Review for 10.1186/s12876-021-01611-0 (2021)

Reviewer’s report
Title: 
Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor
bleeding
Version: 
0 
Date: 
13 Nov 2020
Reviewer's report:
Review on BMGE-D-20-01256 by Shin J et al., entitled "Efficacy of a novel hemostatic adhesive powder
in patients with upper gastrointestinal tumor bleeding"
This study evaluated the effect of UI-EWD, including immediate hemostasis and recurrent bleeding for
tumor bleeding. 
The following comments are for the reference of authors: 
Major comments
1. The weakness of this study is that it was a single-arm study, not a randomized control study; thus, it is
inconclusive about the effectiveness of hemostasis of UI-EWD in tumor bleeding.
2. Regarding the measure bias, there is a concern for immediate hemostasis. I can figure out how
immediate hemostasis being achieved for treating active bleeding lesions, such as those with Forrest Ia or
Ib lesions, by UI-EWD. However, how did the authors define "immediate hemostasis" by UI-EWD for
lesions without active bleeding lesions, such as Forrest IIa, IIb, and IIc, which are non-bleeding visible
vessel and blood clots, respectively?
3. I suggested the authors to address the characteristics of patients who had rebleeding in detail, either in
the salvage therapy or monotherapy. Thus, the authors may propose the possible reasons of treatment
failure. 
4. Whether did UI-EWD have improved hemostasis for bleeding with large tumor size, friability,
pathological angiogenesis, or tumor induced necrosis, which are factors of poor hemostasis for
conventional endoscopic modalities?
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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?
No
Are the methods sufficiently described to allow the study to be repeated?
No
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Yes
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Yes
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manipulation?
Yes