Reviewer ’s report  
Title: Variable Endoscopist Performance in Proximal and  Distal Adenoma Detection during 
Colonoscopy: A Retrospective Cohort Study  
 
Version: 1 Date: 03 Jan 2018  
 
Reviewer: Sauid Ishaq  
 
Reviewer's report:  
I read with interest this R1 revision of study "Variable Endoscopist Performance in Proximal and 
Distal Adenoma Detection during Colonoscopy: A Retrospective Cohort Study". It would have 
been helpful to see the original paper and reviewers comments to see author's response.  
 
Its is interesting retrospective study looking at variability in an endoscopist's detection of distal 
vs proximal adenomas and its impact on performance assessment and improve colonoscopy 
quality and to  determine if intra -operator differences exist in distal and  
proximal ADR factors that predict overall, distal, and proximal adenoma  
detection.  
Authors reported overall ADR of  25%  that lower than expected in their group of patient. 
Adenoma detection also showed a weak inverse association with endoscopy years of practice 
Authors needs to comments  
 
1- Reason for lower than expected ADR in this study  
2- Why no  mention of Withdrawal time that has strong link with ADR and it will be interesting 
to see impact with withdrawal time on variability in endoscopists' distal and proximal 
adenoma detection - this may change study outcome altogether.  
 
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, please specify which controls are required in your comments  to the authors.  
No 
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 manus cript or would you recommend an 
additional statistical revi ew? 
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
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, fees, funding, or salary from an  
organisati on 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 organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, 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 below.  
 
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 any 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 comments 
which I do not wi sh 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: Variable Endoscopist Performance in Proximal and  Distal Adenoma Detection during 
Colonoscopy: A Retrospective Cohort Study  
 
Version: 1 Date: 03 Jan 2018  
 
Reviewer: Sauid Ishaq  
 
Reviewer's report:  
I read with interest this R1 revision of study "Variable Endoscopist Performance in Proximal and 
Distal Adenoma Detection during Colonoscopy: A Retrospective Cohort Study". It would have 
been helpful to see the original paper and reviewers comments to see author's response.  
 
Its is interesting retrospective study looking at variability in an endoscopist's detection of distal 
vs proximal adenomas and its impact on performance assessment and improve colonoscopy 
quality and to  determine if intra -operator differences exist in distal and  
proximal ADR factors that predict overall, distal, and proximal adenoma  
detection.  
Authors reported overall ADR of  25%  that lower than expected in their group of patient. 
Adenoma detection also showed a weak inverse association with endoscopy years of practice 
Authors needs to comments  
 
1- Reason for lower than expected ADR in this study  
2- Why no  mention of Withdrawal time that has strong link with ADR and it will be interesting 
to see impact with withdrawal time on variability in endoscopists' distal and proximal 
adenoma detection - this may change study outcome altogether.  
 
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, please specify which controls are required in your comments  to the authors.  
No 
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 manus cript or would you recommend an 
additional statistical revi ew? 
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
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, fees, funding, or salary from an  
organisati on 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 organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, 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 below.  
 
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 any 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 comments 
which I do not wi sh 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: Variable Endoscopist Performance in Proximal and  Distal Adenoma Detection during 
Colonoscopy: A Retrospective Cohort Study  
 
Version: 1 Date: 03 Jan 2018  
 
Reviewer: Sauid Ishaq  
 
Reviewer's report:  
I read with interest this R1 revision of study "Variable Endoscopist Performance in Proximal and 
Distal Adenoma Detection during Colonoscopy: A Retrospective Cohort Study". It would have 
been helpful to see the original paper and reviewers comments to see author's response.  
 
Its is interesting retrospective study looking at variability in an endoscopist's detection of distal 
vs proximal adenomas and its impact on performance assessment and improve colonoscopy 
quality and to  determine if intra -operator differences exist in distal and  
proximal ADR factors that predict overall, distal, and proximal adenoma  
detection.  
Authors reported overall ADR of  25%  that lower than expected in their group of patient. 
Adenoma detection also showed a weak inverse association with endoscopy years of practice 
Authors needs to comments  
 
1- Reason for lower than expected ADR in this study  
2- Why no  mention of Withdrawal time that has strong link with ADR and it will be interesting 
to see impact with withdrawal time on variability in endoscopists' distal and proximal 
adenoma detection - this may change study outcome altogether.  
 
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, please specify which controls are required in your comments  to the authors.  
No 
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 manus cript or would you recommend an 
additional statistical revi ew? 
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
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, fees, funding, or salary from an  
organisati on 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 organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, 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 below.  
 
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 any 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 comments 
which I do not wi sh 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