Reviewer's report
Title:A Multi-Country Study of Intussusception in Children Under 2 Years of Age
in Latin America: Analysis of Prospective Surveillance Data.
Version: 1Date:13 February 2013
Reviewer: G Kang
Reviewer's report:
This large prospective multi-country survey of childhood intussusception used the
Brighton criteria to attempt an estimation of baseline rates of intussusception
prior to rotavirus vaccine introduction. The study will add considerable value to
the literature on intussusception, but some key issues need to be highlighted and
discussed in greater detail.
Major Compulsory Revisions
1. Presentation of a rate requires consideration of the quality and completeness
of the data. While the methods used once patients reached hospital are
appropriate, the authors have little or no control over what proportion of patients
within the catchment area of the hospital actually access healthcare at the
participating hospital. While the issue has been stated as a single sentence in the
discussion and it has been pointed out that data from catchment areas can not
be generalized to the country, it is essential that some estimate of healthcare
utilization by the catchment area population is presented by country, so that the
incidence rate can be adjusted accordingly.
Minor Essential Revisions
1. It is important to emphasize that both the high rate of surgery and the
presentation with 5 or more symptoms in the majority of cases indicate a late
presentation of cases, so it is likely that intussusception that resolved
spontaneously were not included. It would be useful to include the duration of
symptoms before presentation to hospital and then see what proportion of early
and late presentations required surgery.
Discretionary Revisions
1. It would be interesting to report whether there were any spontaneous
reductions, and whether or not those would might the Brighton criteria.
2. Mexico has the highest numbers and Brazil the lowest rate. How do these
figures affect the understanding of the reports of intussuception post-vaccination
from the two countries?
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:A Multi-Country Study of Intussusception in Children Under 2 Years of Age
in Latin America: Analysis of Prospective Surveillance Data.
Version: 1Date:13 February 2013
Reviewer: G Kang
Reviewer's report:
This large prospective multi-country survey of childhood intussusception used the
Brighton criteria to attempt an estimation of baseline rates of intussusception
prior to rotavirus vaccine introduction. The study will add considerable value to
the literature on intussusception, but some key issues need to be highlighted and
discussed in greater detail.
Major Compulsory Revisions
1. Presentation of a rate requires consideration of the quality and completeness
of the data. While the methods used once patients reached hospital are
appropriate, the authors have little or no control over what proportion of patients
within the catchment area of the hospital actually access healthcare at the
participating hospital. While the issue has been stated as a single sentence in the
discussion and it has been pointed out that data from catchment areas can not
be generalized to the country, it is essential that some estimate of healthcare
utilization by the catchment area population is presented by country, so that the
incidence rate can be adjusted accordingly.
Minor Essential Revisions
1. It is important to emphasize that both the high rate of surgery and the
presentation with 5 or more symptoms in the majority of cases indicate a late
presentation of cases, so it is likely that intussusception that resolved
spontaneously were not included. It would be useful to include the duration of
symptoms before presentation to hospital and then see what proportion of early
and late presentations required surgery.
Discretionary Revisions
1. It would be interesting to report whether there were any spontaneous
reductions, and whether or not those would might the Brighton criteria.
2. Mexico has the highest numbers and Brazil the lowest rate. How do these
figures affect the understanding of the reports of intussuception post-vaccination
from the two countries?
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:A Multi-Country Study of Intussusception in Children Under 2 Years of Age
in Latin America: Analysis of Prospective Surveillance Data.
Version: 1Date:13 February 2013
Reviewer: G Kang
Reviewer's report:
This large prospective multi-country survey of childhood intussusception used the
Brighton criteria to attempt an estimation of baseline rates of intussusception
prior to rotavirus vaccine introduction. The study will add considerable value to
the literature on intussusception, but some key issues need to be highlighted and
discussed in greater detail.
Major Compulsory Revisions
1. Presentation of a rate requires consideration of the quality and completeness
of the data. While the methods used once patients reached hospital are
appropriate, the authors have little or no control over what proportion of patients
within the catchment area of the hospital actually access healthcare at the
participating hospital. While the issue has been stated as a single sentence in the
discussion and it has been pointed out that data from catchment areas can not
be generalized to the country, it is essential that some estimate of healthcare
utilization by the catchment area population is presented by country, so that the
incidence rate can be adjusted accordingly.
Minor Essential Revisions
1. It is important to emphasize that both the high rate of surgery and the
presentation with 5 or more symptoms in the majority of cases indicate a late
presentation of cases, so it is likely that intussusception that resolved
spontaneously were not included. It would be useful to include the duration of
symptoms before presentation to hospital and then see what proportion of early
and late presentations required surgery.
Discretionary Revisions
1. It would be interesting to report whether there were any spontaneous
reductions, and whether or not those would might the Brighton criteria.
2. Mexico has the highest numbers and Brazil the lowest rate. How do these
figures affect the understanding of the reports of intussuception post-vaccination
from the two countries?
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.
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