Title: Can balloon-assisted enteroscopy predict disease outcomes in patients with small-bowel
crohn’s disease?
Version: 1 Date: 21 May 2023
Reviewer's report:
1. In introduction (paragraph 3), authors mentioned "Therefore, this study was designed to
determine the role of BAE in the endoscopic assessment of disease activity and the predictive
value for the risk of surgery in small bowel CD patients."
However in materials and method (outcomes and covariates), authors stated  "primary outcome
was the evaluation of the risk of surgery according to the small-bowel SES-CD (0–6 vs #7). The
secondary outcome was the assessment of the association of the enteroscopic finding (presence
of any ulcer and degree of stricture) with surgery. In addition, we tried to identify the predictors
of surgery in the overall patient cohort."
--> State directly in paragraph 3, for an example: "Therefore, this study was designed to assess
surgery risk in small bowel CD patients based on BAE findings using validated small bowel
SES-CD........."Mention also the secondary and tertiary outcome clearly in introduction.
2. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up),
authors wrote "The examination was performed under conscious sedation."
--> Is conscious sedation the standard anesthesia method for enteroscopy in your center?  I am
asking this because enteroscopy is time consuming, technically demanding and potentially make
patients uncomfortable.
3. Please add total enteroscopy rate in all subjects. Data shows that total enteroscopy is relatively
difficult to achieve with single ballon enteroscopy,yet in this study all segments of small bowel
should be evaluated thoroughly.
4. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up)
paragraph 3, authors stated "The small-bowel SES-CD values ranged from 0 to 12 and were
divided into of 0–6 vs #7, in which a cutoff of 7 points was set by a receiver operating
characteristics curve"
--> Please describe the detailed reason why authors set 7 as cut-off point. The statistical analysis
of ROC curve can be added.
Title: Can balloon-assisted enteroscopy predict disease outcomes in patients with small-bowel
crohn’s disease?
Version: 1 Date: 21 May 2023
Reviewer's report:
1. In introduction (paragraph 3), authors mentioned "Therefore, this study was designed to
determine the role of BAE in the endoscopic assessment of disease activity and the predictive
value for the risk of surgery in small bowel CD patients."
However in materials and method (outcomes and covariates), authors stated  "primary outcome
was the evaluation of the risk of surgery according to the small-bowel SES-CD (0–6 vs #7). The
secondary outcome was the assessment of the association of the enteroscopic finding (presence
of any ulcer and degree of stricture) with surgery. In addition, we tried to identify the predictors
of surgery in the overall patient cohort."
--> State directly in paragraph 3, for an example: "Therefore, this study was designed to assess
surgery risk in small bowel CD patients based on BAE findings using validated small bowel
SES-CD........."Mention also the secondary and tertiary outcome clearly in introduction.
2. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up),
authors wrote "The examination was performed under conscious sedation."
--> Is conscious sedation the standard anesthesia method for enteroscopy in your center?  I am
asking this because enteroscopy is time consuming, technically demanding and potentially make
patients uncomfortable.
3. Please add total enteroscopy rate in all subjects. Data shows that total enteroscopy is relatively
difficult to achieve with single ballon enteroscopy,yet in this study all segments of small bowel
should be evaluated thoroughly.
4. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up)
paragraph 3, authors stated "The small-bowel SES-CD values ranged from 0 to 12 and were
divided into of 0–6 vs #7, in which a cutoff of 7 points was set by a receiver operating
characteristics curve"
--> Please describe the detailed reason why authors set 7 as cut-off point. The statistical analysis
of ROC curve can be added.
Please review this paper.
user
Title: Can balloon-assisted enteroscopy predict disease outcomes in patients with small-bowel
crohn’s disease?
Version: 1 Date: 21 May 2023
Reviewer's report:
1. In introduction (paragraph 3), authors mentioned "Therefore, this study was designed to
determine the role of BAE in the endoscopic assessment of disease activity and the predictive
value for the risk of surgery in small bowel CD patients."
However in materials and method (outcomes and covariates), authors stated  "primary outcome
was the evaluation of the risk of surgery according to the small-bowel SES-CD (0–6 vs #7). The
secondary outcome was the assessment of the association of the enteroscopic finding (presence
of any ulcer and degree of stricture) with surgery. In addition, we tried to identify the predictors
of surgery in the overall patient cohort."
--> State directly in paragraph 3, for an example: "Therefore, this study was designed to assess
surgery risk in small bowel CD patients based on BAE findings using validated small bowel
SES-CD........."Mention also the secondary and tertiary outcome clearly in introduction.
2. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up),
authors wrote "The examination was performed under conscious sedation."
--> Is conscious sedation the standard anesthesia method for enteroscopy in your center?  I am
asking this because enteroscopy is time consuming, technically demanding and potentially make
patients uncomfortable.
3. Please add total enteroscopy rate in all subjects. Data shows that total enteroscopy is relatively
difficult to achieve with single ballon enteroscopy,yet in this study all segments of small bowel
should be evaluated thoroughly.
4. In materials and method (Balloon-assisted enteroscopy, assessment index, and follow-up)
paragraph 3, authors stated "The small-bowel SES-CD values ranged from 0 to 12 and were
divided into of 0–6 vs #7, in which a cutoff of 7 points was set by a receiver operating
characteristics curve"
--> Please describe the detailed reason why authors set 7 as cut-off point. The statistical analysis
of ROC curve can be added.
assistant