Review for 10.1186/s12876-025-03718-0 (2025)

Title: Impact of Simulated Animated Video Education on Patients’ Disease Uncertainty,
Anxiety, and Sleep Quality in Digestive Endoscopy Examination
Version: 2 Date: 09 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While the study describes the content of the conventional education (verbal explanation by
healthcare staff), the specifics of the animated video content are underexplored. More detail is
needed about the animation itself—its length, format, tone, and whether it covered additional
aspects such as psychological coping strategies or personalized information for patients. The
general effectiveness of animated videos in healthcare often depends on the specific content
and design, so a more detailed description would clarify why this particular intervention was
successful.
-Additionally, the duration of the video (two minutes) is noted, but more information about the
content delivery and whether patients had the opportunity to ask questions or revisit the video
would help readers understand the depth and accessibility of the education.
-Although the manuscript reports that baseline characteristics were similar between the two
groups, it would be useful to include more detailed demographic data (such as ethnicity
or socioeconomic status) and clinical characteristics. Differences in patient backgrounds
might influence how they perceive uncertainty or anxiety, and a more granular demographic
breakdown would help assess the generalizability of the findings.
-The manuscript mentions the inclusion of various GI conditions, but it would be useful to know
whether specific diseases (e.g., cancer vs. benign conditions) influenced outcomes in either
group. An analysis of whether disease type modulated the impact of the intervention could offer
valuable insights.
-The study is limited to patients from a single hospital (Banan District People's Hospital of
Chongqing), and the sample may not be fully representative of the broader population of patients
undergoing GI endoscopies. The findings would benefit from additional multicenter studies that
include more diverse patient populations, especially considering cultural or regional differences
in healthcare perceptions and responses to digital interventions.
-The study does not mention how missing data were handled. Were patients who missed follow-
up assessments excluded from the analysis? If not, how were missing data imputed? A more
thorough discussion of these aspects would improve transparency and the rigor of the statistical
analysis.
-The discussion focuses heavily on the positives of the video intervention, but the study does
not explore in detail whether certain patients (e.g., those with limited digital literacy or older
patients) might prefer or benefit more from conventional education.
The discussion mentions that sleep quality improved with both interventions, but it does not
fully explore why this occurred or how it relates to the educational interventions.
-A deeper review of the literature on how visual aids directly reduce patient stress and improve
comprehension would help justify the choice of using animated video over other educational
tools (e.g., pamphlets, verbal instructions, etc.).
-The study provides valuable insights into the potential of simulated animated video education
in improving patient outcomes in gastrointestinal care. With some refinements in the discussion
and conclusion sections, this paper has the potential to make a significant contribution to the
field.