Review for 10.1186/s12876-025-03592-w (2025)

Title: Age-period-cohort analysis of gallbladder and biliary diseases epidemiological trends
from 1990 to 2021 and forecasts for 2035: a systematic analysis from the Global Burden of
Disease Study 2021
Version: 0 Date: 09 Dec 2024
Reviewer:  Amira A A Othman
Reviewer's report:
First of all
I want to congratulate the authors on their work. In this study, He et al. utilized Global Burden of
Disease (GBD) 2021 data to analyze the global trends of gallbladder and biliary diseases, as age-
standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years
rate (ASDR). The study also explored the correlation between the estimated annual percentage
change (EAPC) of such rates and the socio-demographic index (SDI) across 204 countries
and regions. The research filled gaps in previous analyses, providing an updated and critical
foundation for precise GABD prevention strategies tailored by region, gender, and age group.
The authors handled the reviewer comments satisfactorily, nevertheless, there is an observation
for which sufficient justification must be obtained.
In General:
1. The English writing level is shallow, and it is necessary to seek help from an English language
specialist to correct spelling and grammatical errors in the entire text.
2. Simplify complex terminology wherever possible or provide brief definitions (e.g., "EAPC
represents the annual percentage change in age-standardized rates”).
3. Abbreviations must be fully written at their first appearance.
In the Abstract and Introduction Section:
4. Make the abstract simple and concise by emphasizing the most important conclusions. Please
reconstruct the abstract.
5. The introduction revealed the inclusion of updated data from 2020–2021 and future
projections. To maximize its impact, compare your findings with existing literature regarding
risk factors and socio-demographic influences, and how to improve GABD prevention and
management.
In the Methods Section:
6. Give an account on GBD data, as the data source.
7. APC modeling is not fully explained.
In the Results Section:
8. Summarize your significant findings, especially the statistical data.
9. Make a better interpretation of the results.
10. Simplify complex tables and add captions that summarize key findings.
In the Discussion Section:
11. The discussion section is one of the final parts of a research paper, in which an author
describes, analyzes, and interprets their findings. They explain the significance of those results
and tie everything back to the research question(s). In this manuscript, there is confusion
between what should be written in the introduction and discussion sections. Please reconstruct
the discussion section.
12. Discuss the importance of projected decreases in ASIR and ASMR for health systems,
particularly in aging populations.
13. Improve the limitations section such as the impact of missing data, cultural differences in
disease reporting, and assumptions in APC modeling.
14. Discuss the novelty of your study (https://doi.org/10.3389/fmed.2024.1384314,
https://doi.org/10.3389/fmed.2022.1002325, DOI:10.1097/CM9.0000000000002258, https://
doi.org/10.3389/fmed.2022.1002325) . All those papers and others are related to your study.
15. Discuss the importance of continued surveillance for emerging risk factors and the future
studies to handle them.