Review for 10.1186/s12876-023-02656-z (2023)

Reviewer’s report
Title: 
Alcohol treatment discussions and clinical outcomes among patients with
alcohol-related cirrhosis
Version: 
0 
Date: 
13 Sep 2022
Reviewer's report:
This manuscript addresses the important clinical topic of AUD treatment in
patients with alcohol-related cirrhosis. The strengths of this study are:
1)structured approach on documentation of how AUD is addressed by
hepatologists, 2)AUD treatment recommendations by hepatologists, and
3)clinical outcomes in patients with alcohol-related cirrhosis.
Questions for authors
1: Does the final cohort include 433 patients (as mentioned in page 7 row 11) vs
493 patients (used for baseline AUD data - page 7 row 22) vs 436 patients (table
1,2,3, figure 1,2)?
2: What happened to the 203 patients not actively drinking at baseline visit?
Should have a breakdown (abstinence vs alcohol use in followup) similar to the
group with alcohol use at baseline
3: There are a lot of "x" in Figure 1, is this the final figure?
4: While it is certainly important for the hepatologists to advise on AUD, likely
these discussions are not limited to hepatologists, so it is possible patients
stopped alcohol or engaged in AUD treatment after discussing with PCP or
social worker. Any chance to capture at least social work consults? As the
number of patients on treatment is low, it could be feasible to do further chart
review to figure out contribution of PCP/SW re AUD treatment. Also could
referrals to behavioral therapy be captured - and who initiated the referral?
Without more data, not sure if the authors can make the argument that AUD
discussion with hepatologist lead to treatment initiation. If this data cannot be
obtain, it should be addressed in "Limitations". I still think this study has
generated important data, relevant to clinicians.
Minor edits
-page 6 row 38: "Analyses were completed in R."
-page 8 row 48: "treatment at base="font-family:Arial; color:#0e101a"
-page 11 row 27: "investigation.20 <="" span="">"
-page 11 row 33: "treatment but also equity of that treatment.7, 2122"
-page 11 row 56: "these conversations was associated with improved initiation."
-page 12 row 6: "actively engagedn AUD"
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