Reviewer's report
Title:Prevalence and predictors of patient no-shows to outpatient endoscopic
procedures scheduled with anesthesia
Version:2Date:29 May 2015
Reviewer: Manish Singla
Reviewer's report:
This is an interesting study of predictors of no-shows to anesthesia-supported
endoscopy. The authors did a retrospective review of 511 patients, 27% of which
did not show to their endoscopy, and attempted to find factors that predicted
whether or not patients showed for their endoscopy.
Major Compulsory Revisions
1. This is a difficult study to interpret in a vacuum, where it is not clear whether
these numbers are any different in anesthesia-supported cases vs
moderate-sedation supported cases at the authors' institutions. In fact, the
authors quote that previous studies have shown a 40% rate of no-shows for
colonoscopy, which suggests that maybe it is the anesthesia support which may
improve no-show rates. If possible, an age-race-insurance matched population of
those undergoing moderate sedation as a control would make this study much
much stronger.
2. The authors suggest that this population is representative of a significant
portion of patients who will access care via the ACA. This is a strange statement
that is not referenced, and should be elaborated on in the discussion if this is a
point the authors want to drive home.
3. The authors' definition of "heavy use" is troublesome, since endoscopists vary
in their consideration of too much medication to sedate and, in particular, may be
inclined to attempt moderate sedation for a colonoscopy while asking for
anesthesia support for an EGD.
4. While the procedures are broken up into routine vs symptom-driven, there is
no comment on whether these procedures were done for screening purposes
(the asymptomatic includes high risk screening). Are average risk screenings not
included in this block?
5. Are the patients being evaluated in a closed system? That is, are any of the
patients able to be seen elsewhere for their endoscopy after their initial GI
appointment? Was there a difference in the distance to be traveled for those that
were not homeless?
Discretionary Revisions
6. The methods should include any co-pays required by patients, and any
penalties patients suffered by missing their endoscopy appointment.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
No competing interests.
Reviewer's report
Title:Prevalence and predictors of patient no-shows to outpatient endoscopic
procedures scheduled with anesthesia
Version:2Date:29 May 2015
Reviewer: Manish Singla
Reviewer's report:
This is an interesting study of predictors of no-shows to anesthesia-supported
endoscopy. The authors did a retrospective review of 511 patients, 27% of which
did not show to their endoscopy, and attempted to find factors that predicted
whether or not patients showed for their endoscopy.
Major Compulsory Revisions
1. This is a difficult study to interpret in a vacuum, where it is not clear whether
these numbers are any different in anesthesia-supported cases vs
moderate-sedation supported cases at the authors' institutions. In fact, the
authors quote that previous studies have shown a 40% rate of no-shows for
colonoscopy, which suggests that maybe it is the anesthesia support which may
improve no-show rates. If possible, an age-race-insurance matched population of
those undergoing moderate sedation as a control would make this study much
much stronger.
2. The authors suggest that this population is representative of a significant
portion of patients who will access care via the ACA. This is a strange statement
that is not referenced, and should be elaborated on in the discussion if this is a
point the authors want to drive home.
3. The authors' definition of "heavy use" is troublesome, since endoscopists vary
in their consideration of too much medication to sedate and, in particular, may be
inclined to attempt moderate sedation for a colonoscopy while asking for
anesthesia support for an EGD.
4. While the procedures are broken up into routine vs symptom-driven, there is
no comment on whether these procedures were done for screening purposes
(the asymptomatic includes high risk screening). Are average risk screenings not
included in this block?
5. Are the patients being evaluated in a closed system? That is, are any of the
patients able to be seen elsewhere for their endoscopy after their initial GI
appointment? Was there a difference in the distance to be traveled for those that
were not homeless?
Discretionary Revisions
6. The methods should include any co-pays required by patients, and any
penalties patients suffered by missing their endoscopy appointment.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
No competing interests.
Please review this paper.
user
Reviewer's report
Title:Prevalence and predictors of patient no-shows to outpatient endoscopic
procedures scheduled with anesthesia
Version:2Date:29 May 2015
Reviewer: Manish Singla
Reviewer's report:
This is an interesting study of predictors of no-shows to anesthesia-supported
endoscopy. The authors did a retrospective review of 511 patients, 27% of which
did not show to their endoscopy, and attempted to find factors that predicted
whether or not patients showed for their endoscopy.
Major Compulsory Revisions
1. This is a difficult study to interpret in a vacuum, where it is not clear whether
these numbers are any different in anesthesia-supported cases vs
moderate-sedation supported cases at the authors' institutions. In fact, the
authors quote that previous studies have shown a 40% rate of no-shows for
colonoscopy, which suggests that maybe it is the anesthesia support which may
improve no-show rates. If possible, an age-race-insurance matched population of
those undergoing moderate sedation as a control would make this study much
much stronger.
2. The authors suggest that this population is representative of a significant
portion of patients who will access care via the ACA. This is a strange statement
that is not referenced, and should be elaborated on in the discussion if this is a
point the authors want to drive home.
3. The authors' definition of "heavy use" is troublesome, since endoscopists vary
in their consideration of too much medication to sedate and, in particular, may be
inclined to attempt moderate sedation for a colonoscopy while asking for
anesthesia support for an EGD.
4. While the procedures are broken up into routine vs symptom-driven, there is
no comment on whether these procedures were done for screening purposes
(the asymptomatic includes high risk screening). Are average risk screenings not
included in this block?
5. Are the patients being evaluated in a closed system? That is, are any of the
patients able to be seen elsewhere for their endoscopy after their initial GI
appointment? Was there a difference in the distance to be traveled for those that
were not homeless?
Discretionary Revisions
6. The methods should include any co-pays required by patients, and any
penalties patients suffered by missing their endoscopy appointment.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
No competing interests.
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