Review for 10.1186/s12876-023-02797-1 (2023)

Reviewer’s report
Title: 
Clinical Epidemiology and Outcomes of Patients with Gastric Intestinal
Metaplasia in the Los Angeles County System
Version: 
0 
Date: 
16 Jan 2023
Reviewer's report:
The present study reviewed the clinical and endoscopic features, surveillance
practices and outcomes of patients with endoscopic biopsy-proven intestinal
metaplasia (IM) in a multi-center safety-net system in the United States. What
attracted me the most in this study was the study subjects who were
predominantly ethnic minorities with high gastric cancer risk in the United
States. The data of the present study was precious and difficult-to-collect.
However, I think the conclusion that IM was slow progression and may be safe
to be followed up in at least 1-2 years would be misleading. There are several
questions about the present study for the authors' reference:
Major:
1. In this study, 18 in 342 patients (5.3%) were diagnosed gastric cancer in the
index endoscope. The gastric cancer prevalence in the study group was very high
but only 108 patients (31.6%) received biopsies taken from more than one
location and possibly miss the diagnosis of multi-focal IM, a well-recognized
high cancer risk status, in such a high risk group of patients.
2. Only 81 patients received followed up endoscopy with median time to repeat
endoscope of 13 months. This case number and followed-up time would not be
enough to make the conclusion that the IM was slow progression in such a high
risk group patients. 
3. The authors might consider provide the clinical features of the gastric cancer
patients diagnosed in the initial index endoscopy.
Minor:
1. The volume number of Reference 14 is "Endosc Int Open 2021;9(3):E297-
E305". 
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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?
Yes
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Yes
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Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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