Reviewer ’s report  
 
Title: Fecal Calprotectin Predicts Complete Mucosal Healing and Better Correlates with the 
Endoscopic Index of Se verity than with the Mayo Endoscopic Subscore in Patients with 
Ulcerative Colitis  
 
Version: 0 Date: 30 Jul 2017  
 
Reviewer: Hai yun Shi  
 
Reviewer's report:  
Lee et al. performed a retrospective study to evaluate the diagnostic role of FC for determining 
disease activity of UC. Results showed that FC had significant correlation wit h both of the 
clinical and endoscopic activity. The correlations of FC with MES and UCEIS were compared. 
FC appeared to correlate better with the UCEIS than the MES.  
 
Major concerns about this study:  
1. Cases with FC <100 mg/kg were excluded from this stu dy. What is the proportion of 
patients with FC <100mg/kg? Exclusion of these cases can cause bias when determining the 
cut-off value for mucosal healing.  
 
2. The Cohen's weighted Kappa coefficient for 'bleeding' of the UCEIS was too low (0.38).  
 
3. The co rrelation coefficient between FC and pMS, MES, and UCEIS were quite low.  
 
4. The cut -off level (184.5 mg/kg) for FC to predict mucosal healing (MES/UCEIS 0) was 
relatively high. And the cut -off for predicting clinical remission (1252.5mg/kg) was too 
high.  This may be caused by the time interval between the FC tests and the assessment for 
clinical and endoscopic activity, and the exclusion of cases with low FC levels.  
 
5. What were the cut -off FC levels for MH defined as MES = 0 -1, UCEIS = 0, 0 -1, 0-2, and 0-
3? 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are re quired in your comments to the authors.  
 
Yes  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No  
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qu ality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. 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 from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the pu blication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial  competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the websi te along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my name d report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Fecal Calprotectin Predicts Complete Mucosal Healing and Better Correlates with the 
Endoscopic Index of Se verity than with the Mayo Endoscopic Subscore in Patients with 
Ulcerative Colitis  
 
Version: 0 Date: 30 Jul 2017  
 
Reviewer: Hai yun Shi  
 
Reviewer's report:  
Lee et al. performed a retrospective study to evaluate the diagnostic role of FC for determining 
disease activity of UC. Results showed that FC had significant correlation wit h both of the 
clinical and endoscopic activity. The correlations of FC with MES and UCEIS were compared. 
FC appeared to correlate better with the UCEIS than the MES.  
 
Major concerns about this study:  
1. Cases with FC <100 mg/kg were excluded from this stu dy. What is the proportion of 
patients with FC <100mg/kg? Exclusion of these cases can cause bias when determining the 
cut-off value for mucosal healing.  
 
2. The Cohen's weighted Kappa coefficient for 'bleeding' of the UCEIS was too low (0.38).  
 
3. The co rrelation coefficient between FC and pMS, MES, and UCEIS were quite low.  
 
4. The cut -off level (184.5 mg/kg) for FC to predict mucosal healing (MES/UCEIS 0) was 
relatively high. And the cut -off for predicting clinical remission (1252.5mg/kg) was too 
high.  This may be caused by the time interval between the FC tests and the assessment for 
clinical and endoscopic activity, and the exclusion of cases with low FC levels.  
 
5. What were the cut -off FC levels for MH defined as MES = 0 -1, UCEIS = 0, 0 -1, 0-2, and 0-
3? 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are re quired in your comments to the authors.  
 
Yes  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No  
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qu ality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. 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 from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the pu blication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial  competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the websi te along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my name d report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Fecal Calprotectin Predicts Complete Mucosal Healing and Better Correlates with the 
Endoscopic Index of Se verity than with the Mayo Endoscopic Subscore in Patients with 
Ulcerative Colitis  
 
Version: 0 Date: 30 Jul 2017  
 
Reviewer: Hai yun Shi  
 
Reviewer's report:  
Lee et al. performed a retrospective study to evaluate the diagnostic role of FC for determining 
disease activity of UC. Results showed that FC had significant correlation wit h both of the 
clinical and endoscopic activity. The correlations of FC with MES and UCEIS were compared. 
FC appeared to correlate better with the UCEIS than the MES.  
 
Major concerns about this study:  
1. Cases with FC <100 mg/kg were excluded from this stu dy. What is the proportion of 
patients with FC <100mg/kg? Exclusion of these cases can cause bias when determining the 
cut-off value for mucosal healing.  
 
2. The Cohen's weighted Kappa coefficient for 'bleeding' of the UCEIS was too low (0.38).  
 
3. The co rrelation coefficient between FC and pMS, MES, and UCEIS were quite low.  
 
4. The cut -off level (184.5 mg/kg) for FC to predict mucosal healing (MES/UCEIS 0) was 
relatively high. And the cut -off for predicting clinical remission (1252.5mg/kg) was too 
high.  This may be caused by the time interval between the FC tests and the assessment for 
clinical and endoscopic activity, and the exclusion of cases with low FC levels.  
 
5. What were the cut -off FC levels for MH defined as MES = 0 -1, UCEIS = 0, 0 -1, 0-2, and 0-
3? 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are re quired in your comments to the authors.  
 
Yes  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No  
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qu ality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. 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 from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the pu blication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial  competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the websi te along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my name d report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant