Reviewer ’s report  
 
Title: Faecal calprotectin is the biomarker that best disting uishes remission from different 
degrees of endosco pic activity in Crohn's disease  
 
Vers ion: 0 Date: 30 May 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
Yes - the approach is appropriate  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confid ence in the results?  
 
Yes - experiments and analyses were performed appropriately  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current inter pretation/discussion of the results reasonable and not 
overstated?  
 
Yes - the author's interpretation is reasonable  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Overall, the study seeks to  look at the ability for fecal calprotectin 
levels to serve as a surrogate for endoscopic remission of Crohn's Disease.  
 
This has been previously reported as a viable strategy numerous times in the literature, and the 
outcomes of this study confirm this.  
 
The authors conducted a study with a reasonable approach and had appropriate statistical 
methods.  
 
It's only flaw is that it overstates its novelty. The only real novelty is that the study was done in a 
Brazilian population.  
 
 
ADDITIONAL REQUESTS/SUGGESTIO NS:  
There are two revisions that should be undertaken. The first is that the authors overstate the 
novelty of the study in the introduction. Other studies show that fecal calprotectin can be a good 
surrogate for endoscopic severity, not just remission vs active disease. The only novelty lies with 
the study's focus on a Brazilian population. The introduction should be changed to reflect this 
(the discussion already reflects this well enough), and both the introduction and discussion need 
to explain why this  is needed novelty after similar fecal calprotectin studies have already been 
performed in multiple countries across several continents.  
 
Secondly, the language is in need of heavy editing, and the tables have several spacing 
errors/inconsistencies (such as the presence of absence of a space before a "(".  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
 
 
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
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 to 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 reimbursemen ts, fees, 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 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 org anization 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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to  Research Square and 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 understan d that my name will 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 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 wish to be included in my named report can be in cluded 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: Faecal calprotectin is the biomarker that best disting uishes remission from different 
degrees of endosco pic activity in Crohn's disease  
 
Vers ion: 0 Date: 30 May 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
Yes - the approach is appropriate  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confid ence in the results?  
 
Yes - experiments and analyses were performed appropriately  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current inter pretation/discussion of the results reasonable and not 
overstated?  
 
Yes - the author's interpretation is reasonable  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Overall, the study seeks to  look at the ability for fecal calprotectin 
levels to serve as a surrogate for endoscopic remission of Crohn's Disease.  
 
This has been previously reported as a viable strategy numerous times in the literature, and the 
outcomes of this study confirm this.  
 
The authors conducted a study with a reasonable approach and had appropriate statistical 
methods.  
 
It's only flaw is that it overstates its novelty. The only real novelty is that the study was done in a 
Brazilian population.  
 
 
ADDITIONAL REQUESTS/SUGGESTIO NS:  
There are two revisions that should be undertaken. The first is that the authors overstate the 
novelty of the study in the introduction. Other studies show that fecal calprotectin can be a good 
surrogate for endoscopic severity, not just remission vs active disease. The only novelty lies with 
the study's focus on a Brazilian population. The introduction should be changed to reflect this 
(the discussion already reflects this well enough), and both the introduction and discussion need 
to explain why this  is needed novelty after similar fecal calprotectin studies have already been 
performed in multiple countries across several continents.  
 
Secondly, the language is in need of heavy editing, and the tables have several spacing 
errors/inconsistencies (such as the presence of absence of a space before a "(".  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
 
 
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
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 to 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 reimbursemen ts, fees, 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 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 org anization 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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to  Research Square and 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 understan d that my name will 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 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 wish to be included in my named report can be in cluded 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: Faecal calprotectin is the biomarker that best disting uishes remission from different 
degrees of endosco pic activity in Crohn's disease  
 
Vers ion: 0 Date: 30 May 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
Yes - the approach is appropriate  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confid ence in the results?  
 
Yes - experiments and analyses were performed appropriately  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current inter pretation/discussion of the results reasonable and not 
overstated?  
 
Yes - the author's interpretation is reasonable  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: Overall, the study seeks to  look at the ability for fecal calprotectin 
levels to serve as a surrogate for endoscopic remission of Crohn's Disease.  
 
This has been previously reported as a viable strategy numerous times in the literature, and the 
outcomes of this study confirm this.  
 
The authors conducted a study with a reasonable approach and had appropriate statistical 
methods.  
 
It's only flaw is that it overstates its novelty. The only real novelty is that the study was done in a 
Brazilian population.  
 
 
ADDITIONAL REQUESTS/SUGGESTIO NS:  
There are two revisions that should be undertaken. The first is that the authors overstate the 
novelty of the study in the introduction. Other studies show that fecal calprotectin can be a good 
surrogate for endoscopic severity, not just remission vs active disease. The only novelty lies with 
the study's focus on a Brazilian population. The introduction should be changed to reflect this 
(the discussion already reflects this well enough), and both the introduction and discussion need 
to explain why this  is needed novelty after similar fecal calprotectin studies have already been 
performed in multiple countries across several continents.  
 
Secondly, the language is in need of heavy editing, and the tables have several spacing 
errors/inconsistencies (such as the presence of absence of a space before a "(".  
 
Note: This reviewer report can be downloaded - see attached pdf file.  
 
 
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
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 to 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 reimbursemen ts, fees, 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 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 org anization 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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to  Research Square and 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 understan d that my name will 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 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 wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant