Review for 10.1186/s12876-021-01858-7 (2021)

Reviewer’s report
Title: 
Normalisation of the psychometric encephalopathy score within the
Cameroonian population
Version: 
1 
Date: 
21 May 2021
Reviewer's report:
The authors provided proper answers. A limit for this study that this referee
suggest to mention at the end of the discussion is the following. "A further limit
of the study is that the reference population was younger and with higher
education than cirrhotic patients and this fact may have influenced cut-off
values, despite the tests were standardized for age and education. Further
prospective studies will confirm the best cot-off for a diagnosis of MHE in
Cameroon". 
In fact, the parameters of the equation derived by a population
younger and with higher education can be inadequate in another range of age and
education, since the effect of age and education on psychometric performance
are not linear. 
This referee do not want enter into this complex problem (some
reference can be provided, if required), but it is useful to maintain the issue open
for future validation.
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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
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from apparent manipulation?
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