Title: Terminal ileal intubation is not necessary in routine colonoscopy: data from a large-scale
retrospective study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
This study showed that the terminal ileum intubation had low significance for the diagnosis
of ileal lesion and detection of colonic lesion. Although the results of the former were well
written and discussed, those of the latter seems not enough for emphasizing the low value of
terminal ileum intubation due to lack of important information regarding patient backgrounds
and endoscopy details. Please see the following comments.
Major comments:
1. The authors enrolled all patients who underwent colonoscopy during study period (unselected
patients). If so, the authors should describe the information regarding the purpose of examination
clearly (screening or surveillance, symptomatic or asymptomatic, etc.) because the indicators
such as adenoma detection rate vary depending on them. In addition, it would be better to add
those information as coefficients for propensity score matching.
2. Although the quality of bowel cleansing was evaluated by Boston Bowel Preparation
Scale (BBPS) in this study, there were no definition described about adequate or inadequate
preparation. In addition, in which areas were those determined? If they are scored, it would be
better to add them as a coefficient for propensity score matching.
3. The authors should clearly describe the definition of “right-sided colon.” Although there were
no significant differences between TII and no TII groups in the lesion detection rate in the right-
sided colon, how about that in the ascending colon or cecum?
Minor comments:
1. The authors should describe the definition of ADR with appropriate citation.
2. Tables should be numbered in the order they appear in the text.
Title: Terminal ileal intubation is not necessary in routine colonoscopy: data from a large-scale
retrospective study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
This study showed that the terminal ileum intubation had low significance for the diagnosis
of ileal lesion and detection of colonic lesion. Although the results of the former were well
written and discussed, those of the latter seems not enough for emphasizing the low value of
terminal ileum intubation due to lack of important information regarding patient backgrounds
and endoscopy details. Please see the following comments.
Major comments:
1. The authors enrolled all patients who underwent colonoscopy during study period (unselected
patients). If so, the authors should describe the information regarding the purpose of examination
clearly (screening or surveillance, symptomatic or asymptomatic, etc.) because the indicators
such as adenoma detection rate vary depending on them. In addition, it would be better to add
those information as coefficients for propensity score matching.
2. Although the quality of bowel cleansing was evaluated by Boston Bowel Preparation
Scale (BBPS) in this study, there were no definition described about adequate or inadequate
preparation. In addition, in which areas were those determined? If they are scored, it would be
better to add them as a coefficient for propensity score matching.
3. The authors should clearly describe the definition of “right-sided colon.” Although there were
no significant differences between TII and no TII groups in the lesion detection rate in the right-
sided colon, how about that in the ascending colon or cecum?
Minor comments:
1. The authors should describe the definition of ADR with appropriate citation.
2. Tables should be numbered in the order they appear in the text.
Please review this paper.
user
Title: Terminal ileal intubation is not necessary in routine colonoscopy: data from a large-scale
retrospective study
Version: 2 Date: 17 Aug 2024
Reviewer's report:
This study showed that the terminal ileum intubation had low significance for the diagnosis
of ileal lesion and detection of colonic lesion. Although the results of the former were well
written and discussed, those of the latter seems not enough for emphasizing the low value of
terminal ileum intubation due to lack of important information regarding patient backgrounds
and endoscopy details. Please see the following comments.
Major comments:
1. The authors enrolled all patients who underwent colonoscopy during study period (unselected
patients). If so, the authors should describe the information regarding the purpose of examination
clearly (screening or surveillance, symptomatic or asymptomatic, etc.) because the indicators
such as adenoma detection rate vary depending on them. In addition, it would be better to add
those information as coefficients for propensity score matching.
2. Although the quality of bowel cleansing was evaluated by Boston Bowel Preparation
Scale (BBPS) in this study, there were no definition described about adequate or inadequate
preparation. In addition, in which areas were those determined? If they are scored, it would be
better to add them as a coefficient for propensity score matching.
3. The authors should clearly describe the definition of “right-sided colon.” Although there were
no significant differences between TII and no TII groups in the lesion detection rate in the right-
sided colon, how about that in the ascending colon or cecum?
Minor comments:
1. The authors should describe the definition of ADR with appropriate citation.
2. Tables should be numbered in the order they appear in the text.
assistant