Title: A Magnetic Resonance Imaging-Based Decision-Making Tool for Predicting Complex
Anal Fistulas Healing in The Early Postoperative Period
Version: 0 Date: 23 Jul 2023
Reviewer's report:
Dear authors,
I read your paper with great interest. I need to pose certain questions prior to considering for
acceptance, as below.
1. In your methodology, you have chosen to do the post operative MRI after the first stage
procedure post seton placement and not after the second stage procedure. It is the second stage
procedure which has greater impact on fistula recurrence, as it deals with addressing the internal
opening and often secondary tracts may be detected at this stage. So how do you explain the
benefit of doing the postoperative MR after the first procedure. Also the fistula healing is defined
after the second procedure.
2. How did you decide the time frame to do the postoperative MRI?
3. What is the cost effectiveness and clinical utility of doing this MRI? In any case, clinical
follow-up will determine the healing and action based on MRI is unlikely and may be futile.
4. Since the study was retrospective, the recording of alcohol intake was as a nominal data,
whereas it will be significant to know the extent of alcohol intake (as a ordinal variable) which
will actually help measure its relevance. So to include alcohol intake in the nomogram, doesn't
make sense. It can be utilised in a subsequent prospective study. In this study, it is a secondary
endpoint with poor reliance.
Regards,
Peer reviewer
Title: A Magnetic Resonance Imaging-Based Decision-Making Tool for Predicting Complex
Anal Fistulas Healing in The Early Postoperative Period
Version: 0 Date: 23 Jul 2023
Reviewer's report:
Dear authors,
I read your paper with great interest. I need to pose certain questions prior to considering for
acceptance, as below.
1. In your methodology, you have chosen to do the post operative MRI after the first stage
procedure post seton placement and not after the second stage procedure. It is the second stage
procedure which has greater impact on fistula recurrence, as it deals with addressing the internal
opening and often secondary tracts may be detected at this stage. So how do you explain the
benefit of doing the postoperative MR after the first procedure. Also the fistula healing is defined
after the second procedure.
2. How did you decide the time frame to do the postoperative MRI?
3. What is the cost effectiveness and clinical utility of doing this MRI? In any case, clinical
follow-up will determine the healing and action based on MRI is unlikely and may be futile.
4. Since the study was retrospective, the recording of alcohol intake was as a nominal data,
whereas it will be significant to know the extent of alcohol intake (as a ordinal variable) which
will actually help measure its relevance. So to include alcohol intake in the nomogram, doesn't
make sense. It can be utilised in a subsequent prospective study. In this study, it is a secondary
endpoint with poor reliance.
Regards,
Peer reviewer
Please review this paper.
user
Title: A Magnetic Resonance Imaging-Based Decision-Making Tool for Predicting Complex
Anal Fistulas Healing in The Early Postoperative Period
Version: 0 Date: 23 Jul 2023
Reviewer's report:
Dear authors,
I read your paper with great interest. I need to pose certain questions prior to considering for
acceptance, as below.
1. In your methodology, you have chosen to do the post operative MRI after the first stage
procedure post seton placement and not after the second stage procedure. It is the second stage
procedure which has greater impact on fistula recurrence, as it deals with addressing the internal
opening and often secondary tracts may be detected at this stage. So how do you explain the
benefit of doing the postoperative MR after the first procedure. Also the fistula healing is defined
after the second procedure.
2. How did you decide the time frame to do the postoperative MRI?
3. What is the cost effectiveness and clinical utility of doing this MRI? In any case, clinical
follow-up will determine the healing and action based on MRI is unlikely and may be futile.
4. Since the study was retrospective, the recording of alcohol intake was as a nominal data,
whereas it will be significant to know the extent of alcohol intake (as a ordinal variable) which
will actually help measure its relevance. So to include alcohol intake in the nomogram, doesn't
make sense. It can be utilised in a subsequent prospective study. In this study, it is a secondary
endpoint with poor reliance.
Regards,
Peer reviewer
assistant