Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 01 Oct 2024
Reviewer's report:
The authors conducted a retrospective analysis via the NIS entitled : The Impact of Inter-
Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A National Inpatient
Sample Analysis
However, I found several parts that may necessitate some changes to improve their study.
1. the authors used the NIS 2020 as part of their study. It is advisable to remove cases with
COVID-19, as that becomes a new demographic of patients that could have LGIB
2. The authors used T tests for categorical variables. The NIS normally follows a non-parametric
nature. The authors can test their data via Kolmogorov-Smirnov Test, and then adopt the Mann-
Whitney U test for continuous variables.
3. The authors used the term Gender. The NIS does not report gender. It reports the sex of the
patients. Please note that there is a difference between gender and sex, and it is wise to use them
with caution, and for the NIS they should use sex.
4. The authors wrote Asian. The NIS does not provide data for only Asian. They merge asian
and pacific islanders together. So it should be Asian/Pacific islanders
5. The authors created a sample of non transferred vs transferred, and used the embedded
variable Trans_IN. However, the nontransferred cohort should also be screened for variables of
Trans_out and those patients should be excluded.
6. In their discussions, the authors mentioned missing and incomplete data as one of the
limitations. Such limitations can be reduced by removing all cases missing data for the variables
included in the tables.
7. In Table 1, how did the authors construct these variables? Did they use Elixhauser codes,
CCSR codes, or icd-10 codes? among the three, the use of ICD-10 codes is best fitted to create
more accurate versions of the variables. the description for that part is missing in the methods
and the supplementary
8. In table 3: "required icu admission". There are no such variables in the NIS nor icd-10 code.
The authors should properly describe what they categorized (ie diagnosis or procedure) as icu
admission
9. What icd-10 code was used for troponin elevation?
10. The discussion section did not adequately talk about the findings in table 1. The authors are
recommended to expand it further.
Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 01 Oct 2024
Reviewer's report:
The authors conducted a retrospective analysis via the NIS entitled : The Impact of Inter-
Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A National Inpatient
Sample Analysis
However, I found several parts that may necessitate some changes to improve their study.
1. the authors used the NIS 2020 as part of their study. It is advisable to remove cases with
COVID-19, as that becomes a new demographic of patients that could have LGIB
2. The authors used T tests for categorical variables. The NIS normally follows a non-parametric
nature. The authors can test their data via Kolmogorov-Smirnov Test, and then adopt the Mann-
Whitney U test for continuous variables.
3. The authors used the term Gender. The NIS does not report gender. It reports the sex of the
patients. Please note that there is a difference between gender and sex, and it is wise to use them
with caution, and for the NIS they should use sex.
4. The authors wrote Asian. The NIS does not provide data for only Asian. They merge asian
and pacific islanders together. So it should be Asian/Pacific islanders
5. The authors created a sample of non transferred vs transferred, and used the embedded
variable Trans_IN. However, the nontransferred cohort should also be screened for variables of
Trans_out and those patients should be excluded.
6. In their discussions, the authors mentioned missing and incomplete data as one of the
limitations. Such limitations can be reduced by removing all cases missing data for the variables
included in the tables.
7. In Table 1, how did the authors construct these variables? Did they use Elixhauser codes,
CCSR codes, or icd-10 codes? among the three, the use of ICD-10 codes is best fitted to create
more accurate versions of the variables. the description for that part is missing in the methods
and the supplementary
8. In table 3: "required icu admission". There are no such variables in the NIS nor icd-10 code.
The authors should properly describe what they categorized (ie diagnosis or procedure) as icu
admission
9. What icd-10 code was used for troponin elevation?
10. The discussion section did not adequately talk about the findings in table 1. The authors are
recommended to expand it further.
Please review this paper.
user
Title: The Impact of Inter-Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A
Retrospective Cohort Analysis
Version: 3 Date: 01 Oct 2024
Reviewer's report:
The authors conducted a retrospective analysis via the NIS entitled : The Impact of Inter-
Hospital Transfer on Outcomes in Lower Gastrointestinal Bleeding: A National Inpatient
Sample Analysis
However, I found several parts that may necessitate some changes to improve their study.
1. the authors used the NIS 2020 as part of their study. It is advisable to remove cases with
COVID-19, as that becomes a new demographic of patients that could have LGIB
2. The authors used T tests for categorical variables. The NIS normally follows a non-parametric
nature. The authors can test their data via Kolmogorov-Smirnov Test, and then adopt the Mann-
Whitney U test for continuous variables.
3. The authors used the term Gender. The NIS does not report gender. It reports the sex of the
patients. Please note that there is a difference between gender and sex, and it is wise to use them
with caution, and for the NIS they should use sex.
4. The authors wrote Asian. The NIS does not provide data for only Asian. They merge asian
and pacific islanders together. So it should be Asian/Pacific islanders
5. The authors created a sample of non transferred vs transferred, and used the embedded
variable Trans_IN. However, the nontransferred cohort should also be screened for variables of
Trans_out and those patients should be excluded.
6. In their discussions, the authors mentioned missing and incomplete data as one of the
limitations. Such limitations can be reduced by removing all cases missing data for the variables
included in the tables.
7. In Table 1, how did the authors construct these variables? Did they use Elixhauser codes,
CCSR codes, or icd-10 codes? among the three, the use of ICD-10 codes is best fitted to create
more accurate versions of the variables. the description for that part is missing in the methods
and the supplementary
8. In table 3: "required icu admission". There are no such variables in the NIS nor icd-10 code.
The authors should properly describe what they categorized (ie diagnosis or procedure) as icu
admission
9. What icd-10 code was used for troponin elevation?
10. The discussion section did not adequately talk about the findings in table 1. The authors are
recommended to expand it further.
assistant