Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 2 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Auhtors, please address the following points below
-The introduction refers to the use of imaging techniques like CT enterography (CTE) and MRI
enterography (MRE) as part of clinical practice. Still, there is little mention of their accuracy or
how they compare to endoscopy. More details on the current gold standard for detecting small
bowel inflammation in postoperative CD patients would help further justify the study’s approach
and the role of FC in this context.
-The methods section mentions collecting demographic and laboratory data but does not
specifically address whether patients were on immunosuppressive therapy (e.g., biologics or
steroids). Since medication can significantly impact inflammation and FC levels, this is an
important consideration, and the authors should clarify whether therapy was accounted for in
the analysis.
-The median interval between FC testing and imaging/ileoscopy is mentioned as 3 days, but a
wider range is provided (IQR 0-21 days). The authors should address whether this variability in
timing could influence the accuracy of FC in predicting inflammation and whether a shorter or
longer interval would be more optimal for clinical monitoring.
-While the discussion mentions that FC can "potentially replace the need for frequent imaging
and/or endoscopic evaluations," this assertion could benefit from further elaboration. The
authors could explain more clearly in what clinical scenarios FC testing would be preferable to
imaging or endoscopy, or how often FC tests would need to be performed to effectively monitor
disease activity. This would strengthen the real-world applicability of the findings.
-The study does not delve into whether FC levels might vary depending on patient subgroups
(e.g., age, disease phenotype, prior surgeries). A discussion of how FC might perform differently
across these subgroups could make the findings more nuanced and would provide insights into
the potential limitations of FC testing in certain groups of patients.
Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 2 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Auhtors, please address the following points below
-The introduction refers to the use of imaging techniques like CT enterography (CTE) and MRI
enterography (MRE) as part of clinical practice. Still, there is little mention of their accuracy or
how they compare to endoscopy. More details on the current gold standard for detecting small
bowel inflammation in postoperative CD patients would help further justify the study’s approach
and the role of FC in this context.
-The methods section mentions collecting demographic and laboratory data but does not
specifically address whether patients were on immunosuppressive therapy (e.g., biologics or
steroids). Since medication can significantly impact inflammation and FC levels, this is an
important consideration, and the authors should clarify whether therapy was accounted for in
the analysis.
-The median interval between FC testing and imaging/ileoscopy is mentioned as 3 days, but a
wider range is provided (IQR 0-21 days). The authors should address whether this variability in
timing could influence the accuracy of FC in predicting inflammation and whether a shorter or
longer interval would be more optimal for clinical monitoring.
-While the discussion mentions that FC can "potentially replace the need for frequent imaging
and/or endoscopic evaluations," this assertion could benefit from further elaboration. The
authors could explain more clearly in what clinical scenarios FC testing would be preferable to
imaging or endoscopy, or how often FC tests would need to be performed to effectively monitor
disease activity. This would strengthen the real-world applicability of the findings.
-The study does not delve into whether FC levels might vary depending on patient subgroups
(e.g., age, disease phenotype, prior surgeries). A discussion of how FC might perform differently
across these subgroups could make the findings more nuanced and would provide insights into
the potential limitations of FC testing in certain groups of patients.
Please review this paper.
user
Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 2 Date: 16 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Auhtors, please address the following points below
-The introduction refers to the use of imaging techniques like CT enterography (CTE) and MRI
enterography (MRE) as part of clinical practice. Still, there is little mention of their accuracy or
how they compare to endoscopy. More details on the current gold standard for detecting small
bowel inflammation in postoperative CD patients would help further justify the study’s approach
and the role of FC in this context.
-The methods section mentions collecting demographic and laboratory data but does not
specifically address whether patients were on immunosuppressive therapy (e.g., biologics or
steroids). Since medication can significantly impact inflammation and FC levels, this is an
important consideration, and the authors should clarify whether therapy was accounted for in
the analysis.
-The median interval between FC testing and imaging/ileoscopy is mentioned as 3 days, but a
wider range is provided (IQR 0-21 days). The authors should address whether this variability in
timing could influence the accuracy of FC in predicting inflammation and whether a shorter or
longer interval would be more optimal for clinical monitoring.
-While the discussion mentions that FC can "potentially replace the need for frequent imaging
and/or endoscopic evaluations," this assertion could benefit from further elaboration. The
authors could explain more clearly in what clinical scenarios FC testing would be preferable to
imaging or endoscopy, or how often FC tests would need to be performed to effectively monitor
disease activity. This would strengthen the real-world applicability of the findings.
-The study does not delve into whether FC levels might vary depending on patient subgroups
(e.g., age, disease phenotype, prior surgeries). A discussion of how FC might perform differently
across these subgroups could make the findings more nuanced and would provide insights into
the potential limitations of FC testing in certain groups of patients.
assistant