Title: Application effect of Standardized Nursing Process of abdominal drainage tube in
cholelithiasis: a single-center retrospective cohort study
Version: 1 Date: 17 Mar 2025
Reviewer's report:
Major Comments
1.  Clarify the actual study timeline and ensure all data were collected retrospectively.
2.  The manuscript lacks a sample size calculation. Retrospective studies should still justify the
number of included patients to ensure statistical power. Provide a post-hoc power analysis or
rationale for the cohort size.
3.    While multivariate analyses were performed, the choice of adjusted variables (e.g., CRP
for activity rate, neutrophil percentage for pain) lacks justification. Explain why these specific
covariates were selected and whether variables like surgical duration or comorbidities were
considered.
4.    The study design does not mention whether nurses or assessors were blinded to group
allocation. Awareness of SNP/non-SNP status could introduce performance or detection bias.
Address this limitation and discuss its potential impact.
5. Categorizing continuous outcomes (e.g., VAS score, satisfaction) using median splits risks
information loss and reduces sensitivity. Consider using ordinal logistic regression or other
methods preserving data granularity.
- The use of "OR=8.66[4.38,17.11]" for satisfaction (Table 5) implies binary categorization, but
satisfaction was measured on a 4-point scale. Clarify how this was handled statistically.
Minor Comments
1.  The introduction and discussion are repetitive regarding the controversy around drainage
tube use. Condense these sections.
- Avoid phrases like "for the first time" unless supported by a systematic literature review.
2. Table 1 reports median (IQR) for non-normally distributed data, but some variables (e.g.,
CRP, HBP) show large variability. Consider presenting ranges or discussing potential outliers.
3.  Both groups had 0% infection rates (Table 2). This raises questions about surveillance
methods or follow-up duration. Address whether infections were actively monitored or
underreported.
4.   While statistical significance is highlighted, the clinical relevance of outcomes (e.g., "activity
rate of getting out of bed") needs elaboration. How does a 40.82% vs. 23.93% improvement
translate to real-world recovery?
5. Limitations Section
Expand limitations to address:
- Potential selection bias due to retrospective design.
- Lack of standardization in non-SNP care (e.g., variations in nursing practices).
- Generalizability concerns from a single-center study.
Title: Application effect of Standardized Nursing Process of abdominal drainage tube in
cholelithiasis: a single-center retrospective cohort study
Version: 1 Date: 17 Mar 2025
Reviewer's report:
Major Comments
1.  Clarify the actual study timeline and ensure all data were collected retrospectively.
2.  The manuscript lacks a sample size calculation. Retrospective studies should still justify the
number of included patients to ensure statistical power. Provide a post-hoc power analysis or
rationale for the cohort size.
3.    While multivariate analyses were performed, the choice of adjusted variables (e.g., CRP
for activity rate, neutrophil percentage for pain) lacks justification. Explain why these specific
covariates were selected and whether variables like surgical duration or comorbidities were
considered.
4.    The study design does not mention whether nurses or assessors were blinded to group
allocation. Awareness of SNP/non-SNP status could introduce performance or detection bias.
Address this limitation and discuss its potential impact.
5. Categorizing continuous outcomes (e.g., VAS score, satisfaction) using median splits risks
information loss and reduces sensitivity. Consider using ordinal logistic regression or other
methods preserving data granularity.
- The use of "OR=8.66[4.38,17.11]" for satisfaction (Table 5) implies binary categorization, but
satisfaction was measured on a 4-point scale. Clarify how this was handled statistically.
Minor Comments
1.  The introduction and discussion are repetitive regarding the controversy around drainage
tube use. Condense these sections.
- Avoid phrases like "for the first time" unless supported by a systematic literature review.
2. Table 1 reports median (IQR) for non-normally distributed data, but some variables (e.g.,
CRP, HBP) show large variability. Consider presenting ranges or discussing potential outliers.
3.  Both groups had 0% infection rates (Table 2). This raises questions about surveillance
methods or follow-up duration. Address whether infections were actively monitored or
underreported.
4.   While statistical significance is highlighted, the clinical relevance of outcomes (e.g., "activity
rate of getting out of bed") needs elaboration. How does a 40.82% vs. 23.93% improvement
translate to real-world recovery?
5. Limitations Section
Expand limitations to address:
- Potential selection bias due to retrospective design.
- Lack of standardization in non-SNP care (e.g., variations in nursing practices).
- Generalizability concerns from a single-center study.
Please review this paper.
user
Title: Application effect of Standardized Nursing Process of abdominal drainage tube in
cholelithiasis: a single-center retrospective cohort study
Version: 1 Date: 17 Mar 2025
Reviewer's report:
Major Comments
1.  Clarify the actual study timeline and ensure all data were collected retrospectively.
2.  The manuscript lacks a sample size calculation. Retrospective studies should still justify the
number of included patients to ensure statistical power. Provide a post-hoc power analysis or
rationale for the cohort size.
3.    While multivariate analyses were performed, the choice of adjusted variables (e.g., CRP
for activity rate, neutrophil percentage for pain) lacks justification. Explain why these specific
covariates were selected and whether variables like surgical duration or comorbidities were
considered.
4.    The study design does not mention whether nurses or assessors were blinded to group
allocation. Awareness of SNP/non-SNP status could introduce performance or detection bias.
Address this limitation and discuss its potential impact.
5. Categorizing continuous outcomes (e.g., VAS score, satisfaction) using median splits risks
information loss and reduces sensitivity. Consider using ordinal logistic regression or other
methods preserving data granularity.
- The use of "OR=8.66[4.38,17.11]" for satisfaction (Table 5) implies binary categorization, but
satisfaction was measured on a 4-point scale. Clarify how this was handled statistically.
Minor Comments
1.  The introduction and discussion are repetitive regarding the controversy around drainage
tube use. Condense these sections.
- Avoid phrases like "for the first time" unless supported by a systematic literature review.
2. Table 1 reports median (IQR) for non-normally distributed data, but some variables (e.g.,
CRP, HBP) show large variability. Consider presenting ranges or discussing potential outliers.
3.  Both groups had 0% infection rates (Table 2). This raises questions about surveillance
methods or follow-up duration. Address whether infections were actively monitored or
underreported.
4.   While statistical significance is highlighted, the clinical relevance of outcomes (e.g., "activity
rate of getting out of bed") needs elaboration. How does a 40.82% vs. 23.93% improvement
translate to real-world recovery?
5. Limitations Section
Expand limitations to address:
- Potential selection bias due to retrospective design.
- Lack of standardization in non-SNP care (e.g., variations in nursing practices).
- Generalizability concerns from a single-center study.
assistant