Title: Risk factors for inadequate bowel preparation before colonoscopy: a retrospective cohort
study
Version: 3 Date: 17 Oct 2022
Reviewer's report:
I would like to thank the authors for this interesting manuscript. The impact of seasons on bowel
preparation is an interesting finding, although limited by the design and short time-period.
Major points:
The validity of the influence of seasons on BP is limited by the single-center status and the fact
only one calendar year has been analyzed. The authors suggest that the lack of physical activity
and the fact people feel colder in spring might result in poorer bowel preparation. I do not think
this reasoning is valid, since this should be even more the case in winter than in spring (which
the results do not show). As a consequence, there are likely unknown confounders that could not
be accounted for, limiting the clinical interpretability of this interesting, but uncertain finding.
Minor points:
Abstract:
1. The conclusion mentions male and inpatient status as independent risk factors. Why are these
not mentioned in the results section of the abstract?
Methods:
1. Were all patients instructed following standard of care? Or were adaptions made to the
instruction for bowel preparation?
2. Why was the bowel preparation rated by a different endoscopist than the one that performed
the procedure? Was this during the procedure? Or based on the photos taken?
3. Is it fair to score patients who did not complete bowel preparation as 0 or should these be
left out of the analysis?
Results:
1. Typing error in the results section “BBSP”
2. Enteritis and miscellaneous diseases is in my opinion not truly a lesion, but a positive finding.
Please rephrase.
3. Do the authors have any information on the results of bowel preparation during the repeat
colonoscopy in case of inadequate bowel prep? Since the repeat colonoscopy is often performed
weeks to months after the first one, these findings might bolster the results on differences
between seasons.
Discussion:
1. The authors suggest that the differences in physical activity might influence the observed
difference in BP between seasons. However, one could suggest that physicial activity might be
lowest in winter instead of spring. Could the authors comment on this?
2. Could there be an influence of a different diet during spring? E.g. less fresh vegetables after
the winter?
Title: Risk factors for inadequate bowel preparation before colonoscopy: a retrospective cohort
study
Version: 3 Date: 17 Oct 2022
Reviewer's report:
I would like to thank the authors for this interesting manuscript. The impact of seasons on bowel
preparation is an interesting finding, although limited by the design and short time-period.
Major points:
The validity of the influence of seasons on BP is limited by the single-center status and the fact
only one calendar year has been analyzed. The authors suggest that the lack of physical activity
and the fact people feel colder in spring might result in poorer bowel preparation. I do not think
this reasoning is valid, since this should be even more the case in winter than in spring (which
the results do not show). As a consequence, there are likely unknown confounders that could not
be accounted for, limiting the clinical interpretability of this interesting, but uncertain finding.
Minor points:
Abstract:
1. The conclusion mentions male and inpatient status as independent risk factors. Why are these
not mentioned in the results section of the abstract?
Methods:
1. Were all patients instructed following standard of care? Or were adaptions made to the
instruction for bowel preparation?
2. Why was the bowel preparation rated by a different endoscopist than the one that performed
the procedure? Was this during the procedure? Or based on the photos taken?
3. Is it fair to score patients who did not complete bowel preparation as 0 or should these be
left out of the analysis?
Results:
1. Typing error in the results section “BBSP”
2. Enteritis and miscellaneous diseases is in my opinion not truly a lesion, but a positive finding.
Please rephrase.
3. Do the authors have any information on the results of bowel preparation during the repeat
colonoscopy in case of inadequate bowel prep? Since the repeat colonoscopy is often performed
weeks to months after the first one, these findings might bolster the results on differences
between seasons.
Discussion:
1. The authors suggest that the differences in physical activity might influence the observed
difference in BP between seasons. However, one could suggest that physicial activity might be
lowest in winter instead of spring. Could the authors comment on this?
2. Could there be an influence of a different diet during spring? E.g. less fresh vegetables after
the winter?
Please review this paper.
user
Title: Risk factors for inadequate bowel preparation before colonoscopy: a retrospective cohort
study
Version: 3 Date: 17 Oct 2022
Reviewer's report:
I would like to thank the authors for this interesting manuscript. The impact of seasons on bowel
preparation is an interesting finding, although limited by the design and short time-period.
Major points:
The validity of the influence of seasons on BP is limited by the single-center status and the fact
only one calendar year has been analyzed. The authors suggest that the lack of physical activity
and the fact people feel colder in spring might result in poorer bowel preparation. I do not think
this reasoning is valid, since this should be even more the case in winter than in spring (which
the results do not show). As a consequence, there are likely unknown confounders that could not
be accounted for, limiting the clinical interpretability of this interesting, but uncertain finding.
Minor points:
Abstract:
1. The conclusion mentions male and inpatient status as independent risk factors. Why are these
not mentioned in the results section of the abstract?
Methods:
1. Were all patients instructed following standard of care? Or were adaptions made to the
instruction for bowel preparation?
2. Why was the bowel preparation rated by a different endoscopist than the one that performed
the procedure? Was this during the procedure? Or based on the photos taken?
3. Is it fair to score patients who did not complete bowel preparation as 0 or should these be
left out of the analysis?
Results:
1. Typing error in the results section “BBSP”
2. Enteritis and miscellaneous diseases is in my opinion not truly a lesion, but a positive finding.
Please rephrase.
3. Do the authors have any information on the results of bowel preparation during the repeat
colonoscopy in case of inadequate bowel prep? Since the repeat colonoscopy is often performed
weeks to months after the first one, these findings might bolster the results on differences
between seasons.
Discussion:
1. The authors suggest that the differences in physical activity might influence the observed
difference in BP between seasons. However, one could suggest that physicial activity might be
lowest in winter instead of spring. Could the authors comment on this?
2. Could there be an influence of a different diet during spring? E.g. less fresh vegetables after
the winter?
assistant