PONE-D-22-12892Reference intervals for common clinical chemistry parameters in healthy adults of Northeast EthiopiaPLOS ONE

Dear Dr. Fiseha,

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Academic Editor

PLOS ONE

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Additional Editor Comments:

Dear Dr. Fiseha,

Your manuscript “Reference intervals for common clinical chemistry parameters in healthy adults of Northeast Ethiopia” has been assessed by our reviewers. They have raised a number of points which we believe would improve the manuscript and may allow a revised version to be published in PLOS ONE. Their reports, together with any other comments, are below.

If you are able to fully address these points, we would encourage you to submit a revised manuscript to PLOS ONE.

Best regards,

Dr. Donovan McGrowder

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Dear Authors,

I would like to highlight the need for the articles like this which target the specificity of the population. The article is well written, the hypothesis is formulated clearly, and I identified only minor flaws that should be addressed.

Please, change the chemical parameters into biochemical parameters/values/test/reference, etc. in the whole article (it is widely used).

Abstract:

1. the glucose value does not have a unit - mg/dL

2. the analyzer Dimi CS-T240 does not need "chemistry" in its "name", please delete (the same in the material and methods part)

Sample size and sampling techniques:

1. please describe more concrete how the participants were selected - for example at the beginning of the study involved 1000 participants, after exclusion only 344 were suitable for the study.

2. Please describe/characterize better participants (not only age, sex), add e.g. BMI

3. do you think that 60 min clothing of blood samples at RT can affect the reached data?

4. in the article is mentioned that sampling was provided between 8 - 11 am. This is too big a time gate... Do you know the time of starvation of the participants who came for blood sampling at 11 am?

5. do you have any information about how long/far the probands have to travel (by car, by foot - run) to reach the sampling date?

Results:

1. A total of 325 (164 males and 164 females) - in the abstract is 344 participants... how?

Discussion:

I would appreciate the explanation of the obtained results more than a comparison.

Reviewer #2: A well written article, on an important subject.

Errors:

Table 1: U/L: units per litter -> units per Liter (also in Table 2 and Table 3)

AST - Females, 90% CI (lower limit) "5.0, 16.0" should propably be "15.0, 16.0"

It would be helpful, if the Discussion included the important distinction between a 95% reference interval determined in a specific, local group and relevant diagnostic thresholds. When all participants are apparently healthy, no conclusions can be drawn regarding diagnostic significant values.

It is important to determine the local "normal values", but also to allow for diversity, when setting thresholds for diagnostic significance (hopefully the clinicians also recognise this).

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Reference intervals for common clinical chemistry parameters in healthy adults of Northeast Ethiopia

PONE-D-22-12892R1

Dear Dr. Fiseha, 

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Donovan Anthony McGrowder, PhD., MA., MSc

Academic Editor

PLOS ONE

Additional Editor Comments:

Dear Dr. Fiseha,

The manuscript was revised in accordance with the reviewers’ comments and is provisionally accepted pending final checks for formatting and technical requirements.

Best regards,

Dr. Donovan McGrowder (Academic Editor)