Review for 10.1186/s12876-020-01240-z (2020)

Reviewer’s report
Title: Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty
liver disease: The GOASIA study
Version: 0 Date: 18 Oct 2019
Reviewer: Chaohui Yu
Reviewer's report:
This multicenter study obtained more than 1000 patients with NAFLD confirmed by liver biopsy. The
authors found that elderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-
elderly patients. Performance of fibrosis prediction by using non-invasive scoring system including
APRI, NFS and FIB-4 were not good enough to predict the presence of advanced fibrosis stage in the
elderly.  The  study is  very interesting  and  well-performed.  The  manuscript  is  well-written  and  is
acceptable for publication after minor revision. My comments are listed below:
1. In this study, the authors reported that the AUROC of APRI, NFS and FIB-4 to predict advanced
fibrosis in the elderly NAFLD patients were 0.62 (0.52-0.72), 0.65 (0.55-0.75) and 0.64 (0.54-0.74),
respectively. In Table 4, the AUROC of APRI, NFS and FIB-4 to predict advanced fibrosis in the non-
elderly NAFLD patients were 0.67 (0.60-0.74), 0.68 (0.61-0.75) and 0.71 (0.64-0.78), respectively. A
previous meta-analysis reported that the AUROC of NFS and FIB-4 to predict advanced fibrosis in
NAFLD patients were 0.83 and 0.84, respectively (Hepatol Res 2016;46(9):862-70.). The difference
may have to be explained in the Discussion section.
2. In this study, the authors found that females were more likely to have advanced fibrosis in elderly
patients. It would be better to show the characteristics of elderly and non-elderly NAFLD patients in
different genders.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require further
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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