Title: Global Burden of Esophageal Diseases: A Comprehensive Analysis of Disease Trends
and Risk Factors from 1990 to 2021
Version: 2 Date: 22 Apr 2025
Reviewer:  Haoyu An
Reviewer's report:
Overall Recommendation:
Minor Revision
This manuscript provides new insights into the evolving epidemiology of esophageal disorders.
The authors should address the reviewers' technical comments to strengthen the manuscript's
scientific rigor.
1. The description of esophageal diseases (ED) as 'mainly including gastroesophageal
reflux disease (GERD) and esophageal cancer (EC)' requires refinement. Current clinical
classifications typically encompass a broader spectrum, including GERD, esophagitis, Barrett's
esophagus, achalasia, and esophageal cancer.
2. The statement regarding the high recurrence rate of GERD and poor prognosis of EC
contributing to disease burden would benefit from appropriately cited references.
3. While the application of Bayesian age-period-cohort (BAPC) modeling is appropriate, the
methodological description requires expansion to ensure reproducibility. Perhaps you can refer
to this article (10.1007/s10620-024-08465-y).
4. The current analysis of population attributable fractions (PAF) focuses exclusively on EC
risk factors. To enhance the study's comprehensiveness, supplementing the analysis of GERD-
related risk factors for its burden indicators would provide more valuable insights.
5. The isolated presentation of analysis software and statistical thresholds in separate sections
may affect methodological clarity. I recommend consolidating all technical specifications
(including software versions and significance thresholds) within the Methods section for
improved readability.
6. The identification of key risk factors in Figure 9 would benefit from clearer methodological
justification. Prior to conducting population attributable fraction (PAF) analysis, it is essential
to establish an evidence-based selection process for included risk factors. I recommend
either a) explicitly referencing established risk factor hierarchies from authoritative sources
or b) conducting a systematic literature review to justify factor inclusion using predefined
selection criteria. This methodological transparency is critical for validating the 'key risk factor'
designation.
Title: Global Burden of Esophageal Diseases: A Comprehensive Analysis of Disease Trends
and Risk Factors from 1990 to 2021
Version: 2 Date: 22 Apr 2025
Reviewer:  Haoyu An
Reviewer's report:
Overall Recommendation:
Minor Revision
This manuscript provides new insights into the evolving epidemiology of esophageal disorders.
The authors should address the reviewers' technical comments to strengthen the manuscript's
scientific rigor.
1. The description of esophageal diseases (ED) as 'mainly including gastroesophageal
reflux disease (GERD) and esophageal cancer (EC)' requires refinement. Current clinical
classifications typically encompass a broader spectrum, including GERD, esophagitis, Barrett's
esophagus, achalasia, and esophageal cancer.
2. The statement regarding the high recurrence rate of GERD and poor prognosis of EC
contributing to disease burden would benefit from appropriately cited references.
3. While the application of Bayesian age-period-cohort (BAPC) modeling is appropriate, the
methodological description requires expansion to ensure reproducibility. Perhaps you can refer
to this article (10.1007/s10620-024-08465-y).
4. The current analysis of population attributable fractions (PAF) focuses exclusively on EC
risk factors. To enhance the study's comprehensiveness, supplementing the analysis of GERD-
related risk factors for its burden indicators would provide more valuable insights.
5. The isolated presentation of analysis software and statistical thresholds in separate sections
may affect methodological clarity. I recommend consolidating all technical specifications
(including software versions and significance thresholds) within the Methods section for
improved readability.
6. The identification of key risk factors in Figure 9 would benefit from clearer methodological
justification. Prior to conducting population attributable fraction (PAF) analysis, it is essential
to establish an evidence-based selection process for included risk factors. I recommend
either a) explicitly referencing established risk factor hierarchies from authoritative sources
or b) conducting a systematic literature review to justify factor inclusion using predefined
selection criteria. This methodological transparency is critical for validating the 'key risk factor'
designation.
Please review this paper.
user
Title: Global Burden of Esophageal Diseases: A Comprehensive Analysis of Disease Trends
and Risk Factors from 1990 to 2021
Version: 2 Date: 22 Apr 2025
Reviewer:  Haoyu An
Reviewer's report:
Overall Recommendation:
Minor Revision
This manuscript provides new insights into the evolving epidemiology of esophageal disorders.
The authors should address the reviewers' technical comments to strengthen the manuscript's
scientific rigor.
1. The description of esophageal diseases (ED) as 'mainly including gastroesophageal
reflux disease (GERD) and esophageal cancer (EC)' requires refinement. Current clinical
classifications typically encompass a broader spectrum, including GERD, esophagitis, Barrett's
esophagus, achalasia, and esophageal cancer.
2. The statement regarding the high recurrence rate of GERD and poor prognosis of EC
contributing to disease burden would benefit from appropriately cited references.
3. While the application of Bayesian age-period-cohort (BAPC) modeling is appropriate, the
methodological description requires expansion to ensure reproducibility. Perhaps you can refer
to this article (10.1007/s10620-024-08465-y).
4. The current analysis of population attributable fractions (PAF) focuses exclusively on EC
risk factors. To enhance the study's comprehensiveness, supplementing the analysis of GERD-
related risk factors for its burden indicators would provide more valuable insights.
5. The isolated presentation of analysis software and statistical thresholds in separate sections
may affect methodological clarity. I recommend consolidating all technical specifications
(including software versions and significance thresholds) within the Methods section for
improved readability.
6. The identification of key risk factors in Figure 9 would benefit from clearer methodological
justification. Prior to conducting population attributable fraction (PAF) analysis, it is essential
to establish an evidence-based selection process for included risk factors. I recommend
either a) explicitly referencing established risk factor hierarchies from authoritative sources
or b) conducting a systematic literature review to justify factor inclusion using predefined
selection criteria. This methodological transparency is critical for validating the 'key risk factor'
designation.
assistant