Review for 10.1186/s12876-024-03372-y (2024)

Title: Diagnostic Yield of Bidirectional Endoscopy for Iron Deficiency Anemia in Young
Patients
Version: 1 Date: 01 Jun 2024
Reviewer:  Mohamed El- Badry
Reviewer's report:
Thank you for the opportunity to review the manuscript titled "[ Diagnostic Yield of
Bidirectional Endoscopy for Iron Deficiency Anemia in Young Patients]". I have carefully
evaluated the work and provided detailed feedback in this report. My aim is to assist the authors
in strengthening their manuscript and to contribute to the journal's high standards for publication.
Regarding methodeology:
• The methodology is clearly written and outlines the study design (retrospective chart review).
• Inclusion and exclusion criteria are well-defined.
• Briefly mentions data analysis steps.
These points should be considered:
• Sample Size: Consider mentioning the anticipated sample size based on your inclusion criteria
and timeframe. This helps assess the generalizability of your findings.
• Justification for Age Limit: Briefly explain why the study focused on patients under 45 with
IDA. Is this a specific patient population of interest or a limitation of the data source?
• Iron Deficiency Definition: While ferritin cut-off is provided, consider mentioning if additional
criteria for iron deficiency were used (e.g., transferrin saturation, iron parameters).
• Endoscopic Findings:
o Briefly explain the Boston Bowel Prep Score system (e.g., a score of 6 or greater indicates
adequate bowel preparation).
o Consider using a table to clarify positive upper GI and lower GI outcomes with specific
examples. This improves readability and avoids listing everything within the text.
• Data Analysis: Briefly expand on the data analysis methods used (e.g., descriptive statistics,
tests for statistical significance).
• Regarding discussion section:
These points should be considered:
• Clearly addresses the research question and justifies the use of bidirectional endoscopy in
young IDA patients.
• Compares your findings with previous studies and highlights the novelty of your data,
particularly regarding asymptomatic patients.
• Discusses limitations of the study and potential reasons for unexpected findings.
o Briefly summarize key points from previous studies mentioned before elaborating on your
own results.
o Use transition sentences to connect ideas and improve readability.
o The discussion can be condensed slightly.
o Consider combining paragraphs 2 and 3 (H. pylori testing) and streamlining some explanations
(e.g., PPI mechanism of action).
o Briefly emphasize the clinical significance of your findings. Does it suggest a need for revised
guidelines or further research directions?
Regarding conclusion:
• Clearly restates the main finding (supporting bidirectional endoscopy in young IDA).
• Briefly mentions the unexpected finding of higher yield in asymptomatic patients.
• Consider emphasizing the clinical significance of your findings. Does it definitively support
current guidelines, or does it suggest a need for further research to refine the approach for
asymptomatic patients?
• Briefly mention the limitations and their potential impact on generalizability.
• Focus on future directions:
o You can potentially combine this section with the limitations section to suggest future research
directions.