Reviewer ’s report  
Title: Comparison of AIMS65, Glasgow -Blatchford and Rockall s coring approaches in 
predicting the risk of in -hospital death among emergency hospitalized patients with upper 
gastrointestinal  bleeding: a retrospective observational study in Regional China  
 
Version: 1 Date: 18 Mar 2018  
 
Reviewer: Ming -Lun Han  
 
Reviewer's report:  
This is a retrospective single center study performed by Nanjing First Hospital from 2014 to 
2015. Participan ts were recruited for having signs and symptoms of UGIB and were hospitalized 
for treatment; total of 799 participants were recruited in study. The authors focused on finding 
the best predictive scoring system among AIMS65, Glasgow -Blatchford and Rockall r isk score 
for in - hospital morality in patients with acute UGIB. This was an interesting study but had some 
scientific issues need further recognized.  
1. For this is a retrospective study and all the included participants received endoscopy 
examination; th ere is a risk of selection bias. The higher risk patients who could not receive 
the endoscopy exam were excluded from this study; the authors should describe the 
indication and contraindication of endoscopy exam in this study clearly in Methods.    
2. For the low event rate (3.1% ) in this study, Poisson regression instead of logistic regression 
models may be more adequate for exploring the relationship between outcome events and 
scores,  
3. As for table 2, besides the condition of liver disease, percentage  of liver failure (one of the 
important factors in Rockall risk score), percentage of altered mental status or syncope, 
endoscopic findings and stigmata of recent hemorrhage should be completely shown in table 
2. Moreover, the unit of Hemoglobin, urea and albumin in table 2 was different with those in 
table 1. Please correct it.   
4. The footnote of table 3 mentioned "other potential clinical confounders", which should be 
described completely and clearly.  
5. According to the study result, the authors decid ed the optimal cutoff value of each scoring 
system for predicting in -hospital mortality based on ROC analysis, which was not explained 
and described clearly (Youden index?). More detailed information for each scoring system to 
decide cutoff value should be  shown on Table 5.    
6. For improving the readability of this article, English editing is suggested.   
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments t o the authors.  
No 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments t o the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, eit her now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details b elow.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including a ny attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any com ments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Comparison of AIMS65, Glasgow -Blatchford and Rockall s coring approaches in 
predicting the risk of in -hospital death among emergency hospitalized patients with upper 
gastrointestinal  bleeding: a retrospective observational study in Regional China  
 
Version: 1 Date: 18 Mar 2018  
 
Reviewer: Ming -Lun Han  
 
Reviewer's report:  
This is a retrospective single center study performed by Nanjing First Hospital from 2014 to 
2015. Participan ts were recruited for having signs and symptoms of UGIB and were hospitalized 
for treatment; total of 799 participants were recruited in study. The authors focused on finding 
the best predictive scoring system among AIMS65, Glasgow -Blatchford and Rockall r isk score 
for in - hospital morality in patients with acute UGIB. This was an interesting study but had some 
scientific issues need further recognized.  
1. For this is a retrospective study and all the included participants received endoscopy 
examination; th ere is a risk of selection bias. The higher risk patients who could not receive 
the endoscopy exam were excluded from this study; the authors should describe the 
indication and contraindication of endoscopy exam in this study clearly in Methods.    
2. For the low event rate (3.1% ) in this study, Poisson regression instead of logistic regression 
models may be more adequate for exploring the relationship between outcome events and 
scores,  
3. As for table 2, besides the condition of liver disease, percentage  of liver failure (one of the 
important factors in Rockall risk score), percentage of altered mental status or syncope, 
endoscopic findings and stigmata of recent hemorrhage should be completely shown in table 
2. Moreover, the unit of Hemoglobin, urea and albumin in table 2 was different with those in 
table 1. Please correct it.   
4. The footnote of table 3 mentioned "other potential clinical confounders", which should be 
described completely and clearly.  
5. According to the study result, the authors decid ed the optimal cutoff value of each scoring 
system for predicting in -hospital mortality based on ROC analysis, which was not explained 
and described clearly (Youden index?). More detailed information for each scoring system to 
decide cutoff value should be  shown on Table 5.    
6. For improving the readability of this article, English editing is suggested.   
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments t o the authors.  
No 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments t o the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, eit her now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details b elow.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including a ny attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any com ments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Comparison of AIMS65, Glasgow -Blatchford and Rockall s coring approaches in 
predicting the risk of in -hospital death among emergency hospitalized patients with upper 
gastrointestinal  bleeding: a retrospective observational study in Regional China  
 
Version: 1 Date: 18 Mar 2018  
 
Reviewer: Ming -Lun Han  
 
Reviewer's report:  
This is a retrospective single center study performed by Nanjing First Hospital from 2014 to 
2015. Participan ts were recruited for having signs and symptoms of UGIB and were hospitalized 
for treatment; total of 799 participants were recruited in study. The authors focused on finding 
the best predictive scoring system among AIMS65, Glasgow -Blatchford and Rockall r isk score 
for in - hospital morality in patients with acute UGIB. This was an interesting study but had some 
scientific issues need further recognized.  
1. For this is a retrospective study and all the included participants received endoscopy 
examination; th ere is a risk of selection bias. The higher risk patients who could not receive 
the endoscopy exam were excluded from this study; the authors should describe the 
indication and contraindication of endoscopy exam in this study clearly in Methods.    
2. For the low event rate (3.1% ) in this study, Poisson regression instead of logistic regression 
models may be more adequate for exploring the relationship between outcome events and 
scores,  
3. As for table 2, besides the condition of liver disease, percentage  of liver failure (one of the 
important factors in Rockall risk score), percentage of altered mental status or syncope, 
endoscopic findings and stigmata of recent hemorrhage should be completely shown in table 
2. Moreover, the unit of Hemoglobin, urea and albumin in table 2 was different with those in 
table 1. Please correct it.   
4. The footnote of table 3 mentioned "other potential clinical confounders", which should be 
described completely and clearly.  
5. According to the study result, the authors decid ed the optimal cutoff value of each scoring 
system for predicting in -hospital mortality based on ROC analysis, which was not explained 
and described clearly (Youden index?). More detailed information for each scoring system to 
decide cutoff value should be  shown on Table 5.    
6. For improving the readability of this article, English editing is suggested.   
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments t o the authors.  
No 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments t o the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, eit her now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details b elow.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including a ny attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any com ments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant