Reviewer’s report
Title:  AIMS65  scoring  system  is  comparable  to  Glasgow-Blatchford  score  or  Rockall  score  for
prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding
Version: 2 Date: 23 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
REVISION ASSESSMENT FROM THE ACADEMIC PEER REVIEWER: 
Has  the  author  addressed  your  concerns  sufficiently for  you  to  now  recommend  the  work  as  a
technically sound contribution? Yes
Reviewer comments: SUMMARY COMMENTS
Additional suggestions
1. Page 2 line 21 delete "visited" and change to "who were treated at"
1. Page 3 lines 4-7. I would make this statement a bit stronger to see the most important finding of your
study. What about  changing "it might be recommended" to "we would recommend using the AIMS75"
and in tads the word "so" before the word easier I on line 4.   You have good data why not emphasize
it!
3. Page lines 9-19 I am confused about ref #14. Were there a lot of varicella bleeding patients at in that
study? If so then say it, maybe by adding the phrase "but this study included many (or even add the %
of patients with variceal bleeding) patients with variceal bleeding which confounds the use of this
scoring system for non-variceal UGI (NVUGI) bleeding" then delete the first two sentences starting on
line 14.
4. Page 4 line 45 change to "Patients with esophageal or gastric variceal bleeding were excluded".
5. Page 4 line 38 change "enrolled" to "reviewed" and line 51 change "collected in" to "recovered
from"
6.  Page  5  line  16  capitalize  "Dieulafoy's"  also  line  19  add  the  word  "and"  after  the  word
"angiodysplasia"
7. Might the AIM75 also provide a rational for delaying emergency endoscopic intervention until the
next day of patients arrive in the evening or night time? Think about this in the discussion; it is always
debated if UGI bleeders who are stable need emergency endoscopy when they arrive.
8. You still need a bit of editing by someone a bit more precise with English writing ( for instance page
6 line 4 "patients" should be "patient" and there are many other places that could be written a bit more
smoothly, please do not take this as criticism but rather as constructive advice; being from the US, I can
only try to imagine how difficult it would be for me to try to write a paper in a non native language.  A
more precise editing will make you look "better", it never hurts because some journals consider this
inappropriate while others realize that these minor necessary edits of the grammar are to be expected
but other journals do not.
9. Page 7 line 9 don't you mean that the p values were "DIVIDED by 4 because of 4 multiple
simultaneous comparisons"?
10. Page 7 line 48 do you mean "melena" (black tarry stools or do you mean "hematochezia" (altered
blood in stool)? These two terms are different.
11. Page 8 line 14-16. Add what the cause of such massive bleeding was. It is very u usual to die from
nonvariceal massive bleeding !
12. Page 8 line 19 change to "All but one of the 17 patients who died"
13. Page 8 line 36-39 I would again suggest that you delete the phrase "but there was no statistically
significant difference between the groups".  You give a p value let the reader determine how important
these differences are! Or if you want say "There was a trend ( p=0.07) suggesting that the AIMS65
scoring system (0.84) was more accurate.
14. Page 10 lines 43-page 11 line 19. Were these all NVUGI bleeding ? If so say it.
15. Page 11 line 38. Change "somewhat" to "much more difficult to apply by the busy clinician"
16 page 11 line 51. Again point out that ref 14 had variceal bleeders as well and maybe also include
their percentage.
17 page 12 line 9 delete the phrase "both study design and". The study design has nothing to do with
data retrieval from the medical records and is not a limitation
18. Page 12 line 21. Move the last sentence up to the previous line before the sentence starting with
"Because" - and add the word "Another " before "limitation"
19. Page 12 line 38 change to "The AIMS65 scoring system, however, is much easier". And online 41
add "by the busy clinician" after the word "performed". You have good data, showing it is as good may
be better and moreover it is MUCH easier to calculate for a busy clinician! So why not emphasize this!
29. Finally Page 21 figure 2 legend. Again I would suggest that you delete the phrase "but there was
no.... groups". Leave the p value there.
Good luck. I think with these changes you emphasize the worth of your study better and are fair to the
statistics because when a p value is =0.07 and you show it but do not say definitively that the values are
"different" you are being honest!ou show it but do not say definitively that the values are
"different" you are being honest!
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. 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/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title:  AIMS65  scoring  system  is  comparable  to  Glasgow-Blatchford  score  or  Rockall  score  for
prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding
Version: 2 Date: 23 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
REVISION ASSESSMENT FROM THE ACADEMIC PEER REVIEWER: 
Has  the  author  addressed  your  concerns  sufficiently for  you  to  now  recommend  the  work  as  a
technically sound contribution? Yes
Reviewer comments: SUMMARY COMMENTS
Additional suggestions
1. Page 2 line 21 delete "visited" and change to "who were treated at"
1. Page 3 lines 4-7. I would make this statement a bit stronger to see the most important finding of your
study. What about  changing "it might be recommended" to "we would recommend using the AIMS75"
and in tads the word "so" before the word easier I on line 4.   You have good data why not emphasize
it!
3. Page lines 9-19 I am confused about ref #14. Were there a lot of varicella bleeding patients at in that
study? If so then say it, maybe by adding the phrase "but this study included many (or even add the %
of patients with variceal bleeding) patients with variceal bleeding which confounds the use of this
scoring system for non-variceal UGI (NVUGI) bleeding" then delete the first two sentences starting on
line 14.
4. Page 4 line 45 change to "Patients with esophageal or gastric variceal bleeding were excluded".
5. Page 4 line 38 change "enrolled" to "reviewed" and line 51 change "collected in" to "recovered
from"
6.  Page  5  line  16  capitalize  "Dieulafoy's"  also  line  19  add  the  word  "and"  after  the  word
"angiodysplasia"
7. Might the AIM75 also provide a rational for delaying emergency endoscopic intervention until the
next day of patients arrive in the evening or night time? Think about this in the discussion; it is always
debated if UGI bleeders who are stable need emergency endoscopy when they arrive.
8. You still need a bit of editing by someone a bit more precise with English writing ( for instance page
6 line 4 "patients" should be "patient" and there are many other places that could be written a bit more
smoothly, please do not take this as criticism but rather as constructive advice; being from the US, I can
only try to imagine how difficult it would be for me to try to write a paper in a non native language.  A
more precise editing will make you look "better", it never hurts because some journals consider this
inappropriate while others realize that these minor necessary edits of the grammar are to be expected
but other journals do not.
9. Page 7 line 9 don't you mean that the p values were "DIVIDED by 4 because of 4 multiple
simultaneous comparisons"?
10. Page 7 line 48 do you mean "melena" (black tarry stools or do you mean "hematochezia" (altered
blood in stool)? These two terms are different.
11. Page 8 line 14-16. Add what the cause of such massive bleeding was. It is very u usual to die from
nonvariceal massive bleeding !
12. Page 8 line 19 change to "All but one of the 17 patients who died"
13. Page 8 line 36-39 I would again suggest that you delete the phrase "but there was no statistically
significant difference between the groups".  You give a p value let the reader determine how important
these differences are! Or if you want say "There was a trend ( p=0.07) suggesting that the AIMS65
scoring system (0.84) was more accurate.
14. Page 10 lines 43-page 11 line 19. Were these all NVUGI bleeding ? If so say it.
15. Page 11 line 38. Change "somewhat" to "much more difficult to apply by the busy clinician"
16 page 11 line 51. Again point out that ref 14 had variceal bleeders as well and maybe also include
their percentage.
17 page 12 line 9 delete the phrase "both study design and". The study design has nothing to do with
data retrieval from the medical records and is not a limitation
18. Page 12 line 21. Move the last sentence up to the previous line before the sentence starting with
"Because" - and add the word "Another " before "limitation"
19. Page 12 line 38 change to "The AIMS65 scoring system, however, is much easier". And online 41
add "by the busy clinician" after the word "performed". You have good data, showing it is as good may
be better and moreover it is MUCH easier to calculate for a busy clinician! So why not emphasize this!
29. Finally Page 21 figure 2 legend. Again I would suggest that you delete the phrase "but there was
no.... groups". Leave the p value there.
Good luck. I think with these changes you emphasize the worth of your study better and are fair to the
statistics because when a p value is =0.07 and you show it but do not say definitively that the values are
"different" you are being honest!ou show it but do not say definitively that the values are
"different" you are being honest!
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. 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/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title:  AIMS65  scoring  system  is  comparable  to  Glasgow-Blatchford  score  or  Rockall  score  for
prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding
Version: 2 Date: 23 Jan 2019
Reviewer: Reviewer 2
Reviewer's report:
REVISION ASSESSMENT FROM THE ACADEMIC PEER REVIEWER: 
Has  the  author  addressed  your  concerns  sufficiently for  you  to  now  recommend  the  work  as  a
technically sound contribution? Yes
Reviewer comments: SUMMARY COMMENTS
Additional suggestions
1. Page 2 line 21 delete "visited" and change to "who were treated at"
1. Page 3 lines 4-7. I would make this statement a bit stronger to see the most important finding of your
study. What about  changing "it might be recommended" to "we would recommend using the AIMS75"
and in tads the word "so" before the word easier I on line 4.   You have good data why not emphasize
it!
3. Page lines 9-19 I am confused about ref #14. Were there a lot of varicella bleeding patients at in that
study? If so then say it, maybe by adding the phrase "but this study included many (or even add the %
of patients with variceal bleeding) patients with variceal bleeding which confounds the use of this
scoring system for non-variceal UGI (NVUGI) bleeding" then delete the first two sentences starting on
line 14.
4. Page 4 line 45 change to "Patients with esophageal or gastric variceal bleeding were excluded".
5. Page 4 line 38 change "enrolled" to "reviewed" and line 51 change "collected in" to "recovered
from"
6.  Page  5  line  16  capitalize  "Dieulafoy's"  also  line  19  add  the  word  "and"  after  the  word
"angiodysplasia"
7. Might the AIM75 also provide a rational for delaying emergency endoscopic intervention until the
next day of patients arrive in the evening or night time? Think about this in the discussion; it is always
debated if UGI bleeders who are stable need emergency endoscopy when they arrive.
8. You still need a bit of editing by someone a bit more precise with English writing ( for instance page
6 line 4 "patients" should be "patient" and there are many other places that could be written a bit more
smoothly, please do not take this as criticism but rather as constructive advice; being from the US, I can
only try to imagine how difficult it would be for me to try to write a paper in a non native language.  A
more precise editing will make you look "better", it never hurts because some journals consider this
inappropriate while others realize that these minor necessary edits of the grammar are to be expected
but other journals do not.
9. Page 7 line 9 don't you mean that the p values were "DIVIDED by 4 because of 4 multiple
simultaneous comparisons"?
10. Page 7 line 48 do you mean "melena" (black tarry stools or do you mean "hematochezia" (altered
blood in stool)? These two terms are different.
11. Page 8 line 14-16. Add what the cause of such massive bleeding was. It is very u usual to die from
nonvariceal massive bleeding !
12. Page 8 line 19 change to "All but one of the 17 patients who died"
13. Page 8 line 36-39 I would again suggest that you delete the phrase "but there was no statistically
significant difference between the groups".  You give a p value let the reader determine how important
these differences are! Or if you want say "There was a trend ( p=0.07) suggesting that the AIMS65
scoring system (0.84) was more accurate.
14. Page 10 lines 43-page 11 line 19. Were these all NVUGI bleeding ? If so say it.
15. Page 11 line 38. Change "somewhat" to "much more difficult to apply by the busy clinician"
16 page 11 line 51. Again point out that ref 14 had variceal bleeders as well and maybe also include
their percentage.
17 page 12 line 9 delete the phrase "both study design and". The study design has nothing to do with
data retrieval from the medical records and is not a limitation
18. Page 12 line 21. Move the last sentence up to the previous line before the sentence starting with
"Because" - and add the word "Another " before "limitation"
19. Page 12 line 38 change to "The AIMS65 scoring system, however, is much easier". And online 41
add "by the busy clinician" after the word "performed". You have good data, showing it is as good may
be better and moreover it is MUCH easier to calculate for a busy clinician! So why not emphasize this!
29. Finally Page 21 figure 2 legend. Again I would suggest that you delete the phrase "but there was
no.... groups". Leave the p value there.
Good luck. I think with these changes you emphasize the worth of your study better and are fair to the
statistics because when a p value is =0.07 and you show it but do not say definitively that the values are
"different" you are being honest!ou show it but do not say definitively that the values are
"different" you are being honest!
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. 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/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
assistant