Review for 10.1186/s12876-025-03822-1 (2025)

Title: The prevalence of Barrett 's esophagus in Iranian patients with gastrointestinal symptoms:
a systematic review and meta-analysis
Version: 2 Date: 26 Dec 2024
Reviewer:  Milad Azami
Reviewer's report:
Dear author
Your manuscript is an interesting and favorite topic.
Please apply the following comments:
In introduction section:
1. It is stated about why this study was conducted: " Our goal was to ascertain the prevalence
of BE in Iran by combining the data from all research that evaluated the condition. In order to
discover the most effective approach for determining BE prevalence in Iran, we also sought to
evaluate the variability of BE prevalence according to the definition, geographic region, time
period, and method used."
The lack of reviewers is not a valid reason to do it, but the shortcomings between the studies
make us inclined to conduct review studies; please edited this.
In metod:
- The PRISMA guideline is for reporting, not conducting a meta-analysis.
- Why your team not searched reliable databases such as Science Direct and Cochrane Library?
-  Why your team not searched Google Scholar search engine?
-  Talk about searching for gray literature like theses.
- Why are the national and local databases of Irain (like Barakat Knowledge Network
System (http://health.barakatkns.com), (Iranian Research Institute for Information Science and
Technology (IranDoc) (https://irandoc.ac.ir), Regional Information Center for Science and
Technology (RICST) (http://en.ricest.ac.ir/), Iranian National Library (http://www.nlai.ir/) ) not
searched
- Are your team checked the references list of the retrieved articles?
- Why did you not use mesh terms?
- Your entry criteria for BE prevalence in Iran is wrong. In Table 1, all studies examined BE
in specific groups such as patients with GERD symptoms, patients with dyspepsia and patients
underwent EGD and did not include the general population.
What do you mean patients underwent EGD? Were they randomly selected from the general
population and underwent EGD? Were the patients GERD patients?
After reviewing the articles, I found out: BE prevalence among patients who were candidates
for endoscopy. So you cannot report the prevalence of BE in Iran due to non-random selection.
That's why the title of the paper is also wrong.
suggest changing the title of the article to: Prevalence of BE in Iranian patients with
gastrointestinal disorder or / symptoms (based on method of conducting studies included in
meta-analysis).
- You cannot combine the BA prevalence in SCC patients with GERD patients because it causes
bias. In the editing, Khoshbaten study must be removed.
-
Results:
- “The included studies were published between 2005 and 2014 (Table 1) from four diferent
cities of Iran; includung Tehran (n=5), Tabriz (n=1), Kashan (n=1) and Yazd (n=1).  All studies
were cross sectional with regard to study design. The sample sizes ranged from 100 to 1144
participants. BE prevalence ranged from ranged from 0% observed in a sample of esophageal
SCC cases (15) to 92% for patients with GERD symptoms (19).”
The above paragraph is not related to qualitative analysis. Please mention the results of the
qualitative review of the studies.
- The table contains abbreviations. Their full names are listed at the bottom of the table.
- The results of the qualitative analysis of each article are presented in Table 1.
- Meta-analysis reporting is confusing. Please refer to similar published articles.
- Subgroup analysis should be performed based on the year of study, province, and populations
studied (GERD patients, GERD patients, etc.) to discover the cause of heterogeneity.
In the discussion:
Should be used meta-analysis studies in Iran, such as GERD prevalence?
Azami M, YektaKooshali MH, Shohani M, Khorshidi A, Mahmudi L. Epidemiology
of multiple sclerosis in Iran: A systematic review and meta-analysis. PLoS One.
2019 Apr 9;14(4):e0214738. doi: 10.1371/journal.pone.0214738. Erratum in: PLoS One.
2019 Jul 9;14(7):e0219466. doi: 10.1371/journal.pone.0219466. PMID: 30964886; PMCID:
PMC6456231.