JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-022-02413-8 (2022)

Title: Prediction of the need for emergency endoscopic treatment for upper gastrointestinal
bleeding and new score model: A retrospective study
Version: 1 Date: 04 Jun 2022
Reviewer's report:
Thank you for the opportunity to review your research about a retrospective study, prediction of
the need for emergency endoscopic treatment for upper gastrointestinal bleeding and new score
model. It is interesting for our readers of BMC gastroenterology, and I believe that your findings
are important in a clinical setting, however, your manuscript has several concerns which should
be addressed.
Major points
1. It is difficult to conclude as in lines 41 and 42 because the endpoints of the scores created
from this study are different from the endpoints of the respective scores in the past, and therefore
it is difficult to compare them.
We believe that the conclusion in lines 290 - 293 is better.
2. Since this HB score was only intenal validation, I believe that validation with another cohort
would be a more objective way to evaluate the HB score.
3. Since the endpoint was endoscopic hemostasis, the score may be valid in Japan, where
endoscopy is relatively available immediately, but may not be useful overseas, where endoscopy
is not available immediately.
4. Regarding the HB score, why is BUN scored 2 while the other items are scored 1? It seems
to me that the scoring system is not stated in the text.
5. Question for the author. Hypothetically, would you not perform an endoscopy when the HB
score is 0, 1, or 2?
Presumably, endoscopy would be performed in Japan. Would it be clinically important to predict
whether or not endoscopic hemostasis would be performed at that time?
Minor points
1. What are the details of the method used to perform endoscopic hemostasis?
2. What are the details of the disease requiring endoscopic hemostasis?
3. Do you have a collection of cases with symptoms and endoscopy performed within 6 hours?
It would be easier for the readers to understand if you made a flowchart Figure.
4. Line 78 our HB score is mentioned, but since it is the first time the word is used and it is
considered to interfere with reading comprehension, we think it should not be mentioned in the
background.
5. I think the font of sore in table 3 and table 5 is different.
6. Table 7 endoscopic therapist is listed, but isn't it a mistake for endoscopic therapy?
7. I don't think we need the p value listed for BUN in Table 8.
While Table 8 is the important data, I think there are items that could be removed to make it a
little more understandable to the reader.
8. The statements in lines 180 and 181 should be deleted because they are methods, not results.
Review for 10.1186/s12876-022-02413-8 (2022)

Title: Prediction of the need for emergency endoscopic treatment for upper gastrointestinal
bleeding and new score model: A retrospective study
Version: 1 Date: 06 Jun 2022
Reviewer's report:
Thank you for submitting your manuscript to BMC Gastroenterology.
I think simplicity of Hb score is the grate strength. Thanks to its simplicity, the score would be
easy to use for endoscopist and even for non-specialists in  emergency medicine.
Limitation  of this study is no validation research of this score. I hope that  the prospective study
to evaluate the validity of the score will be conducted.
I recommend minor revisions.
1,  You should add a description of the number of patients in abstract.
2, Line 121-122, "whether hemostatic treatment or other hemostatic treatment" should be
described "whether endoscopic hemostatic treatment or other hemostatic treatment".
3, Line 208-209, I  recommend deleting the duplicate sentences.
4, Line 229-230, I  recommend deleting the duplicate sentences.
Review for 10.1186/s12876-022-02416-5 (2022)

Title: Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate
but higher rates of loss to follow-up
Version: 2 Date: 09 May 2022
Reviewer's report:
• Several grammatical and spelling errors that should be corrected
• Abstract: Would suggest less detail in the Results section and an additional sentence or two
in Conclusions
• Table 1 Data source: MBS # section – would add further labeling like “utilization over past
[time period]”
• Table 1 – Based on count data, it’s not clear why chi-square used for mental health and fisher
exact used for GP or specialist
• Supplementary Table 3: “N/S” for a number of Adjusted OR
o Logistic regression estimates are affected by omitted variables, even when they are unrelated
to the independent variables in the model (omitted variable bias)
o Should more variables be included in the adjusted OR analysis as the cutoff (p<0.2) could be
too low given the small sample sizes? Suggest discussing as a limitation.
Review for 10.1186/s12876-022-02416-5 (2022)

Title: Hepatitis C treatment outcomes for Australian First Nations Peoples: equivalent SVR rate
but higher rates of loss to follow-up
Version: 2 Date: 15 May 2022
Reviewer's report:
Reviewer report to BMC
Ref: Submission ID 7b1130ef-0cb0-422c-8ed6-df016d66775c
Thanks for the reference and thanks for the authors for their efforts
Title: needs to be more informative
Aim of the work lack novelty and not clearly stated, whether is SVR predictors, LTFU predictors.
It seems it s rather panoramic view of the HCV patients (being collected from multiple sources
in the present and past) rather than HCV outcome
Methodology
Sources of data needs to be clearer.
• In paragraph of “Data collection and governance” in first line; “Sociodemographic and clinical
data were obtained prospectively from medical records.” I think “prospectively to be revised
and corrected “retrospectively”
• In third line in the same paragraph “Clinical data collected every six months included HCV
diagnosis, HCV treatment and transmission history, concurrent opioid replacement therapy, risk
factors for liver disease including significant alcohol intake (#40g of ethanol per day), and
comorbidities. “ Clinical data only to be collected repetitively for FUP, however, risk factors
and comorbidities is only once in first calls. This paragraph needs to be rephrased.
Results
• First line “Of 3,295 patients enrolled in the OPERA-C study, 89 (2.7%) identified as First
Nations Peoples (Figure 1).” On revising the figure, it does not include categorization of the
patients into first nation and non indigenous Australian. This was clear in table 1 not figure 1.
• Authors mentioned health care utilisation in results. However, a deeper analysis to health care
facilities was not mentioned.
• MVA was conducted to assess LTFU in first nation people. A MVA for the other group would
enrich the analysis and give more informative data for the LTFU predictors in both groups rather
than one group
Discussion
• discussion is directed to multiple aims that distract attention of the readers. For example;
First two paragraphs talks about notification of HCV and initiation of treatment in previous
studies with comparison to this study. The following paragraphs talks about mental health and
comorbidities. This raise question about what the final aim of all these paragraphs is
Conclusions
• too long conclusion needs to be more concise and more accurate
Review for 10.1186/s12876-022-02415-6 (2022)

Title: Establishment and Evaluation of a Nomogram Predicting Risks of Missed Diagnoses of
Colorectal Polyps
Version: 1 Date: 14 May 2022
Reviewer's report:
This is a nice effort and has to be supported by a nomogram for each individual procedure.
Although the overall idea is interesting, I had difficulties following the process and I found the
introduction long and repetitive, the methods too hard to revise and the discussion too long.
Please rewrite with clarity
Review for 10.1186/s12876-022-02415-6 (2022)

Title: Establishment and Evaluation of a Nomogram Predicting Risks of Missed Diagnoses of
Colorectal Polyps
Version: 1 Date: 09 Jun 2022
Reviewer:  Babak Shokrani
Reviewer's report:
Very interesting study looking at a missed diagnosis of colorectal polyps during colonoscopy.
1- The author assumes the interval colorectal cancer is one of the consequences, however it does
not address the possibility of a fast growing cancer especially in the cecum. Colorectal cancer
after surveillance colonoscopy can be due to false-negative examination or fast growth! Some
previous studies (T F Gorski et. al. PMID: 10411433) showed the size, differentiation, and stage
of colorectal cancer in addition to the interval to diagnosis suggest that the majority of cancers
found during surveillance colonoscopy followed prior false-negative examinations.
2- Also it would be very interesting to look at the polyp architecture in addition of the size
and number. For example are sessile polyps were missed in higher frequency in compare to
pedunculated polyps? what about the  serrated polyps/lesions? which tend to be harder to identify
on endoscopy. Were there any differences in term of the pathological type of the polyp?
3- The study proposes a reference value for clinicians to analyse the risk of a missed diagnosis
of colorectal polyps in individuals, identify high-risk groups, and formulate appropriate follow-
up strategies. This would be very helpful and new.
4- The author concluded the factors for missed diagnoses included age, endoscopist experience,
bowel preparation, retroflected view, withdrawal time, number of polyps in the right colon.
These are more and less have been presented in the previous studies.
Review for 10.1186/s12876-022-02414-7 (2022)

Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 1 Date: 04 May 2022
Reviewer's report:
The aim of this systematic review was to evaluate the different surgical approach to rectal cancer
in Japan compared to western countries. Nowadays we don’t have an affordable tool capabe
to predict lateral lymph node swelling that can be managed by neoadjuvant chemoradiotherapy
(nCRT). So, in this study the authors want to assess characteristics of the lateral lymph node
recurrence (LLNR) and LLND (lateral lymph node dissection) that can be managed by nCRT.
Furthermore, no established criteria for lateral lymph node dissection indication were proposed
in current literature.
Interestingly,it is clinically significant if we can distinguish the lymph nodes which require
LLND from the lymph nodes which can avoid LLND by nCRT. Previous studies have not yet
assessed factors for LLND indication beside size of the lymph node.
The authors, beside the lateral lymph node size, considered neutrophil/lymphocyte NLR,
platelet/lymphocyte (PLR), CEA, tumor shrinkage rate, tumour regression grade (TRG) and
laterl lymph node short axis as predictors factors capable to conduct a correct indication for
LLND.
168 patients with low rectal cancer (cT3-T4, any N) were scheduled for nCRT and TME without
LLND.
Lateral lymph node short axis was measured using MRI.
Statistical analysis and results assessment methodology were both correct. A median
observational period of 1.874 days is oncological correct.
The authors have reported these results: pre- and post-CRT CEA levels were not statistically
related with lateral lymph node recurrence; significant statistical relations between pre- and post-
CRT PLR and lateral lymph node recurrence; no statistical relation between tumor regression
rate and lateral lymph node recurrence; statistically significant relations between pre- or post-
CRT and lateral lymph node short-axis diameter.
The authors suggests that the histological effect of rectal lesions by CRT does not support the
omission of LLND. And the minor axis of the lateral lymph node and PLR are risk factors for
recurrence of the lateral lymph node.
Beyond the limitations of the study (single center experience, small sample size), in the current
study is the first in which lateral lymph node recurrence was evaluated by various factors not
limited to only lymph node size.
The short axis diameters taken into consideration seems to be a feasible and easy to use in clinical
and surgical management of low rectal cancers (pre and post nCRT).
I think that the authors could make more clear the relationship between lateral lymph node
dissection, lateral lymph node recurrence and local recurrence.
Tables and Figures are well structured.
The lack of randomized trials makes it impossible to draw strenght conclusions.
Review for 10.1186/s12876-022-02414-7 (2022)

Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 1 Date: 26 May 2022
Reviewer:  Alexis Ulrich
Reviewer's report:
The authors present their data on 168 patients with low rectal cancer less than 7 cm from the av
receiving nCRT and TME without LLND between 2009 and 2016.
In Western countries LLND is rarely performed as only 3% develop LLN metastases and the
need for LLND is not clear. The authors try to find predictors for LLN involvement and could
show that in their small cohort the pre nCRT (>11.6mm) and post CRT (>5.5mm) size of the
LLN were predictive. Furthermore, the PLR before and after CRT seemed to predict lateral
positive notes. The authors point to the limitations of the study.
The manuscript is well written, though the conclusions are a little weak. Do the authors suggest
to perform LLND in case of increased risk according to size and PLR? Would it really decrease
local recurrence? Does increased morbidity due to LLND justify the extension of the operation?
In case of larger Lymph nodes at only one side, would the authors recommend LLND only of
the involved or both sides? Please discuss.
Review for 10.1186/s12876-022-02414-7 (2022)

Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 4 Date: 02 Jul 2022
Reviewer:  Alexis Ulrich
Reviewer's report:
The authors changed the manuscript according to the reviewers`suggestions.
Review for 10.1186/s12876-022-02410-x (2022)

Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 01 Apr 2022
Reviewer's report:
great job done
with this survey Mary Rinella provide an interesting snapshot of the current management and
diagnostic path of patients with a final diagnosis of NASH.
I would have been pleased if the questionnaire had also been sent to a sample of cardiologists
who probably see a percentage of patients with NAFLD / NASH.
I would recommend Authors to add  a comment  near the reason for not taking this class of
doctors into consideration for the survey
Review for 10.1186/s12876-022-02410-x (2022)

Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 18 Apr 2022
Reviewer's report:
The manuscript "Nonalcoholic steatohepatitis medical patient journey from the perspective
of hepatologists, gastroenterologists and patients: a cross-sectional survey" by Rinella et al.
is an unusual approach to a well-known topic: the colleagues conducted a questionnaire
survey to collect different assessments of NASH among patients and physicians. Special
emphasis is placed in the analysis on the 75 gastroenterologists/hepatologists who answered the
questionnaire.
I have 3 main points of criticism:
(i) It is unfortunately unclear how the doctors and patients were recruited. The process of
interviewing is described, but how were the patients identified in the first place. There may be
a bias here.
(ii) Both the introduction and the discussion are clearly too long and need to be shortened.
(iii) 75 gastroenterologists/hepatologists are too small a cohort to draw valid conclusions. In
some cases, the authors split this cohort into a subgroup of gastroenterologists and a group of
hepatologists and give percentages. With such small groups, single individuals have a massive
impact.
Review for 10.1186/s12876-022-02410-x (2022)

Title: Nonalcoholic steatohepatitis medical patient journey from the perspective of
hepatologists, gastroenterologists and patients: a cross-sectional survey
Version: 3 Date: 28 Apr 2022
Reviewer's report:
In the present manuscript the Authors report the results of a survey aimed at evaluating
the medical journey of patients with NASH and role of hepatologists/gastroenterologists in
diagnosing and treating patients with NASH. The manuscript is well written and easy to follow
and deals with an interesting topic.
I have the following comments:
- I would better specify how participants to the present survey were identified and contacted
(both doctors and patients)
- The Authors correctly point out in the introduction that NASH is a histological diagnosis,
which can only be made through liver biopsy. Nonetheless, most hepatologists argued that they
diagnose NASH based on fibroscan (which is a noninvasive proxy for fibrosis, not inflammation)
or even with liver function tests. I believe that the question was not well formulated and the
aspect dealing with a bit of confusion between steatosis, inflammation and fibrosis among
gastroenterologists /hepatologists deserves some comments.
- When discussing the prevalence of NAFLD in the United States, I would mention a recent study
performed using NHANES data and reporting the prevalence of both NAFLD and advanced
liver fibrosis in the general US population (see doi: 10.1111/liv.14828).
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 2 Date: 15 Feb 2022
Reviewer's report:
In this study, the authors report the use of nasointestinal tube (NIT) to treat conservatively
patients with small bowel occlusion. The concept seems interesting but this study can’t answer
to the superiority of this treatment as compared with other conservative management. Only a
randomized study could evaluate risk and benefits of NIT.
Many points have to be addressed to improve the quality of this paper.
In the diagnosis criteria, the authors mentioned a: distended large bowel. Is it usual in patients
with SBO? In figure 6 we can see contrast in large bowel. Why? Did the authors use gastrograffin
to treat SBO?
Could the authors precise what were the etiologies of SBO? Did all patients have CT-Scan? Did
they exclude patients with inflammatory disease or tumors?
Could the authors described the population in term of results? How many patients required
surgery for bowel necrosis? Was suspected bowel necrosis (clinical or biological markers) a
contraindication for NIT? How many patients required surgery for bowel necrosis?
Did the authors compared NIT versus NG tube in term of success or adverse events?  Is NIT
more dangerous than NG tube? Only a randomized study coud answer this question.
The authors described many adverse events. Are they related to NIT or to SBO???
The authors report a clinical case in chapter discussion!! This should be deleted or appeared in
results chapter…
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 2 Date: 20 Feb 2022
Reviewer's report:
Dear Authors,
This is an interesting paper. You have reviewed your institution's use of NIT to treat SBO and
identified risk factors for adverse outcomes.
Interestingly the finding that Hb and chloride levels can predict failure/SAE of conservative
treatment is new.
Please justify your institutions usage of NIT compared to standard NG tube decompression.
Also correct the sentence in the patient population section: "and a distended large bowel with
air-fluid" should read SMALL bowel.
The overall structure is fair and with a few amendments may be suitable for publication
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 2 Date: 06 Mar 2022
Reviewer's report:
This article is interesting. However, when assessing the risk factors of SAE and non-SAE , the
PSM should not be used. First, PSM can not reflect the real incident rate of SAE; Second, many
risk factors may be ignored.
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 4 Date: 29 Mar 2022
Reviewer's report:
revision is necessary.
Response to point-to-point response
1. Ok for changing distended large bowel with distended small bowel. The authors did not answer
about the use of gastrograffin to treat SBO
2. The authors included patients presenting with different etiology that makes the study
very heterogeneous!!! Patients with tumor or hernia seem very different from patients with
adhesions… That significantly decrease the value of this study.
3. The authors did not answer to the question.
4. Perhaps we need to wait for the randomized study to publish these results!!!
5. Waiting for randomized study to answer this topic…
6. Ok for your answer…
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 5 Date: 13 Apr 2022
Reviewer's report:
The authors tried to answer to my questions but the main problem of this paper is an analysis
of heterogeneous population in term of diagnosis. I imagine that patients with adhesions differ
from patients with tumor or reflex ileus caused by inflammatory disease or hernia!!! So it seems
difficult for me to accept this paper for publication unless  they improve  this problem. Perhaps
a paper based only on analysis of patients with small bowel occlusion due to adhesions coud
be useful.... furthermore, they mixed two analysis.: results of conservative treatment or SAE
following NIT insertion. What did they consider the main results?
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 6 Date: 23 Apr 2022
Reviewer's report:
Ok with your answers. I understand the dificulty to obtain an homgeneous population of patients.
I would like you change the title of this paper  since there is an ambiguity concerning the term
"benefit".  benefit in terms of sbo successful treatment or benefit in term of no SAE? The term
SAE shoud appear in the title!
Review for 10.1186/s12876-022-02405-8 (2022)

Title: Who would avoid severe adverse events from nasointestinal tube in small bowel
obstruction?—a matched case-control study
Version: 7 Date: 07 Jun 2022
Reviewer's report:
according to your previous comments, I woud like that  the notion of "no SAE" appears in the
title!! If i well understood your paper, this is the main issue.
Review for 10.1186/s12876-022-02412-9 (2022)

Title: Analysis of clinical features and prognostic factors in patients with Hepatic Hydrothorax:
A single-center study from China
Version: 1 Date: 04 May 2022
Reviewer:  Sikandar Ansari
Reviewer's report:
1-page 5 last line:
All patients had pleural fluid combined with ascites, including 87 cases (66.4%) with massive
pleural fluid combined with massive ascites and 96 cases (73.3%) with compressive pulmonary
atelectasis.
Recommendation: This line is not clear and may need to be rephrased.
2-page 5 line 4:This was followed by hyponatraemia in 52 cases (39.7%), infection of the pleural
fluid in 30 cases (22.9%), renal insufficiency in 24 cases (18.3%), liver failure in 21 cases (16%),
peritonitis in 18 cases (13.7%), hepatic encephalopathy and gastrointestinal bleeding both in 16
cases (12.2%) and hepatorenal syndrome in 9 cases
Recommendation : Please consider mentioning how pleural fluid infection was determined? by
culture? by Empyema standards?
3-Page 8:The most common symptoms of HH are dyspnoea and abdominal distention, which
may be associated with massive pleural effusion compressing the lung tissue and massive
accumulation of abdominal fluid resulting in.
Recommendation: Spelling of Dyspnea needs to be corrected.
4: Page 8:More complete clinical data from hospital records of patients with decompensated
cirrhosis and ascites admitted to the First Hospital of Jilin University from January 2013 to June
2021 were extracted for retrospective analysis, and risk factors affecting prognostic survival
were further analysed based on follow-up survival time.
Recommendation: Spelling of analyzed needs to be corrected.
5: spelling for Hyponatremia needs to be corrected at multiple sites.
Review for 10.1186/s12876-022-02412-9 (2022)

Title: Analysis of clinical features and prognostic factors in patients with Hepatic Hydrothorax:
A single-center study from China
Version: 4 Date: 16 Jun 2022
Reviewer's report:
Many thanks to the authors for addressing all the points highlighted in the previous revision.
They did a great job.
I just have three minor comments that can be easily addressed:
1. In the statistical analysis section, with the changes incorporated in the revision, the following
text is not clear "The variables that met the hypothesis test were incorporated into the univariate
Cox proportional hazard model to assess the effect of different variables on survival time". You
could say instead: "The variables that seemed to satisfy the proportional hazard assumption were
incorporated..." or something similar.
2. Also in the statistical analysis section, after incorporating the explanation of how you select
your variables in the multivariate analysis, the following text does not make sense now: "After
controlling for covariates that were associated with liver-related mortality in the univariate
analysis, determined the association between statistically significant factors and the prognostic
impact of HH".  I suggest just removing it.
3. In section 3.4 of the results, it is not clear what the authors mean by the 95% confidence
interval for the follow-up time. In clinical papers, the follow-up time is usually reported in
median and interquartile range. The follow-up time is not "estimated".
Review for 10.1186/s12876-022-02402-x (2022)

Title: Endoscopic sphincterotomy and endoscopic biliary stenting do not affect the sensitivity
of transpapillary forceps biopsy for the diagnosis of bile duct adenocarcinoma
Version: 1 Date: 08 May 2022
Reviewer's report:
Dear authors,
I congratulate you for your idea and your great work!
I have few suggestions and questions
line 11: I would suggest using post-ERCP pancreatitis (PEP) instead of ERCP-induced
pancreatitis (the same as you use in line 187)
line 60 This is not clear to me.
Do you define EST group, only if it EST was done in previous ERCP session? (this is my
understanding as you state later in the text  (line 98) that all EST’s were undertaken in other
institutions)
As opposed to those patients without EST?
But were there patients that underwent EST during the same ERCP and just prior to TB (in your
institution)? I would expect some patients undergoing EST just before TB, especially as this
was retrospective study and in clinical scenarios some patients from first to second reevaluation/
ERCP become jaundiced and need stenting and therefore EST in most cases
line 72: I would suggest being more precise concerning time limits specially weeks; as bleeding
let’s say eight weeks after the procedure with the drop in Hb level I’d say is quite likely to be
for other reasons
line 188 - I suggest to rewrite  and be more precise  on risk factors for PEP if you point that TB
after EST is safer and easier  (multiple cannulation procedures? you mean difficult cannulation,
multiple insertions before achieving deep biliary cannulation, different cannulation techniques
used?)
line 150 (table) EST and EBS often go together so if possible it would be great to have this
additional analysis
As for example it does not make much sense that patents that undergo TB without previous EBS
have much more PEP. Was this maybe because those without EBS actually did not undergo
EST, so therefore they were more prone to PEP as TB was done without EST?
Maybe additional analysis would be useful or at least a comment in discussion
I fell that that PEP incidence is significantly higher in patient undergoing TB without EST needs
to be stressed more in discussion/conclusion sections - I feel this very important information;
I personally would never do TB without previously doing EST (of course if EST is not
contraindicated)
Review for 10.1186/s12876-022-02396-6 (2022)

Title: ECONOMIC EVALUATIONS OF RADIOEMBOLIZATION WITH ITRIUM-90
MICROSPHERES IN HEPATOCELLULAR CARCINOMA: A SYSTEMATIC REVIEW
Version: 1 Date: 26 May 2022
Reviewer's report:
In this study, the authors aimed to perform a systematic review of the available economic
evaluations of Transarterial radioembolization (TARE) with yttrium-90 microspheres for the
treatment of HCC.
All studies identified as economic evaluations with TARE for HCC treatment in English or
Spanish language were considered.
They selected 20 studies  and assessed populations included early- (n=4), and intermediate-
advanced-stages patients (n=15).
TARE was compared with transarterial chemoembolization (TACE) (n=9) or sorafenib (n=11).
Life-years gained for TARE ranged from 1.3 to 3.1 vs. TACE and from 1.1 to 2.53 for TARE
vs. sorafenib. TARE was associated with lower treatment cost in ten studies. TARE cost varied
widely according to Barcelona Clinic Liver Cancer (BCLC) staging system .
They concluded that economic evaluations of TARE for HCC treatment are heterogeneous. and
that TARE is a cost-effective short- and long-term therapy for the treatment of intermediate-
advanced HCC.
The study is of interest and the topic of current major clinical relevance. However, some points
deserve further data and should be addressed.
In my opinion, the authors should further discuss the comparison between TARE and systemic
treatment. They have only considered sorafenib, however, new systemic agents were developed
and approved after 2015.  In their conclusion, they should recall how the systemic treatment
of HCC is improved in the last 5 years. In particular, they should discuss the availability
of sequential systemic treatments after sorafenib failure, with second-line regorafenib and
third-line cabozantinib, as recently described (Experience with regorafenib in the treatment of
hepatocellular carcinoma. Therap Adv Gastroenterol. 2021 May 28;14:17562848211016959;
Real-Life Clinical Data of Cabozantinib for Unresectable Hepatocellular Carcinoma. Liver
Cancer. 2021 Jul;10(4):370-379.).
Moreover, they should also discuss that TARE may be associated with liver function
deterioration (from Child-Pugh class A to Child-Pugh class B) potentially precluding the
feasibility of systemic therapy that can be administered only to patients with preserved liver
function (Non-transplant therapies for patients with hepatocellular carcinoma and Child-Pugh-
Turcotte class B cirrhosis. Lancet Oncol. 2017 Feb;18(2):e101-e112.).
Review for 10.1186/s12876-022-02404-9 (2022)

Title: The Impact of Treatment with Bile Acid Sequestrants on Quality of Life in Patients with
Bile Acid Diarrhoea
Version: 1 Date: 29 Jan 2022
Reviewer:  Tadashi Ikegami
Reviewer's report:
This is a study examining whether administration of drugs such as cholestyramine, which is
used to treat BAD, improves the patient's quality of life. The authors evaluated QOL before
and after treatment using three different QOL evaluation questionnaires. No correlation was
found between drug responsiveness and quality of life improvement, but treatment improved
quality of life, especially in the BAD and CD cohorts. On the other hand, in the PC cohort (after
cholecystectomy), the QOL was rather decreased by the administration of the drug.  The authors
evaluate which factors that make up QOL are improving in each of the pathological conditions
that cause BAD, but the number of cases in each is small and it cannot be concluded that it is
definitive, unfortunately.
Comment:
1. SeHCAT, which is used to diagnose bile acid malabsorption, is an established assay for that
purpose, but still not common in many countries, so please add a brief description about this
assay to the background or M & M section.
2. Since authors discussed that the degree of improvement in QOL differs depending on the
disease group (BAD, CD, PC, CG), please summarize the patient backgrounds of the four groups
used in this analysis on a table.
3. It was stated that the CD group, which had a high degree of improvement in clinical efficacy
and QOL, had a lower SeHCAT score, which means severe BAD. On the other hand, patients
with indeterminate was also included in this study. Is there a difference in QOL improvement by
drug administration depending on the degree of bile acid absorption disorder? In other words,
isn't it less effective for patients with mild bile acid malabsorption?
Review for 10.1186/s12876-022-02404-9 (2022)

Title: The Impact of Treatment with Bile Acid Sequestrants on Quality of Life in Patients with
Bile Acid Diarrhoea
Version: 2 Date: 06 Apr 2022
Reviewer:  Tadashi Ikegami
Reviewer's report:
I believe the authors have adequately responded to my comments.
Review for 10.1186/s12876-022-02404-9 (2022)

Title: The Impact of Treatment with Bile Acid Sequestrants on Quality of Life in Patients with
Bile Acid Diarrhoea
Version: 2 Date: 15 Apr 2022
Reviewer:  Ginevra Berti
Reviewer's report:
I have examined again the article and I am grateful that the authors have accepted my suggestions
for the correction. The manuscript is now clearer. I would like just to clarify some points:
- I apologize for some mistakes that prevented the authors to understand two points of my
previous review, I have reported them with the correct number of page and lines (referring to
the updated manuscript)
o Page 14 line 365 for SF-36 MCS could you check if the values of P and N are correct?
o Page 14-15 lines 364-367 The phrase is a bit confused. It would be useful to separate
clinically and statistically significant findings. I also suggest correcting as “EQ-5D-3L pain and
discomfort”. Is not IBDQ32 also statistically significant? Talking about the moderate effect size
coefficient, should not it be >0.5?
- Page 23 Figure 1 legend line 525: The number of patients that completed the visit in figure 1
is 109, I think you should correct the legend
- About the comparison of the three groups’ scores (PC; BAD and CD) pre and post treatment
using the Student’s t-tests, check if it can be used to compare three groups or if it would be better
use another test like ANOVA
Review for 10.1186/s12876-022-02403-w (2022)

Title: Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to
severe acute pancreatitis
Version: 1 Date: 29 Jan 2022
Reviewer's report:
The paper is interesting although the retrospective unicentric design and the limited sample
size represent major limitations to the paper and should be properly addressed as such in the
discussion.
Time to event data should be reported in terms of median and 95% confidence intervals (not
interquartile range).
The authors should comment in the discussion that the center experience and volume might have
an impact in severe pancreatic disease/complications as reported in a recent paper (please cite
PMID: 34932991)
Review for 10.1186/s12876-022-02403-w (2022)

Title: Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to
severe acute pancreatitis
Version: 1 Date: 11 Mar 2022
Reviewer's report:
The authors conducted the retrospective study to investigate the incidence and risk factors
for gastric feeding intolerance (GFI) in moderate-severe to severe acute pancreatitis (AP) in
the Centre of Severe Acute Pancreatitis of Jinling Hospital in China. Patients diagnosed with
moderate-severe to severe AP and admitted within seven days from the onset of abdominal pain
were assessed for eligibility. A total of 561 patients were hospitalized with AP during the study
period and 93 (16.5%) patients were enrolled in the analysis; 73.1% of the enrolled patients had
moderately severe AP. They found that 24 (25.8%) patients had GFI and respiratory failure was
an independent risk factor of developing GFI. They concluded that GFI is common in moderate-
severe to severe AP patients, and the presence of respiratory failure is a risk factor of GFI. The
study is of clinical interest; however, the results may be unreliable due to referral and selection
biases. Major comments are shown below.
Major comments
1. The study hospital seems to be a referral center for severe AP. Therefore, a referral bias is
likely and may lead to underestimate the incidence of GFI if patients referred to the hospital
were predominantly moderately severe cases (73.1%, Table 1). Moreover, the timing of referral
can also influence the estimate of GFI incidence. For example, of the 468 excluded patients,
346 (71%) were more than seven days from onset of AP at hospital admission (Figure 1). The
distribution of AP severity among the excluded patients is unclear. If these patients were referred
to the hospital earlier, the case mix may be different.
2. The classification of AP severity is questionable. In Table 1, 39 patients had respiratory failure,
but only 26 were classified as severe AP.
3. The definition of GFI is unclear. “Patients who showed signs of intolerance to gastric
feeding and required switching to NJ feeding were deemed GFI.” However, “The final decision
regarding the requirement of NJ feeding depends on the physician in charge.” Therefore, it is
likely that some patients may not be classified as GFI if they showed signs of intolerance to
gastric feeding, but the physician in charge was reluctant to switch to NJ feeding.
Review for 10.1186/s12876-022-02403-w (2022)

Title: Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to
severe acute pancreatitis
Version: 1 Date: 25 Mar 2022
Reviewer's report:
Dear Editor,
Thank you for giving me the opportunity to review the manuscript entitled "Incidence and risk
factors of nasogastric feeding intolerance in moderate-severe to severe acute pancreatitis" for
your journal.
In this retrospective study the authors assessed 93 patients with moderate-severe to severe AP
and evaluated the incidence and risk factors for nasogastric feeding intolerance.
Please find below my comments:
1. The technique used to place the NJ tube in the med-distal jejunum should be explained. It
seems to the reviewer that the normal position of the NJ tube should be the proximal jejunum,
aiming to pass the ligament of Treitz.
2. The definition of GFI is provided twice in the manuscript and this should be amended.
3. The definition of "respiratory failure" is not provided in the manuscript. This should be
amended, while description of this outcome was assessed should also be made available (time
of respiratory failure regarding admission, etc..).
4. The univariable analysis included the following variables: age, sex, BMI, etiology of
pancreatitis, presence of respiratory failure and APACHE II score. The authors should explain
why other organ failures were not chosen to be included in the analysis model. Moreover, the
APACHE II score already includes a part of what the authors describe as "respiratory failure"
since both the respiratory rate and the FiO2 are used to calculate the score. Hoe can the authors
be sure that there is no interaction between the two variables? Did they check for multiple
interactions and did they assessed the appropriateness of their model?
5. From a statistical point of view this type of analysis with the relative small number of patients
is not suitable to perform a multivariable analysis. Moreover, the two groups differed in several
baseline characteristics. For exemple patients in GFI group presented higher rates of respiratory
failure, AKI and APACHE, meaning that more severe patients may be associated with higher
rates of GFI. In order to avoid this type of uneven distribution I believe the authors should either
undergo another type of analysis (e.g. propensity score match) or simply reorientate their paper
reporting the incidence of GFI among patients with moderate-sever to severe AP.
Review for 10.1186/s12876-022-02403-w (2022)

Title: Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to
severe acute pancreatitis
Version: 2 Date: 09 May 2022
Reviewer's report:
The authors have addressed my prior comments. However, there are still some additional issues
in the revised manuscript.
1. The median time from onset of abdominal pain to admission is usually within 1-2 days (Phillip
et al. Pancreas 2013;42: 647-654). However, “the majority of the screened patients (346/561,
61.7%) were admitted later than seven days from the onset of abdominal pain in the present
study” and “The median time from the onset of abdominal pain to hospital admission was three
days in the study cohort.” Since the study hospital is a referral centre, the authors should clarify
“time from onset of abdominal pain to admission” and “time from onset of abdominal pain to
referral”.
2. Please provide abbreviations for MAP, MSAP, and SAP.
Review for 10.1186/s12876-022-02403-w (2022)

Title: Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to
severe acute pancreatitis
Version: 2 Date: 02 Jun 2022
Reviewer's report:
Dear Editor,
Thank you for giving me the opportunity to review the revised version of the manuscript entitled
"Incidence and risk factors of nasogastric feeding intolerance in moderately-severe to severe
acute pancreatitis" for your prestigious journal.
I would lie to commit the authors for their efforts to adequately address reviewers' commets.
More precisely, additional analysis has been performed, lacking definitions have been provided
and important limitations have been highlight in the discussion as requested.
In my opinion the manuscript can be considered eligible for acceptance.
Thank you
Review for 10.1186/s12876-022-02344-4 (2022)

Title: Hepatic Arterial Infusion Chemotherapy plus Regorafenib in Advanced Colorectal
Cancer: A Real-World Retrospective Study
Version: 2 Date: 10 Feb 2022
Reviewer's report:
This article explored the benefits and tolerability of Hepatic arterial infusion chemotherapy
plus regorafenib in advanced colorectal liver metastasis refractory to standard systemic
chemotherapy. Regorafenib combined with Hepatic arterial infusion chemotherapy is an
effective second-line treatment option for treating colorectal cancer patients with liver metastasis
refractory to standard systemic therapy. Their results indicate that the toxicity was tolerable,
and efficacy outcomes in terms of ORR and PFS were comparable to those of previous reports
in which regorafenib combined with hepatic arterial infusion chemotherapy. The notion that
the regorafenib combined with hepatic arterial infusion chemotherapy is feasible and can be
performed safely in patients with mCRC is interesting. However, the data are too weak to support
their conclusion.
1) The content of the paper and Figures 1, 2, 3, and 5 do not match.
2) The number of metastatic organs was not described, which may have a selection bias.
3)There is no description of RAS status or Location.
Review for 10.1186/s12876-022-02344-4 (2022)

Title: Hepatic Arterial Infusion Chemotherapy plus Regorafenib in Advanced Colorectal
Cancer: A Real-World Retrospective Study
Version: 3 Date: 07 Apr 2022
Reviewer:  Hironaga Satake
Reviewer's report:
Thank you for submitting the revised version.
Please address the inadequate response to the following
Major
Although "patients with a history of systemic drug therapy" is specified as eligibility for this
study (P7. inclusioin criteria 4), in Table 1, N=23 patients have no history of prior therapy. I
think that these N=23 patients without prior treatment should be excluded from the analysis of
this research, and that this study should be analyzed with N=34 patients. How do you think?
P6-L155
Since the exclusion criterion is "cases without a history of systemic treatment (exclusioin criteria
5)", delete this sentence and and if the analysis includes cases with no history of systemic
chemotherapy, exclude them from the analysis.
Review for 10.1186/s12876-022-02344-4 (2022)

Title: Hepatic Arterial Infusion Chemotherapy plus Regorafenib in Advanced Colorectal
Cancer: A Real-World Retrospective Study
Version: 4 Date: 18 May 2022
Reviewer:  Hironaga Satake
Reviewer's report:
Thank you for the correction.
The points raised have been addressed appropriately and are worthy of acceptance.
Review for 10.1186/s12876-022-02401-y (2022)

Title: Evaluating future risk of NAFLD in adolescents: a prediction and decision curve analysis
Version: 2 Date: 31 Mar 2022
Reviewer's report:
1- I believe that instead of discussion, it is a conclusion in the abstract. I suggest inserting in the
conclusion, some practical solution and applied in the clinical context.
2- Insert the term Body composition in the keywords.
3- Insert the sample power calculation in the method.
4- Regarding anthropometry, what protocol was used? What was the value of the measurement
technical error, such information is necessary.
5- Shallow discussion, all results data must be discussed, please insert the paragraphs for
discussion of each of the results. It is necessary to bring the main findings, but discuss the best
models and why they are useful.
Review for 10.1186/s12876-022-02401-y (2022)

Title: Evaluating future risk of NAFLD in adolescents: a prediction and decision curve analysis
Version: 2 Date: 04 Apr 2022
Reviewer's report:
The authors revealed that insulin resistance was the best predictor of NAFL in all adolescents,
central adiposity was the best predictor in overweight/obese group, and BMI was the best
predictor of NAFLD fibrosis in all adolescents. Thereover, it was revealed that  “routine clinical
measures” model had the greatest net benefit, but the benefit is small, for increased NAFLD
fibrosis detection in overweight/obese adolescent participants, using decision curve analysis.
These findings are interested, but there are some concerns.
1. Why was the decision curve analysis performed only for the participant with overweight/
obese at the age of 17 year?
2. Specifically, how does the RCM model predict NAFLD fibrosis? What is the impact of each
factor that makes up the model?
Review for 10.1186/s12876-022-02401-y (2022)

Title: Evaluating future risk of NAFLD in adolescents: a prediction and decision curve analysis
Version: 4 Date: 17 May 2022
Reviewer's report:
The authors advanced in relation to the questions. However, I request that you be informed of
the technical errors of intra and inter-evaluator measurements, of the research evaluators for
anthropometric measurements. Such information is necessary in the field of body composition.
Review for 10.1186/s12876-022-02389-5 (2022)

Title: CT enterography for evaluation of disease activity in patients with ileocolonic Crohn's
disease
Version: 1 Date: 20 Jan 2022
Reviewer:  Ilhami Yuksel
Reviewer's report:
The present study aimed to develop a quantitative CTE scoring system in detecting disease
activity of ileocolonic CD based on ileocolonoscopy.
However, several major points should be addressed by the Authors.
Major points:
The Authors used ileocolonoscopy as reference standard for detecting CD activity and they used
Crohn's disease endoscopic index of severity (CDEIS) for this purpose. But CDEIS cut-off value
was not given to define endoscopic remission or activation.
The Authors used the presence of an endoscopic lesions and the presence of ulcers at endoscopy
rather than CDEIS as a predictive markers to determine CTE activity score.
The Authors should address sub-score of the CDEIS by using standard cut-off value for each
evaluating ileal and colonic segments. The Authors must compare between sub-score of the
CDEIS and CTE parameters, because statistic analysis was applied for assessing the association
between CDEIS and CTE variables in the present study. New statistic analysis should be done
according to current standard definition of CDEIS.
Finally current results should be rewritten and discussed in the text.