Review for 10.1186/s12876-021-01680-1 (2021)

Reviewer’s report
Title: 
Ten-day bismuth-containing quadruple therapy versus 7-day proton pump
inhibitor-clarithromycin containing triple therapy as first-line empirical therapy
for the Helicobacter pylori infection in Korea: A randomized open-label trial
Version: 
1 
Date: 
18 Oct 2020
Reviewer's report:
Dear Editor in chief
I reviewed the manuscript entitled as "Ten-day bismuth-containing quadruple
therapy versus 7-day proton pump inhibitor clarithromycin containing triple
therapy as first-line empirical therapy for the Helicobacter pylori infection in
Korea".
The work is valuable due to the importance of introducing suitable regimens for
H. pylori eradication in every country according to the pattern of H. pylori
resistance to antibiotics in every geographical region.
However, there are some minor points to be mentioned. And the manuscript
seems suitable for publication after these minor revisions.
In Methods and Results:
The severity of side effects is not described. It is not clear how the authors
classified side effects as: mild, moderate or severe! Also, it seems better to show
the kinds and rates of mild, moderate or severe side effects in a table.
In Results:
It is better to draw a flowchart that shows the number of patients in each analysis
step (The whole patients - The number of patients included in intention to treat
analysis - the number of patients that were deleted due to poor compliance or
not performing UBT while analyzing modified intention to treat analysis - The
number of patients in Modified intention to treat analysis - the number of
patients that were deleted while analyzing per-protocol analysis and the reason
of their deletion 
- The number of patients remained for per-protocol analysis -
 the number of patients that received second-line regimen and the final results.
In Discussion:
It is mentioned that "The lower eradication rate in the ITT analysis was observed
in this study because of a higher than expected rate of participants who declined
to participate in the study due to chronic gastritis". Since all the patients had
given informed consents before starting the protocol, this justification /
explanation seems to be unaccountable.
It is mentioned that "An interesting finding was that the eradication rate of the
BQT remained high as much as 83%, even in participants who consumed at least
50% but less than 80% of the study drugs." Since the eradication rate was less
than 85%, according to reference number 17, this rate of eradication is "poor"
and therefore, is not interesting!
At the end of discussion, it is written that "this study was planned to evaluate the
eradication rates in the empirical treatment setting that did not require
endoscopic evaluation". Since most patients had undergone endoscopy, this
phrase "did not require endoscopic evaluation" is better to be deleted.
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Declaration of competing interests
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questions:
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. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
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paper?
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interests' below. If your reply is yes to any, please give details below.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes