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Since the author has addressed all the questions and all the reviewers agree to publish this article, I believe this article is suitable for acceptance and publication.
Thanks to the authors for their hard work on the revision.
Now I think it's up to publication standard.
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The manuscript has been revised according to the comments.
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95% CI should be correctly presented. e.g. (RR= ; 95%CI: [XX, XX]); P= XX)
So many grammar errors and typos can be found in this paper. Please correct.
Please re-edit the language and make revisions according to the reviewers' comments.
**PeerJ Staff Note:** Please ensure that all review, editorial, and staff comments are addressed in a response letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.
**Language Note:** The Academic Editor has identified that the English language must be improved. PeerJ can provide language editing services - please contact us at copyediting@peerj.com for pricing (be sure to provide your manuscript number and title). Alternatively, you should make your own arrangements to improve the language quality and provide details in your response letter. – PeerJ Staff
This study aimed to comprehensively investigate the potential association between serum phosphate levels and the prognosis of sepsis, shedding light on its clinical implications. However, several critical points warrant attention and should be addressed to ensure the rigor and clarity of the research findings:
1. The authors should take steps to supplement the publication bias analysis by providing additional details and corresponding results. Addressing this aspect would enhance the credibility of the study and strengthen the evidence supporting its conclusions.
2. In order to adhere to standard scientific writing conventions, it is suggested that P-values be presented in italics throughout the manuscript. This simple formatting adjustment will ensure consistency and make the statistical results visually distinguishable.
3. It is crucial to further refine the discussion section of the paper. A comprehensive and coherent discussion will not only help readers better understand the significance of the findings but also provide valuable insights into the potential mechanisms underlying the observed association between serum phosphate and sepsis prognosis.
4. Consistency in the font size of the figures is of utmost importance. Maintaining uniformity in the presentation of graphical data will facilitate their interpretation and avoid potential confusion for the readers.
5. Several grammatical errors and incorrect sentences have been identified in the introduction, discussion, and conclusion sections. These issues need to be carefully addressed through thorough proofreading and editing to ensure the clarity and accuracy of the manuscript.
6. The purpose of the study must be appropriately stated to reflect precisely what the research was about. A well-defined and concise statement of the study's objectives will provide readers with a clear understanding of the research focus, guiding them through the rest of the paper with clarity and purpose.
By addressing these points, the study will be significantly strengthened, and its findings will hold greater value for the scientific community. Rigorous attention to detail and precise communication of research outcomes are essential to advance knowledge and improve the management of sepsis, making this study a valuable contribution to the field of medical research.
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1.In 3.3.1.1 Hyperphosphatemia vs Normophosphatemia,"In order to explore potential sources of heterogeneity, a subgroup analysis was performed by data outcomes from single or multiple factors…”.Why not presented the results of the subgroup analysis?
2.According to the Cochrane Handbook, heterogeneity between studies can be considered when I squared is greater than 50%. It is therefore recommended that the authors consider a subgroup analysis of the results of 3.3.1.3.
3.Section 3.4 has a similar problem with comment 2. In addition, heterogeneous results are not appropriately placed in supplementary material.
4."levels, it was found that the results of the study conducted by Li, Z et al.(23) had a significant impact on meta-analysis results. As a result, this article was eliminated from the analysis. In contrast, the sensitivity analysis results for other outcomes were relatively robust", Li, Z et al.(23)
5.The study of Li, Z et al.(23) has the most weight in most of the results in the paper, and the results presented in the paper also play an important role in this paper. If the article is eventually eliminated from the analysis, should both pre-eliminating and post-eliminating results be presented in the graph?
6.As mentioned in discussion, "A study conducted by Li, Z. et al. was a registry database-based study of 11,658 sepsis patients, with 2,749 with low serum phosphate levels and 2,423 with high serum phosphate levels.” Please explain why such an article is appropriate for use in meta-analyses.
7.It is proposed to revise the discussion, the current version is unattractive to read and lacks logic.
The authors analyzed the prognostic value of serum phosphate levels in patients with sepsis through systematic review and meta-analysis, which has certain research significance. Overall, the topic addressed in this manuscript is both interesting and important. However, there are fundamental errors that impact the overall quality of the paper, and the authors need to address these concerns before it can be considered for publication.
Comments:
1) Authors should refer to the published literature and express the 95%CI value in the correct way.
2) All abbreviations should be spelled-out in the first appearance.
3) The author should check the punctuation of the whole manuscript and make sure that they are represented in English punctuation.
4) In this manuscript, there is no statistical difference in most of the conclusions drawn by the authors. Please describe the purpose of this paper and its guiding significance for future clinical practice.
5) The manuscript was poorly written. A large number of typos and grammatical errors were seen throughout the whole manuscript. I would recommend it to be proofread by a fluent English speaker.
In conclusion, the topics discussed in this manuscript are of substantial scientific interest. However, the current structure, organization, scientific content and accuracy need to be improved. Solving the above problems will greatly improve the quality of manuscripts and make them more suitable for publication.
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