarify when the platelet
count used for grouping was measured. The maximum number or the data just
before procedure ?
3) In Table 1, the authors should indicate the period between the date of starting
lusutrombopag and the procedure because the period impact the efficacy of
lusutrombopag. The authors should also indicate this period in "each" treatment
when analyze the patients who received lusutrombopag treatment repeatedly.
Minor comments:
1) Please describe in detail the method of splenic volume measurement. The
name of software used for splenic volume measurement and so on.
2) The authors should describe how selected the variables for multivariate
analysis. Stepwise selection, or selection according to the P value in univariate
analysis, and so on.
3) Comparisons with previous reports should be described in Discussion (Page 7
Line 17).
4) In Discussion, the authors described that chronic HCV infection reduces the
platelet count. However, the sample size of this study is too small to lead this
conclusion.
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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?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes