Reviewer's report
Title:Appointment waiting times and education level influence the quality of
bowel preparation in adult patients undergoing colonoscopy
Version: 2Date:20 June 2011
Reviewer: Benjamin Lebwohl
Reviewer's report:
The revisions are noted and are acceptable.
Two minor essential revisions:
I am uncertain why the authors reference the Ottawa Bowel Preparation and
Boston Bowel Preparation scales after describing the scale that they used. The
scale used in this study more closely resembles the Aronchick scale (Aronchick
CA, Lipshutz WH, Wright H, et al. Validation of an instrument to assess colon
cleansing [abstract].AmJ Gastroenterol 1999;94:2667.) The point of the Ottawa
and Boston scales was to reduce the subjectivitiy inherent in the Aronchick scale.
It would be more fitting to reference Aronchick at that point (Methods section,
under the heading Bowel Preparation and Grading) while acknowledging (as the
authors appropriately do) as a limitation in the Discussion section that neither the
Ottawa nor the Boston scale was used.
The authors state that “the association of increased patient discomfort with poor
bowel preparation during and 1-hour post-colonoscopy was independent of the
indication for the procedure and the total colonoscopy time.” However, the data is
not shown. In their response to the reviewers, the authors mention that “a linear
regression was performed.” If the outcome was moderate-to-severe discomfort, I
assume that the authors had actually performed logistic (not linear) regression. In
any case, the authors should either state the odds ratio with 95% confidence
limits, or simply state “data not shown.”
When the authors comment on this finding in the Discussion, they write
“Furthermore, poor bowel preparation additionally resulted in more patient
discomfort, presumably from the longer duration of procedure and excessive air
insufflations, as sedation doses were similar in patients with and without poor
preparation.” It is inconsistent to state that this occurs “presumably from the
longer duration of procedure” if this finding was significant independent of total
colonoscopy time.
Level of interest: An article of importance in its field
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:Appointment waiting times and education level influence the quality of
bowel preparation in adult patients undergoing colonoscopy
Version: 2Date:20 June 2011
Reviewer: Benjamin Lebwohl
Reviewer's report:
The revisions are noted and are acceptable.
Two minor essential revisions:
I am uncertain why the authors reference the Ottawa Bowel Preparation and
Boston Bowel Preparation scales after describing the scale that they used. The
scale used in this study more closely resembles the Aronchick scale (Aronchick
CA, Lipshutz WH, Wright H, et al. Validation of an instrument to assess colon
cleansing [abstract].AmJ Gastroenterol 1999;94:2667.) The point of the Ottawa
and Boston scales was to reduce the subjectivitiy inherent in the Aronchick scale.
It would be more fitting to reference Aronchick at that point (Methods section,
under the heading Bowel Preparation and Grading) while acknowledging (as the
authors appropriately do) as a limitation in the Discussion section that neither the
Ottawa nor the Boston scale was used.
The authors state that “the association of increased patient discomfort with poor
bowel preparation during and 1-hour post-colonoscopy was independent of the
indication for the procedure and the total colonoscopy time.” However, the data is
not shown. In their response to the reviewers, the authors mention that “a linear
regression was performed.” If the outcome was moderate-to-severe discomfort, I
assume that the authors had actually performed logistic (not linear) regression. In
any case, the authors should either state the odds ratio with 95% confidence
limits, or simply state “data not shown.”
When the authors comment on this finding in the Discussion, they write
“Furthermore, poor bowel preparation additionally resulted in more patient
discomfort, presumably from the longer duration of procedure and excessive air
insufflations, as sedation doses were similar in patients with and without poor
preparation.” It is inconsistent to state that this occurs “presumably from the
longer duration of procedure” if this finding was significant independent of total
colonoscopy time.
Level of interest: An article of importance in its field
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:Appointment waiting times and education level influence the quality of
bowel preparation in adult patients undergoing colonoscopy
Version: 2Date:20 June 2011
Reviewer: Benjamin Lebwohl
Reviewer's report:
The revisions are noted and are acceptable.
Two minor essential revisions:
I am uncertain why the authors reference the Ottawa Bowel Preparation and
Boston Bowel Preparation scales after describing the scale that they used. The
scale used in this study more closely resembles the Aronchick scale (Aronchick
CA, Lipshutz WH, Wright H, et al. Validation of an instrument to assess colon
cleansing [abstract].AmJ Gastroenterol 1999;94:2667.) The point of the Ottawa
and Boston scales was to reduce the subjectivitiy inherent in the Aronchick scale.
It would be more fitting to reference Aronchick at that point (Methods section,
under the heading Bowel Preparation and Grading) while acknowledging (as the
authors appropriately do) as a limitation in the Discussion section that neither the
Ottawa nor the Boston scale was used.
The authors state that “the association of increased patient discomfort with poor
bowel preparation during and 1-hour post-colonoscopy was independent of the
indication for the procedure and the total colonoscopy time.” However, the data is
not shown. In their response to the reviewers, the authors mention that “a linear
regression was performed.” If the outcome was moderate-to-severe discomfort, I
assume that the authors had actually performed logistic (not linear) regression. In
any case, the authors should either state the odds ratio with 95% confidence
limits, or simply state “data not shown.”
When the authors comment on this finding in the Discussion, they write
“Furthermore, poor bowel preparation additionally resulted in more patient
discomfort, presumably from the longer duration of procedure and excessive air
insufflations, as sedation doses were similar in patients with and without poor
preparation.” It is inconsistent to state that this occurs “presumably from the
longer duration of procedure” if this finding was significant independent of total
colonoscopy time.
Level of interest: An article of importance in its field
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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