Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed C irrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 2 Date: 19 Aug 2019  
 
Reviewer: Research Square  
 
Reviewer's report:  
 
STATISTICAL REVIEWER ASSESSMENT:  
 
Is the study design appropriate for the research question (considering whether the analyzed 
population accurately reflects the design and whether you see a ny problems with 
control/comparison groups, e.g., likely confounders)?  
 
Yes - overall design, population, and control groups are appropriate  
 
 
Are methodologies adequate and well implemented (considering whether assumptions are 
addressed and whether analyses  are robust)?  
 
Yes - methodologies are adequate and well implemented, assumptions are addressed, analysis is 
robust  
 
 
Are the analyses adequately communicated (considering whether reporting details are adequate 
and whether figures and tables are well labeled and described)?  
 
No - there are minor issues  
 
 
Does the interpretation accurately reflect the analyses without overst atement (considering 
whether limitations/bias are acknowledged and whether accurate descriptors, e.g., 'significant', 
are used?  
 
No - there are minor issues  
 
 
Could an appropriately REVISED version of this work represent a statistically sound 
contribution?  
 
Probably - with minor revisions  
 
STATISTICAL REVIEWER COMMENTS:  
 
This is a satisfactory revision, in which the bulk of my comments were addressed. The paper has 
much improved and the methods, results and their interpretation are now much more meaningful. 
I only have a few minor comments for the authors to consider.  
 
 
Specific minor comments:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvi ous typo in the lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the  adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, hepatorenal syndrome etc, are comp lications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures of associations and predictive p erformance.  
 
 
REQUESTED REVISIONS:  
 
Specific minor comments for revision:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvious typo in t he lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, h epatorenal syndrome etc, are complications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures  of associations and predictive performance.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, pleas e specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript 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 to the editors.  
 
I am able to assess the statistics  
 
Quality of written Engli sh 
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 i n 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, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organi sation 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 com peting 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 below.  
 
This reviewer has been recruited by a partner organiza tion, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. T his reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square a nd was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name w ill be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available u nder an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comment s 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not b e published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed C irrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 2 Date: 19 Aug 2019  
 
Reviewer: Research Square  
 
Reviewer's report:  
 
STATISTICAL REVIEWER ASSESSMENT:  
 
Is the study design appropriate for the research question (considering whether the analyzed 
population accurately reflects the design and whether you see a ny problems with 
control/comparison groups, e.g., likely confounders)?  
 
Yes - overall design, population, and control groups are appropriate  
 
 
Are methodologies adequate and well implemented (considering whether assumptions are 
addressed and whether analyses  are robust)?  
 
Yes - methodologies are adequate and well implemented, assumptions are addressed, analysis is 
robust  
 
 
Are the analyses adequately communicated (considering whether reporting details are adequate 
and whether figures and tables are well labeled and described)?  
 
No - there are minor issues  
 
 
Does the interpretation accurately reflect the analyses without overst atement (considering 
whether limitations/bias are acknowledged and whether accurate descriptors, e.g., 'significant', 
are used?  
 
No - there are minor issues  
 
 
Could an appropriately REVISED version of this work represent a statistically sound 
contribution?  
 
Probably - with minor revisions  
 
STATISTICAL REVIEWER COMMENTS:  
 
This is a satisfactory revision, in which the bulk of my comments were addressed. The paper has 
much improved and the methods, results and their interpretation are now much more meaningful. 
I only have a few minor comments for the authors to consider.  
 
 
Specific minor comments:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvi ous typo in the lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the  adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, hepatorenal syndrome etc, are comp lications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures of associations and predictive p erformance.  
 
 
REQUESTED REVISIONS:  
 
Specific minor comments for revision:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvious typo in t he lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, h epatorenal syndrome etc, are complications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures  of associations and predictive performance.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, pleas e specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript 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 to the editors.  
 
I am able to assess the statistics  
 
Quality of written Engli sh 
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 i n 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, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organi sation 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 com peting 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 below.  
 
This reviewer has been recruited by a partner organiza tion, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. T his reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square a nd was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name w ill be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available u nder an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comment s 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not b e published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: The Magnitude and correlates of Esophageal Varices among newly diagnosed C irrhotic 
Patients Undergoing Screening Upper Gastrointestinal Endosc ope before incident bleeding in 
North -Western Tanzania; a Cross Sectional Study  
 
Version: 2 Date: 19 Aug 2019  
 
Reviewer: Research Square  
 
Reviewer's report:  
 
STATISTICAL REVIEWER ASSESSMENT:  
 
Is the study design appropriate for the research question (considering whether the analyzed 
population accurately reflects the design and whether you see a ny problems with 
control/comparison groups, e.g., likely confounders)?  
 
Yes - overall design, population, and control groups are appropriate  
 
 
Are methodologies adequate and well implemented (considering whether assumptions are 
addressed and whether analyses  are robust)?  
 
Yes - methodologies are adequate and well implemented, assumptions are addressed, analysis is 
robust  
 
 
Are the analyses adequately communicated (considering whether reporting details are adequate 
and whether figures and tables are well labeled and described)?  
 
No - there are minor issues  
 
 
Does the interpretation accurately reflect the analyses without overst atement (considering 
whether limitations/bias are acknowledged and whether accurate descriptors, e.g., 'significant', 
are used?  
 
No - there are minor issues  
 
 
Could an appropriately REVISED version of this work represent a statistically sound 
contribution?  
 
Probably - with minor revisions  
 
STATISTICAL REVIEWER COMMENTS:  
 
This is a satisfactory revision, in which the bulk of my comments were addressed. The paper has 
much improved and the methods, results and their interpretation are now much more meaningful. 
I only have a few minor comments for the authors to consider.  
 
 
Specific minor comments:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvi ous typo in the lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the  adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, hepatorenal syndrome etc, are comp lications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures of associations and predictive p erformance.  
 
 
REQUESTED REVISIONS:  
 
Specific minor comments for revision:  
 
(1) Abstract/results: For the sensitivity and specificity values to make sense, the cutoffs used 
for continuous variables should be reported.  
 
(2) Abstract/results: Obvious typo in t he lower confidence limit for the age OR.  
 
(3) Figure 2 does not add much and appears redundant. You should consider deleting fig.2.  
 
(4) Page 6, first 2 lines: Report p and roc values rounded to 3 decimals.  
 
(5) Page 8, 2nd paragraph: Report the adjusted ORs for both variables.  
 
(6) Discussion/limitations. The cross sectional nature of the study induces an important 
limitation that was not acknowledged. Many predictor variables, such as 
thrombocytopenia, ascites, h epatorenal syndrome etc, are complications of liver cirrhosis 
and so is esophageal varices which was the outcome variable. The cross -sectional data 
collection in one point in time may have blurred the temporal sequence of events and the 
subsequent measures  of associations and predictive performance.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, pleas e specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript 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 to the editors.  
 
I am able to assess the statistics  
 
Quality of written Engli sh 
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 i n 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, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organi sation 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 com peting 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 below.  
 
This reviewer has been recruited by a partner organiza tion, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. T his reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square a nd was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name w ill be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available u nder an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comment s 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not b e published.  
 
I agree to the open peer review policy of the journal  
assistant