Review for 10.1186/s12876-021-02081-0 (2022)

Reviewer’s report
Title: 
Comparing Colon Capsule Endoscopy To Colonoscopy; A Symptomatic
Patient’s Perspective
Version: 
0 
Date: 
21 Jun 2021
Reviewer's report:
The topic of the article is very interesting for those involved in endoscopy and/or
CCE. However, in my opinion, the argumentation for the statistical evaluation,
and in particular a sample size calculation were lacking. If the appropriate
number of patients has not been included, all conclusions based on these data are
irrelevant and not transferable to other patient groups. A way around would be to
describe it as a pilot, but one cannot state that the results of this trial are 100%
reliable. That's why I don't agree with the article's summary. One could
definitely offer a CCE to a patient, but according to ESGE guidelines
colonoscopy and CTC are still the preferred methods of investigation, making
CCE mostly an option in those that would not be accepting one of the other
investigations. 
In the discussion I am missing a thorough evaluation of the weaknesses of this
study, for example, how good is the recollection of patients after an average of
over 6 months of a particular health care experience? Especially under the
influence of midazolam in case of colonoscopy?
Other concerns: in the introduction the ESGE guideline is referenced, however,
the newest guideline dates from 2020 (Spada et al.), and would not recommend
CCE: it could be considered in patients with non-alarm symptoms (weak
recommendation). 
Move the information that all patients participated in a trial, with a heading study
population over to methods. 
Results: The subgroup analysis is nicely portraied in table 4, why write all the
same data in the text as well? Refer to the table, and keep your text simple. Table
4 should be outfitted with an extra column describe 95% CI, and all p-values
should be presented with the same number of decimals. 
All redundant information, like the risk on aspiration of the capsule, should be
removed from the article, in order to keep it focused and accessible. The
discussion could also be more organised, discussing strenghts and weaknesses
sequentially.
Small adjustments: no capital letters with colonoscopy (in aims), endoscopist,or
clinician. 
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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?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes