Chen R, Luo L, Zhang YZ, Liu Z, Liu AL, Zhang YW. Bayesian network-based survival prediction model for patients having undergone post-transjugular intrahepatic portosystemic shunt for portal hypertension. World J Gastroenterol 2024; 30(13): 1859-1870 [PMID: 38659484 DOI: 10.3748/wjg.v30.i13.1859]
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07941024
Submitted on:
April 15, 2024, 07:00
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Reader Comments:
Portal hypertension (PHT) is when increased pressure in the portal vein system causes various clinical syndromes, mainly seen in advanced cirrhosis. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) is commonly used to treat PHT and its complications. However, there's still a risk of further health decline and death after TIPS, highlighting the need for accurate models to predict patient outcomes and improve survival rates. Current models for predicting survival after TIPS are not comprehensive, missing some critical factors and their interactions. It is essential to analyze these factors thoroughly to refine prognosis predictions, aiming to better treatment approaches and patient outcomes.
The authors utilized a Bayesian networks（BNs） model combined with clinical data to construct a predictive model for patient survival after TIPS. The meticulous selection of variables through Cox and least absolute shrinkage and selection operator regression methods strengthens the model's reliability. The inclusion of key factors such as age, ascites, hypertension, and postoperative portal vein pressure, among others, ensures a comprehensive assessment of patient prognosis. The model's impressive accuracy, precision, recall, and F1 score, coupled with its ability to predict 2-year survival, make it a valuable tool for clinicians in strategizing treatment and evaluating prognosis. By creating a BN-based model to predict survival, this study marks a big step forward in personalized medicine. It helps the clinical physicians better understand how different factors affecting PHT interact and influence patient outcomes.
However, there are certain limitations to this study. Firstly, the training and verification data used in the model were obtained from the same hospital, which lacks external validation and may introduce selection bias. Additionally, the sample size is limited, necessitating further confirmation of its predictive universality through prospective studies in the future. Secondly，recent research has indicated a close association between sarcopenia and postoperative outcomes in tips procedures. Therefore, it is necessary to investigate whether sarcopenia can be incorporated into this prognostic model in future studies. Furthermore，all existing postoperative prediction models for tips fail to consider how heterogeneity within tips surgeries impacts prognosis. It would be worthwhile exploring whether variables related to tips surgery can be integrated into this prognostic model as well.
Reply from the Editorial Office:
First, thank you very much for your professional comments on the article published in World Journal of Gastroenterology.
Second, we read your comments with great interest. You are welcome to format your valuable comments into a Letter to the Editor and submit it online to World Journal of Gastroenterology at https://www.f6publishing.com. There are no restrictions on the number of words, figures (color, B/W) or authors for a Letter to the Editor. In addition, the article processing charge will be exempted for this Letter to the Editor. As with all articles published by the Baishideng Publishing Group, the Letter to the Editor will be published online after completing peer review. The guidelines for a Letter to the Editor can be found at: https://www.wjgnet.com/bpg/GerInfo/219.
Finally, we look forward to receiving your high-quality Letter to the Editor, which will promote academic communication and lead the development of this discipline.
Reader's ID:
06407411
Submitted on:
April 12, 2024, 10:42
Reader Expertise:
Reader’s expertise on the topic of the manuscript
Conflicts-of-Interest Statement:
Does the reader have a conflict of interest?
Reader Comment Standards for Published Articles:
1 Title
Does the title reflect the main subject/hypothesis of the manuscript?
2 Abstract
Does the abstract summarize and reflect the work described in the manuscript?
3 Key Words
Do the key words reflect the focus of the manuscript?
4 Background
Does the manuscript adequately describe the background, present status and significance of the study?
5 Methods
Does the manuscript describe methods (e.g., experiments, data analysis, surveys, and clinical trials, etc.) in adequate detail?
6 Results
Are the research objectives achieved by the experiments used in this study?
Has the study made meaningful contributions towards research progress in this field?
7 Discussion
Does the manuscript interpret the findings adequately and appropriately, highlighting the key points concisely, clearly and logically?
Are the findings and their applicability/relevance to the literature stated in a clear and definite manner?
Is the Discussion accurate and does it discuss the paper’s scientific significance and/or relevance to clinical practice sufficiently?
8 Illustrations and Tables
Are the figures, diagrams and tables sufficient, good quality and appropriately illustrative of the paper contents?
Do figures require labeling with arrows, asterisks, etc., or better legends?
9 Biostatistics
Does the manuscript meet the requirements of biostatistics?
10 Units
Does the manuscript meet the requirements of use of SI units?
11 References
Does the manuscript appropriately cite the latest, important and authoritative references in the Introduction and Discussion sections?
Does the author self-cite, omit, incorrectly cite and/or over-cite references?
12 Quality of manuscript organization and presentation
Is the manuscript concisely and coherently organized and presented?
Are the style, language and grammar accurate and appropriate?
13 Ethics statements
For all manuscripts involving human studies and/or animal experiments, author(s) must submit the related formal ethics documents that were reviewed and approved by their local ethical review committee. Did the manuscript meet the requirements of ethics?
Scientific Quality:
The overall quality of the manuscript, based on the above-listed criteria, should be evaluated and classified according to the following five categories
Language Quality:
Language quality (style, grammar, and spelling) should be evaluated and classified according to the following five categories.
Reader Comments:
The study exhibits a robust scientific methodology, utilizing retrospective analysis of clinical data from a substantial sample size of 393 patients. The selection of variables through Cox regression and least absolute shrinkage and selection operator regression methods enhances the credibility of the findings. The establishment of a Bayesian network-based survival prediction model reflects an innovative approach to address the limitations of existing prognostic models. Moreover, the model's validation through cross-validation techniques adds to its reliability. However, further validation studies in diverse patient populations would strengthen the generalizability of the model.
Reply from the Editorial Office:
First, thank you very much for your professional comments on the article published in World Journal of Gastroenterology.
Second, we read your comments with great interest. You are welcome to format your valuable comments into a Letter to the Editor and submit it online to World Journal of Gastroenterology at https://www.f6publishing.com. There are no restrictions on the number of words, figures (color, B/W) or authors for a Letter to the Editor. In addition, the article processing charge will be exempted for this Letter to the Editor. As with all articles published by the Baishideng Publishing Group, the Letter to the Editor will be published online after completing peer review. The guidelines for a Letter to the Editor can be found at: https://www.wjgnet.com/bpg/GerInfo/219.
Finally, we look forward to receiving your high-quality Letter to the Editor, which will promote academic communication and lead the development of this discipline.