Reviewer's report
Title:Factors Impacting Physicians' Decisions to Prevent Variceal Hemorrhage
Version:2Date:15 February 2015
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
This study by Yan et al. evaluated the gastroenterologists’ preference and
characteristics in decision-making of esophageal varices ligation (EVL) or
beta-blockers (BBS) for prevention of first variceal bleeding. In this survey of 110
physician members of AASLD and AGA, all responders were classified into two
groups according to decision preferences. While physicians (group 1) who
preferred EVL were influenced by the visual confirmation of varices eradication,
group 2 physicians were likely concerned BBS side effects and mechanisms.
However, there were 39% physicians preferred combined EVL with BBS.
Major comments
1. Despite either EVL or BBS for preventing first varicella bleeding was
recommended in practice guideline, there were 39% physicians choosing
combined EVL with BBS. Did the authors survey the physicians’ compliance or
attitude of the practice guideline in interview or before this study?
2. The decision-making might be influenced not only the physician but also the
resources available. Did the survey interview the availability of EVL for each
physician?
3. Most physicians surveyed were worked in fee-for service setting. Was there
difference in decision of combined EVL with BBS decision between physicians
working in different locations?
4. Physician performing EVL needed experience and expertise. For those
physicians with training fellowships both in gastroenterology and hepatology had
different treatment decisions compared to others?
5. In table 1, there are no data showing physicians’ practice location (academic
or non-academic).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no commpeting interests.
Reviewer's report
Title:Factors Impacting Physicians' Decisions to Prevent Variceal Hemorrhage
Version:2Date:15 February 2015
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
This study by Yan et al. evaluated the gastroenterologists’ preference and
characteristics in decision-making of esophageal varices ligation (EVL) or
beta-blockers (BBS) for prevention of first variceal bleeding. In this survey of 110
physician members of AASLD and AGA, all responders were classified into two
groups according to decision preferences. While physicians (group 1) who
preferred EVL were influenced by the visual confirmation of varices eradication,
group 2 physicians were likely concerned BBS side effects and mechanisms.
However, there were 39% physicians preferred combined EVL with BBS.
Major comments
1. Despite either EVL or BBS for preventing first varicella bleeding was
recommended in practice guideline, there were 39% physicians choosing
combined EVL with BBS. Did the authors survey the physicians’ compliance or
attitude of the practice guideline in interview or before this study?
2. The decision-making might be influenced not only the physician but also the
resources available. Did the survey interview the availability of EVL for each
physician?
3. Most physicians surveyed were worked in fee-for service setting. Was there
difference in decision of combined EVL with BBS decision between physicians
working in different locations?
4. Physician performing EVL needed experience and expertise. For those
physicians with training fellowships both in gastroenterology and hepatology had
different treatment decisions compared to others?
5. In table 1, there are no data showing physicians’ practice location (academic
or non-academic).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no commpeting interests.
Please review this paper.
user
Reviewer's report
Title:Factors Impacting Physicians' Decisions to Prevent Variceal Hemorrhage
Version:2Date:15 February 2015
Reviewer: Jing-Houng Wang
Reviewer's report:
General comments
This study by Yan et al. evaluated the gastroenterologists’ preference and
characteristics in decision-making of esophageal varices ligation (EVL) or
beta-blockers (BBS) for prevention of first variceal bleeding. In this survey of 110
physician members of AASLD and AGA, all responders were classified into two
groups according to decision preferences. While physicians (group 1) who
preferred EVL were influenced by the visual confirmation of varices eradication,
group 2 physicians were likely concerned BBS side effects and mechanisms.
However, there were 39% physicians preferred combined EVL with BBS.
Major comments
1. Despite either EVL or BBS for preventing first varicella bleeding was
recommended in practice guideline, there were 39% physicians choosing
combined EVL with BBS. Did the authors survey the physicians’ compliance or
attitude of the practice guideline in interview or before this study?
2. The decision-making might be influenced not only the physician but also the
resources available. Did the survey interview the availability of EVL for each
physician?
3. Most physicians surveyed were worked in fee-for service setting. Was there
difference in decision of combined EVL with BBS decision between physicians
working in different locations?
4. Physician performing EVL needed experience and expertise. For those
physicians with training fellowships both in gastroenterology and hepatology had
different treatment decisions compared to others?
5. In table 1, there are no data showing physicians’ practice location (academic
or non-academic).
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no commpeting interests.
assistant