Reviewer's report
Title:Predictors Of Gastrointestinal Lesions On Endoscopy In Iron Deficiency
Anemia Without Gastrointestinal Symptoms
Version: 1Date:22 November 2007
Reviewer: bruno annibale
Reviewer's report:
General comment
This paper investigates, in a group of asymptomatic IDA patients ( n=95), the
frequency of upper and lower potential GI causes able to justify their anemia and
evaluate potential predictors for the GI diagnosis .
I think the study and its results are interesting, however there are important
methodological aspects that should be better addressed
a) Criteria for IDA definition are questionable, since both WHO criteria and the
previous literature data are different than those used in this paper ( Hb levels in
man > 13,5 g/dl or 14 g/dl; women < 12 g/dl ). Why the author choosed this low
cut off values ?
b) The population investigated refer to both patients referred and admitted for
urgency , this represents two completely different population with different
prevalence of IDA causes. Authors should to consider them separately.
C) Portal hypertensive gastropathy and esophagastric varices are conditions
related to the cirrosis that is a chronic condition that per se’ justify the IDA and
should be considered criteria of exclusion from the study . Are these patients
really asymptomatic from GI point of view ?
d) How authors classified heavy menstrual flow : on the basis of self-reported
patients’ opinion or on the basis of gynecological evaluation ?
e) Erosive esophagitis is not sufficient to be considered a causes of IDA .
f) In table 3 authors include patients with oesophageal mass, gastric mass ,
colonic mass please specify are neoplatic lesions or what else ?
g) It’s interesting to kown the results of GI endoscopical investigation in patients
with FOB positive
h) It is surprisingly low the percentage of patients with both upper and lower GI
lesion just one
All the literature data observe more robust prevalence ( 15-20%). Moreover the
concomitant IDA causes are usually observed e.g. Hp gastritis and large hiatal
hernia, atrohic gastritis and colon cancer and so on . This aspect is not covered
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:Predictors Of Gastrointestinal Lesions On Endoscopy In Iron Deficiency
Anemia Without Gastrointestinal Symptoms
Version: 1Date:22 November 2007
Reviewer: bruno annibale
Reviewer's report:
General comment
This paper investigates, in a group of asymptomatic IDA patients ( n=95), the
frequency of upper and lower potential GI causes able to justify their anemia and
evaluate potential predictors for the GI diagnosis .
I think the study and its results are interesting, however there are important
methodological aspects that should be better addressed
a) Criteria for IDA definition are questionable, since both WHO criteria and the
previous literature data are different than those used in this paper ( Hb levels in
man > 13,5 g/dl or 14 g/dl; women < 12 g/dl ). Why the author choosed this low
cut off values ?
b) The population investigated refer to both patients referred and admitted for
urgency , this represents two completely different population with different
prevalence of IDA causes. Authors should to consider them separately.
C) Portal hypertensive gastropathy and esophagastric varices are conditions
related to the cirrosis that is a chronic condition that per se’ justify the IDA and
should be considered criteria of exclusion from the study . Are these patients
really asymptomatic from GI point of view ?
d) How authors classified heavy menstrual flow : on the basis of self-reported
patients’ opinion or on the basis of gynecological evaluation ?
e) Erosive esophagitis is not sufficient to be considered a causes of IDA .
f) In table 3 authors include patients with oesophageal mass, gastric mass ,
colonic mass please specify are neoplatic lesions or what else ?
g) It’s interesting to kown the results of GI endoscopical investigation in patients
with FOB positive
h) It is surprisingly low the percentage of patients with both upper and lower GI
lesion just one
All the literature data observe more robust prevalence ( 15-20%). Moreover the
concomitant IDA causes are usually observed e.g. Hp gastritis and large hiatal
hernia, atrohic gastritis and colon cancer and so on . This aspect is not covered
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:Predictors Of Gastrointestinal Lesions On Endoscopy In Iron Deficiency
Anemia Without Gastrointestinal Symptoms
Version: 1Date:22 November 2007
Reviewer: bruno annibale
Reviewer's report:
General comment
This paper investigates, in a group of asymptomatic IDA patients ( n=95), the
frequency of upper and lower potential GI causes able to justify their anemia and
evaluate potential predictors for the GI diagnosis .
I think the study and its results are interesting, however there are important
methodological aspects that should be better addressed
a) Criteria for IDA definition are questionable, since both WHO criteria and the
previous literature data are different than those used in this paper ( Hb levels in
man > 13,5 g/dl or 14 g/dl; women < 12 g/dl ). Why the author choosed this low
cut off values ?
b) The population investigated refer to both patients referred and admitted for
urgency , this represents two completely different population with different
prevalence of IDA causes. Authors should to consider them separately.
C) Portal hypertensive gastropathy and esophagastric varices are conditions
related to the cirrosis that is a chronic condition that per se’ justify the IDA and
should be considered criteria of exclusion from the study . Are these patients
really asymptomatic from GI point of view ?
d) How authors classified heavy menstrual flow : on the basis of self-reported
patients’ opinion or on the basis of gynecological evaluation ?
e) Erosive esophagitis is not sufficient to be considered a causes of IDA .
f) In table 3 authors include patients with oesophageal mass, gastric mass ,
colonic mass please specify are neoplatic lesions or what else ?
g) It’s interesting to kown the results of GI endoscopical investigation in patients
with FOB positive
h) It is surprisingly low the percentage of patients with both upper and lower GI
lesion just one
All the literature data observe more robust prevalence ( 15-20%). Moreover the
concomitant IDA causes are usually observed e.g. Hp gastritis and large hiatal
hernia, atrohic gastritis and colon cancer and so on . This aspect is not covered
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
assistant