Review for 10.1186/s12876-023-02963-5 (2023)

Title: A Magnetic Resonance Imaging-Based Decision-Making Tool for Predicting Complex
Anal Fistulas Healing in The Early Postoperative Period
Version: 0 Date: 23 Apr 2023
Reviewer's report:
• (A) abstract
•   This is a very traditional study, the authors aimed to build a MRI-based decision-making
nomogram model for predicting complex anal fistulas healing in the early postoperative period.
The author's thought is clear, the content of the article is complete and the structure is reasonable.
• (B) Provide an overview/summary of the manuscript
I think the article is acceptable, but it needs some methodological improvements, deeper
discussion, and a native-level polish to the sentences. For example, in the discussion part, the
author can go further to discuss the deeper mechanism and reasons of CNR affecting the fistula
healing, as well as the similarities and differences between this study and other similar studies.
(B) Introduction and discussion
• Have any relevant previously published studies not been cited?
To my limited knowledge, none. But similar studies previously published in BMC journal can
be duly noted and cited.
• Are the aims, significance and the novelty of the work clearly outlined in the manuscript?
Yes.
(C) Materials and methods
• Are the experimental methods and statistical analyses appropriate? Should the authors use
alternative methods or add additional experiments to their current work?
There is a problem with statistical methods, that is, after randomly divided into training group
and verification group, all single-factor and multi-factor analysis and model building should
be carried out in the training group, and then the data of the verification group should be
used to verify the model, so as to ensure that the two processes are relatively independent.
It seems that the authors conducted univariate and multivariate analysis based on the whole
patient population, and then applied the training group to construct the model after finding the
independent influencing factors. Obviously, this can also achieve a good effect in the verification
set, so the statistical methodology should be corrected.
• Does the manuscript comply with relevant national or international ethics guidelines? Where
applicable, has the study been approved by an ethics committee/has consent been obtained from
patients?
Yse.
• Have any mis-identified cell lines been used?
No
• Are there any limitations to the methods used by the authors? If so, have the authors
appropriately discussed them?
For model construction and validation, the validation with the highest testing power should be
the patients arranged in chronological order (or other predictable order) and orderly divided into
the training group and the external validation group in a ratio of 7:3, rather than the so-called
"random" grouping. It is recommended that the patients be grouped in the way mentioned above,
or at least the reason why it is not used in this article should be discussed.
(D) Results
• Can you comment on the quality of the data presented, including the reliability and validity
of the results and the figures?
In this study, the authors included a relative small number of study patients, and the study was
conducted in a single center.
• Have the authors presented the relevant controls?
Yes.
• Do the data support all the conclusions made by the authors?
Yes.
(E) Quality of english language
• Can you comment on the level of the English?
The English level of this article is moderate, readers can understand, but can seek professional
institutions for further polishing
• Does the manuscript require further revisions by a language editing company or native English
speaker?
Yes.