Reviewer’s report
Title: 
Analysis of gastroscopy results among healthy people undergoing a
medical checkup: A retrospective study
Version: 
1 
Date: 
19 Oct 2020
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: It has good material, but needs more revisions. 
REQUESTED REVISIONS: 
In Background, 2nd paragraph, please give a reference to the statement starting
with " as the pace of….". Otherwise, this is a subjective statement and does not
read too professional. 
The following statements in the whole second paragraph
also have speculations that need references to support. 
Can the authors report some drawbacks of the studies in the literature on routine
performance of gastroscopy in asymptomatic patients and then based on the
drawbacks existing, develop a hypothesis? Current Introduction/background
does not read too compelling.
In Results, line 124, replace "diseases" with "findings". 
The same
recommendation applies to the use of "disease/s" in the whole Results section. 
I suggest to also include a multivariate regression analysis on the presence of the
findings highlighted. 
For instance, if H. Pylori is the most significant predictor of
these findings, what about noninvasive H.Pylori testing, instead of a
gastroscopy?
In Discussion, 1st sentence, I recommend you to highlight what the strength of
your study is and how it contributes to the literature. Is it the largest study? Are
you reporting a finding no one else has reported before? 
I would also include a follow up. 
How were the endoscopic findings treated?
What if they were not treated? What would have been the outcome? Hence, the
argument for routine gastroscopy. 
I would also use some these discussions in the
Introduction 
to create the background for the study.
The gastric pathologies change from geographic region to region. 
As gastric
pathologies are more common in the Eastern world, the findings of the study
might be more relevant to that part of the world. Therefore, I suggest the authors
to reiterate this fact both as a strength and weakness of the study. 
Overall, this is good data and a very large study. The authors should do a better
job in setting up the background, hypothesis and discussion of the relevance of
their findings. 
They also need to stay away from generalizing their findings to
the whole world, but rather highlight it for the geography that they apply to.
Publons Reviewer Recognition
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review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
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Review Data to generate derivative metadata for the benefit of Publons and you
as a reviewer, carefully considering the sensitivity of such information. For
example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help
editors to identify candidate reviewers. Please find the details of processing in
Publons’ privacy policy 
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No
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 publication 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.
This reviewer has been recruited by a partner organization, Research Square.
Reviewers with declared or apparent competing interests are not utilized for
these reviews. This reviewer has agreed to publication of their comments online
under a Creative Commons Attribution License attributed to Research Square
and was paid a small honorarium for completing the review within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer
recommendation.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
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
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Analysis of gastroscopy results among healthy people undergoing a
medical checkup: A retrospective study
Version: 
1 
Date: 
19 Oct 2020
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: It has good material, but needs more revisions. 
REQUESTED REVISIONS: 
In Background, 2nd paragraph, please give a reference to the statement starting
with " as the pace of….". Otherwise, this is a subjective statement and does not
read too professional. 
The following statements in the whole second paragraph
also have speculations that need references to support. 
Can the authors report some drawbacks of the studies in the literature on routine
performance of gastroscopy in asymptomatic patients and then based on the
drawbacks existing, develop a hypothesis? Current Introduction/background
does not read too compelling.
In Results, line 124, replace "diseases" with "findings". 
The same
recommendation applies to the use of "disease/s" in the whole Results section. 
I suggest to also include a multivariate regression analysis on the presence of the
findings highlighted. 
For instance, if H. Pylori is the most significant predictor of
these findings, what about noninvasive H.Pylori testing, instead of a
gastroscopy?
In Discussion, 1st sentence, I recommend you to highlight what the strength of
your study is and how it contributes to the literature. Is it the largest study? Are
you reporting a finding no one else has reported before? 
I would also include a follow up. 
How were the endoscopic findings treated?
What if they were not treated? What would have been the outcome? Hence, the
argument for routine gastroscopy. 
I would also use some these discussions in the
Introduction 
to create the background for the study.
The gastric pathologies change from geographic region to region. 
As gastric
pathologies are more common in the Eastern world, the findings of the study
might be more relevant to that part of the world. Therefore, I suggest the authors
to reiterate this fact both as a strength and weakness of the study. 
Overall, this is good data and a very large study. The authors should do a better
job in setting up the background, hypothesis and discussion of the relevance of
their findings. 
They also need to stay away from generalizing their findings to
the whole world, but rather highlight it for the geography that they apply to.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons upon publication of the manuscript. If you have already registered at
Publons, they will notify you of the receipt of this review and update your profile
as per your settings and their policy. If you are not registered with Publons, you
will receive an email from them asking you to register in order for them to be
able to recognize your review on your new profile page. Publons may use the
Review Data to generate derivative metadata for the benefit of Publons and you
as a reviewer, carefully considering the sensitivity of such information. For
example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help
editors to identify candidate reviewers. Please find the details of processing in
Publons’ privacy policy 
https://publons.com/about/terms
No
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 publication 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.
This reviewer has been recruited by a partner organization, Research Square.
Reviewers with declared or apparent competing interests are not utilized for
these reviews. This reviewer has agreed to publication of their comments online
under a Creative Commons Attribution License attributed to Research Square
and was paid a small honorarium for completing the review within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer
recommendation.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
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
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Analysis of gastroscopy results among healthy people undergoing a
medical checkup: A retrospective study
Version: 
1 
Date: 
19 Oct 2020
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: It has good material, but needs more revisions. 
REQUESTED REVISIONS: 
In Background, 2nd paragraph, please give a reference to the statement starting
with " as the pace of….". Otherwise, this is a subjective statement and does not
read too professional. 
The following statements in the whole second paragraph
also have speculations that need references to support. 
Can the authors report some drawbacks of the studies in the literature on routine
performance of gastroscopy in asymptomatic patients and then based on the
drawbacks existing, develop a hypothesis? Current Introduction/background
does not read too compelling.
In Results, line 124, replace "diseases" with "findings". 
The same
recommendation applies to the use of "disease/s" in the whole Results section. 
I suggest to also include a multivariate regression analysis on the presence of the
findings highlighted. 
For instance, if H. Pylori is the most significant predictor of
these findings, what about noninvasive H.Pylori testing, instead of a
gastroscopy?
In Discussion, 1st sentence, I recommend you to highlight what the strength of
your study is and how it contributes to the literature. Is it the largest study? Are
you reporting a finding no one else has reported before? 
I would also include a follow up. 
How were the endoscopic findings treated?
What if they were not treated? What would have been the outcome? Hence, the
argument for routine gastroscopy. 
I would also use some these discussions in the
Introduction 
to create the background for the study.
The gastric pathologies change from geographic region to region. 
As gastric
pathologies are more common in the Eastern world, the findings of the study
might be more relevant to that part of the world. Therefore, I suggest the authors
to reiterate this fact both as a strength and weakness of the study. 
Overall, this is good data and a very large study. The authors should do a better
job in setting up the background, hypothesis and discussion of the relevance of
their findings. 
They also need to stay away from generalizing their findings to
the whole world, but rather highlight it for the geography that they apply to.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons upon publication of the manuscript. If you have already registered at
Publons, they will notify you of the receipt of this review and update your profile
as per your settings and their policy. If you are not registered with Publons, you
will receive an email from them asking you to register in order for them to be
able to recognize your review on your new profile page. Publons may use the
Review Data to generate derivative metadata for the benefit of Publons and you
as a reviewer, carefully considering the sensitivity of such information. For
example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help
editors to identify candidate reviewers. Please find the details of processing in
Publons’ privacy policy 
https://publons.com/about/terms
No
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 publication 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.
This reviewer has been recruited by a partner organization, Research Square.
Reviewers with declared or apparent competing interests are not utilized for
these reviews. This reviewer has agreed to publication of their comments online
under a Creative Commons Attribution License attributed to Research Square
and was paid a small honorarium for completing the review within a specified
timeframe. Honoraria for reviews such as this are paid regardless of the reviewer
recommendation.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
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
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
assistant