Review for 10.1186/s12876-020-01274-3 (2020)

Reviewer ’s report  
 
Title: Effects of audio and visual distraction on patients ’ vital signs and tolerance during 
esophagogastroduodenoscopy: a randomized controlled trial  
 
Version: 0 Date: 27 Nov 2019  
 
Reviewer: Takuma Higurashi  
 
Reviewer's report:  
 
This paper concluded that Audio and visual distractions effectively improved psychological 
factors, vital signs and some of the autonomic nerve function pre and post -EGD. Distractions 
may suppress BP elevation during the latter half of EGD and lead to stab ility of autonomic nerve 
function on EGD. This is well written manuscript and novel information, however, this study has 
some limitations, in the following areas.  
  
&lt;Major＞ 
 
1. I guess the readers of this journal are mainly physian or gastroenterologist.  Then, 
POMS, PSA and HRV analysis are not familier. Therfore the auhothors should better explain 
politely why the authors choose these parameter to analys the psychological and autonomic 
nervous function. If there are familier parameters for readers to exp lain these condition, the 
authors should be better to choose it.  
 
2. The authors compared 4 groups, however, they did not discuss about audio and visual 
distractions, respectively. The authors should discuss about it.  
 
3. I don't understand why pre -procedure  distraction improve vital sign during procedure. 
Please explain it.  
 
&lt;Minor &gt; 
 
1. The manuscript needs editing by a native English speaker  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to th e authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to t he editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publi cation of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you curr ently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any  other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
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