Review for 10.1186/1471-230X-8-6 (2008)

Reviewer's report
Title:Meta-analysis of prophylactic corticosteroid use in post-ERCP pancreatitis
Version: 1Date:4 October 2007
Reviewer: Alberto Mariani
Reviewer's report:
Major Compulsory Revisions
Although data appears to be complete, the manner of presentation makes the
manuscript more detailed by a statistical or technical than by a clinical point of
view.
The discussion needs a complete rewrite: too much extended the part referred to
the first retrospective study; there are many results and few comments.
A better English language is mandatory.
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Minor Essential Revisions
BACKGROUND:
Page 3 line 6: “……. Were still 10% of cases…..” Add a reference.
RESULTS:
Combine Table 1 and Table 2.
Comments for table 1:
1. In the first column substitute reference with author and year of publication
(i.e.Budzynska, 1997).
2. Keep “setting” as second column
3. Put in the third column quality or Jadad score (i.e. 0-5) reported in your table2.
4. Put In the fourth column “sample size” data
5. Delete “patient inclusion criteria”. Specify in the methods that 4 out of 7 studies
included patients submitted only to diagnostic ERCP and 3 to diagnostic and
therapeutic ERCP).
6. Delete “outcomes”. PEP was the common outcome of all the studies. Specify
in the methods that in two studies the grade of severity of PEP was not reported
or that a severe PEP was reported in five studies.
7. Describe in the methods the allocation concealment judgment and not in the
table.
8. Include other three columns (fifth, sixth and seventh column) about type,
dosage (mg) and duration (min/h) of corticosteroid administration.
9. Delete table 2 and the last line (from “the quality…. To Table 2) in the
Assessment of study quality paragraph (page 4, line 14-15).
Comments for Table 3 and 4:
Keep your Table 3 and 4. Change titles, i.e.: Sensitivity analysis of the effect of
corticosteroid prophylaxis of post-ERCP pancreatitis in clinical trials.
Comments for Figure 2:
1. Change the title of the figure. Example: Effect of corticosteroids in the
prophylaxis of post-ERCP pancreatitis. In the Forest plot (figure 2a) values of
relative risk ….. in the Funnel plot (figure 2B at the place of Figure 3)……..
2. Put in the middle of the figure (as shown in your table 4) the terms PEP (delete
01 PEP), severe PEP (delete 02 ..) and post-ERCP hyperamylasemia (delete
03…) to better emphasize them as subtitles of the figure.
3. Delete the two columns on the right of the figure: “weight %” and “OR (fixed)
95% CI”.
4. In the first column, insert “pooled” in place of subtotal (95% CI)” reporting the
following numbers: 157/1312 and 142/1320 for corticosteroid and placebo,
respectively.
5. Show by small size characters the OR (fixed) and 95% IC values for each of
the three sub-categories just on the right of the triangular sign into OR (fixed)
column.
6. In the first column delete, for each sub-category, the following three lines: total
events ……., test for heterogeneity….. and test for overall effect…… Show the
results of the test for heterogeneity and overall effect in the text (result section).
7. Into the new figure 2b (in palce of your figure 3) it’s better to show data by OR
(fixed) against sample size (number; i.e. 10-10000) axis deleting the two diagonal
lines.
What next?: Accept after minor essential revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests' below.