Reviewer's report
Title:A comparative study of 22-channel water-perfusion system and solid-state
system with 36-sensors in esophageal manometery
Version: 1Date:26 July 2012
Reviewer: Albert Bredenoord
Reviewer's report:
In this study a 36-channel solid state high-resolution manometry system (SSM) is
compared to 22-channel water-perfused manometry (WPM). Significant but
differences were found in LES location, LES relaxation ratio and UES pressure.
WPM was better tolerated and easier to introduce. The authors should be
complimented with their efforts, it is important to compare new diagnostic
techniques (SSM) with older, established systems (WPM). I have listed some
comments below.
1. The authors state that SSM provided higher resolution images and more
information that WPM. How was this scored? What parameters were used for
this comparison?
2. The differences in LES position and LES relaxation ratio are significant but
very small and probably clinically irrelevant (on average less than 0.5 cm).
Please discuss this. How often was the difference in LES location more than 1
cm and how often more than 2 cm? What do the authors regard as clinically
relevant?
3. Please discuss that besides the differences in techniques there is also a
considerable normal variation that can explain part of the variation when
performing a second test in the same subject as shown by Bogte et al
Neurogastroenterol Motil. 2011 Jul;23(7):e271-6.
4. The point of performing the polynomial equations is not clear to me.
5. The analyses have been done using parametric pairwise comparisons. I think
that when comparing two diagnostic techniques it is better to use Blant-Altman
plots and Kappa statistics. Also, I would be very surprised if these data were
normally distributed and I think that presentation as medians and IQR would
therefore be more appropriate. Also, the statistic tests used should be
non-parametric tests.
6. A 36-sensor circumferential HRM catheter from MMS is described but to my
knowledge this catheter does not exist. Did the authors use the catheter with
unidirectional sensors instead?
7. It is described that the SSM catheter can be equipped with impedance but
WPM systems can also be used with impedance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have received research funding from MMS
Reviewer's report
Title:A comparative study of 22-channel water-perfusion system and solid-state
system with 36-sensors in esophageal manometery
Version: 1Date:26 July 2012
Reviewer: Albert Bredenoord
Reviewer's report:
In this study a 36-channel solid state high-resolution manometry system (SSM) is
compared to 22-channel water-perfused manometry (WPM). Significant but
differences were found in LES location, LES relaxation ratio and UES pressure.
WPM was better tolerated and easier to introduce. The authors should be
complimented with their efforts, it is important to compare new diagnostic
techniques (SSM) with older, established systems (WPM). I have listed some
comments below.
1. The authors state that SSM provided higher resolution images and more
information that WPM. How was this scored? What parameters were used for
this comparison?
2. The differences in LES position and LES relaxation ratio are significant but
very small and probably clinically irrelevant (on average less than 0.5 cm).
Please discuss this. How often was the difference in LES location more than 1
cm and how often more than 2 cm? What do the authors regard as clinically
relevant?
3. Please discuss that besides the differences in techniques there is also a
considerable normal variation that can explain part of the variation when
performing a second test in the same subject as shown by Bogte et al
Neurogastroenterol Motil. 2011 Jul;23(7):e271-6.
4. The point of performing the polynomial equations is not clear to me.
5. The analyses have been done using parametric pairwise comparisons. I think
that when comparing two diagnostic techniques it is better to use Blant-Altman
plots and Kappa statistics. Also, I would be very surprised if these data were
normally distributed and I think that presentation as medians and IQR would
therefore be more appropriate. Also, the statistic tests used should be
non-parametric tests.
6. A 36-sensor circumferential HRM catheter from MMS is described but to my
knowledge this catheter does not exist. Did the authors use the catheter with
unidirectional sensors instead?
7. It is described that the SSM catheter can be equipped with impedance but
WPM systems can also be used with impedance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have received research funding from MMS
Please review this paper.
user
Reviewer's report
Title:A comparative study of 22-channel water-perfusion system and solid-state
system with 36-sensors in esophageal manometery
Version: 1Date:26 July 2012
Reviewer: Albert Bredenoord
Reviewer's report:
In this study a 36-channel solid state high-resolution manometry system (SSM) is
compared to 22-channel water-perfused manometry (WPM). Significant but
differences were found in LES location, LES relaxation ratio and UES pressure.
WPM was better tolerated and easier to introduce. The authors should be
complimented with their efforts, it is important to compare new diagnostic
techniques (SSM) with older, established systems (WPM). I have listed some
comments below.
1. The authors state that SSM provided higher resolution images and more
information that WPM. How was this scored? What parameters were used for
this comparison?
2. The differences in LES position and LES relaxation ratio are significant but
very small and probably clinically irrelevant (on average less than 0.5 cm).
Please discuss this. How often was the difference in LES location more than 1
cm and how often more than 2 cm? What do the authors regard as clinically
relevant?
3. Please discuss that besides the differences in techniques there is also a
considerable normal variation that can explain part of the variation when
performing a second test in the same subject as shown by Bogte et al
Neurogastroenterol Motil. 2011 Jul;23(7):e271-6.
4. The point of performing the polynomial equations is not clear to me.
5. The analyses have been done using parametric pairwise comparisons. I think
that when comparing two diagnostic techniques it is better to use Blant-Altman
plots and Kappa statistics. Also, I would be very surprised if these data were
normally distributed and I think that presentation as medians and IQR would
therefore be more appropriate. Also, the statistic tests used should be
non-parametric tests.
6. A 36-sensor circumferential HRM catheter from MMS is described but to my
knowledge this catheter does not exist. Did the authors use the catheter with
unidirectional sensors instead?
7. It is described that the SSM catheter can be equipped with impedance but
WPM systems can also be used with impedance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have received research funding from MMS
assistant