Reviewer's report
Title:The value of age and medical history for predicting the likelihood of
colorectal cancer and adenomas
Version: 1Date:7 April 2011
Reviewer: Michael Hoffmeister
Reviewer's report:
In this study from Australia including 8200 participants aged 18 years or older
and undergoing colonoscopy in practices or in hospitals for any reason, an
attempt was made to predict different grades of colorectal neoplasia from
information of a self-administered questionnaire and from medical records. The
aim of the study was to find a combination of risk factors that predicts prevalence
of cancer, advanced adenomas and other adenomas, respectively, in order to
better select people at higher risk and to save resources spent on colonscopy.
Among the study's strengths are the assessment of information before the date
of colonoscopy, the availability of medical records, and the large number of
participants. However, from my point of view, there are some major concerns
with respect to the informative value of the results.
Major compulsory revisions:
(1) What is the practical relevance of this prediction model? What is the target
group? Of course, age is the major risk factor. Is this prediction model eligible for
all age groups? The prevalence of most risk factors and the set of risk factors
vary with age.
(2) The mixture of subjects with a history of colonoscopy or even with neoplastic
findings at previous colonoscopy and subjects with no previous colonoscopy
brings in different underlying risks (let alone the risks of those who have
colonoscopies or advanced neoplasia before the age of 40 or 50). If the aim is to
sort out people in the average-risk population who should be advised to have a
colonoscopy, why not focus e.g. on people with no previous colonoscopy? The
target group should be defined more clearly.
(3) How do people have a positive history of polyps although no previous
colonoscopy was performed so that we know?
Minor Essential Revisions:
(4) Table 4 can be omitted. In my opinion, it doesn't add to the major result of this
study and an appropriate discussion would distract from the major findings, as
this table is not easy to comprehend.
(5) The conclusions are poor and include an introductory part (first 2 sentences)
that can be omitted. Please provide a more focussed discussion and
conclusions. Who will be assisted by your models, and what is the rationale for
recommending colonoscopy on the basis of your models?
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 declare that I have no competing interests.
Reviewer's report
Title:The value of age and medical history for predicting the likelihood of
colorectal cancer and adenomas
Version: 1Date:7 April 2011
Reviewer: Michael Hoffmeister
Reviewer's report:
In this study from Australia including 8200 participants aged 18 years or older
and undergoing colonoscopy in practices or in hospitals for any reason, an
attempt was made to predict different grades of colorectal neoplasia from
information of a self-administered questionnaire and from medical records. The
aim of the study was to find a combination of risk factors that predicts prevalence
of cancer, advanced adenomas and other adenomas, respectively, in order to
better select people at higher risk and to save resources spent on colonscopy.
Among the study's strengths are the assessment of information before the date
of colonoscopy, the availability of medical records, and the large number of
participants. However, from my point of view, there are some major concerns
with respect to the informative value of the results.
Major compulsory revisions:
(1) What is the practical relevance of this prediction model? What is the target
group? Of course, age is the major risk factor. Is this prediction model eligible for
all age groups? The prevalence of most risk factors and the set of risk factors
vary with age.
(2) The mixture of subjects with a history of colonoscopy or even with neoplastic
findings at previous colonoscopy and subjects with no previous colonoscopy
brings in different underlying risks (let alone the risks of those who have
colonoscopies or advanced neoplasia before the age of 40 or 50). If the aim is to
sort out people in the average-risk population who should be advised to have a
colonoscopy, why not focus e.g. on people with no previous colonoscopy? The
target group should be defined more clearly.
(3) How do people have a positive history of polyps although no previous
colonoscopy was performed so that we know?
Minor Essential Revisions:
(4) Table 4 can be omitted. In my opinion, it doesn't add to the major result of this
study and an appropriate discussion would distract from the major findings, as
this table is not easy to comprehend.
(5) The conclusions are poor and include an introductory part (first 2 sentences)
that can be omitted. Please provide a more focussed discussion and
conclusions. Who will be assisted by your models, and what is the rationale for
recommending colonoscopy on the basis of your models?
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 declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:The value of age and medical history for predicting the likelihood of
colorectal cancer and adenomas
Version: 1Date:7 April 2011
Reviewer: Michael Hoffmeister
Reviewer's report:
In this study from Australia including 8200 participants aged 18 years or older
and undergoing colonoscopy in practices or in hospitals for any reason, an
attempt was made to predict different grades of colorectal neoplasia from
information of a self-administered questionnaire and from medical records. The
aim of the study was to find a combination of risk factors that predicts prevalence
of cancer, advanced adenomas and other adenomas, respectively, in order to
better select people at higher risk and to save resources spent on colonscopy.
Among the study's strengths are the assessment of information before the date
of colonoscopy, the availability of medical records, and the large number of
participants. However, from my point of view, there are some major concerns
with respect to the informative value of the results.
Major compulsory revisions:
(1) What is the practical relevance of this prediction model? What is the target
group? Of course, age is the major risk factor. Is this prediction model eligible for
all age groups? The prevalence of most risk factors and the set of risk factors
vary with age.
(2) The mixture of subjects with a history of colonoscopy or even with neoplastic
findings at previous colonoscopy and subjects with no previous colonoscopy
brings in different underlying risks (let alone the risks of those who have
colonoscopies or advanced neoplasia before the age of 40 or 50). If the aim is to
sort out people in the average-risk population who should be advised to have a
colonoscopy, why not focus e.g. on people with no previous colonoscopy? The
target group should be defined more clearly.
(3) How do people have a positive history of polyps although no previous
colonoscopy was performed so that we know?
Minor Essential Revisions:
(4) Table 4 can be omitted. In my opinion, it doesn't add to the major result of this
study and an appropriate discussion would distract from the major findings, as
this table is not easy to comprehend.
(5) The conclusions are poor and include an introductory part (first 2 sentences)
that can be omitted. Please provide a more focussed discussion and
conclusions. Who will be assisted by your models, and what is the rationale for
recommending colonoscopy on the basis of your models?
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 declare that I have no competing interests.
assistant