Review for 10.1186/s12876-025-03886-z (2025)

Title: The relationship between the eradication of Helicobacter pylori and the occurrence of
stomach cancer: an updated meta-analysis and systemic review
Version: 2 Date: 11 Mar 2025
Reviewer's report:
This article provides an updated meta-analysis on the correlation between Helicobacter pylori
eradication and the incidence of gastric cancer, based on the most recent evidence, thereby
deepening our comprehension of the link between Helicobacter pylori eradication treatment and
the development of gastric cancer. In my view, the paper has some issues that require further
modification and settlement.
1.Overall, the language in this article needs further revision as many expressions do not conform
to conventional conventions, such as "extermination" which should be changed to "eradication".
There were also many other similar expressions in the article that did not conform to conventions.
Please carefully review the entire text and make further revisions.
2.All phrases “helicobacter pylori” in the article should be italicized.
3.Abstract: the description of the sentence (“In the subgroup analysis, 0.67 and the occurrence
of cancer of the stomach among healthy adults was recorded at 0.67 (RR: 0.67; 95% CI: 0.48
~0.93; NNT = 476).”) was incorrect.
4.Abstract: Please confirm if 'endoscopic mucosal surgery' is correct, isn't it 'endoscopic mucosal
resection'?
5.Methods: The PRISMA guideline referenced by the author was outdated as it has been
updated to the latest version-PRISMA 2020 statement, please refer to the recent 2020
statement (The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
BMJ.2021;372: n71).
6.Methods: The Authors used the Cochrane risk of bias (RoB) tool to assess the risk of bias in the
included studies. The RoB tool has been recently updated and the RoB-2 is now recommended
(RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898).
Therefore, the Authors should use the RoB-2 to assess the risk of bias.
7.Methods: the statistical significance of heterogeneity was determined at P < 0.05 in the
statistical analysis section is not fully accurate given the higher threshold used in the Cochran’s
Q- test (P < 0.1). In addition, random or fixed effects models should not be selected based on
the size of I2 value. I suggest that the authors use random effects models for meta-analysis, as it
considers the differences between studies and produces more conservative and reliable results.
8.Methods: the description of the sentence “For outcomes exhibiting low diversity” was
incorrect.  What does' low diversity 'mean?
9.Results: Table 1 was very ugly and did not present the content of the article well.
10.Results: The author should use the latest RoB-2 tool to evaluate the risk of bias in the article
and present the results using the "Risk of Bias Summary" figure.
11.Results: the “Sensitivity study” should be changed to “Sensitivity analysis”.
12.In the discussion, the author did not point out the advantages and similarities and differences
between this study and the latest meta-analysis on Helicobacter pylori eradication and prevention
of gastric cancer (doi: 10.1053/j.gastro.2024.12.033).
13.The reference format in the article was inconsistent and confusing.