Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 05 Sep 2024
Reviewer's report:
First of all, I would like to commend the authors for their efforts to investigate immature
granulocyte (IG) count as a potential diagnostic tool for predicting complications in right-sided
diverticulitis. The search for novel biomarkers that can enhance diagnostic accuracy and aid
clinical decision-making is of great importance in the medical field. This study represents a
valuable attempt to contribute to this critical area.
1. Major Points
1.1 Lack of Novelty and Clinical Significance
This study presents immature granulocyte (IG) count as a predictor for complications (cAD) in
right-sided diverticulitis. However, the study faces significant issues regarding both its novelty
and clinical significance. The use of IG count as a diagnostic marker for severe infections is
already well-established, and the study does not clearly articulate what new insights it offers
by focusing specifically on right-sided diverticulitis. Additionally, while the study proposes IG
count as an alternative to CT scans, the potential clinical impact of this approach is inadequately
discussed. The paper does not sufficiently explain how IG count influences clinical decision-
making, such as its role in guiding antibiotic use or early surgical intervention. A more detailed
discussion on the practical applications of IG count in clinical settings, including its specific
impact on patient outcomes, is necessary to emphasize its relevance in medical practice.
Furthermore, the study mentions the utility of IG count in children and pregnant women, but
these groups are either excluded from the study or not clearly identified (e.g., no mention of
pregnancy status). As a result, these claims lack solid grounding, and the overall clinical value of
using IG count as a substitute or complement to CT remains unclear. The discussion also contains
inconsistencies, further complicating the ability of readers to fully understand and accept the
study's conclusions.
2. Minor Points
2.1 Small Sample Size in the cAD Group
With only 31 patients in the complicated acute diverticulitis (cAD) group, there may be a lack of
statistical power, increasing the risk of overfitting in regression analyses. This could affect the
reliability of the results, and this limitation should be carefully considered in the interpretation
of the study's findings.
2.2 Lack of Univariate Analysis Results in Tables
Although both univariable and multivariable logistic regression analyses were conducted, the
provided tables do not clearly distinguish between the results of these analyses. Including
univariate analysis results explicitly would make the interpretation of the findings easier and
more transparent.
Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 05 Sep 2024
Reviewer's report:
First of all, I would like to commend the authors for their efforts to investigate immature
granulocyte (IG) count as a potential diagnostic tool for predicting complications in right-sided
diverticulitis. The search for novel biomarkers that can enhance diagnostic accuracy and aid
clinical decision-making is of great importance in the medical field. This study represents a
valuable attempt to contribute to this critical area.
1. Major Points
1.1 Lack of Novelty and Clinical Significance
This study presents immature granulocyte (IG) count as a predictor for complications (cAD) in
right-sided diverticulitis. However, the study faces significant issues regarding both its novelty
and clinical significance. The use of IG count as a diagnostic marker for severe infections is
already well-established, and the study does not clearly articulate what new insights it offers
by focusing specifically on right-sided diverticulitis. Additionally, while the study proposes IG
count as an alternative to CT scans, the potential clinical impact of this approach is inadequately
discussed. The paper does not sufficiently explain how IG count influences clinical decision-
making, such as its role in guiding antibiotic use or early surgical intervention. A more detailed
discussion on the practical applications of IG count in clinical settings, including its specific
impact on patient outcomes, is necessary to emphasize its relevance in medical practice.
Furthermore, the study mentions the utility of IG count in children and pregnant women, but
these groups are either excluded from the study or not clearly identified (e.g., no mention of
pregnancy status). As a result, these claims lack solid grounding, and the overall clinical value of
using IG count as a substitute or complement to CT remains unclear. The discussion also contains
inconsistencies, further complicating the ability of readers to fully understand and accept the
study's conclusions.
2. Minor Points
2.1 Small Sample Size in the cAD Group
With only 31 patients in the complicated acute diverticulitis (cAD) group, there may be a lack of
statistical power, increasing the risk of overfitting in regression analyses. This could affect the
reliability of the results, and this limitation should be carefully considered in the interpretation
of the study's findings.
2.2 Lack of Univariate Analysis Results in Tables
Although both univariable and multivariable logistic regression analyses were conducted, the
provided tables do not clearly distinguish between the results of these analyses. Including
univariate analysis results explicitly would make the interpretation of the findings easier and
more transparent.
Please review this paper.
user
Title: The early biomarker of immature granulocyte count in predicting right-side colonic
complicated acute diverticulitis: A retrospective cohort study
Version: 2 Date: 05 Sep 2024
Reviewer's report:
First of all, I would like to commend the authors for their efforts to investigate immature
granulocyte (IG) count as a potential diagnostic tool for predicting complications in right-sided
diverticulitis. The search for novel biomarkers that can enhance diagnostic accuracy and aid
clinical decision-making is of great importance in the medical field. This study represents a
valuable attempt to contribute to this critical area.
1. Major Points
1.1 Lack of Novelty and Clinical Significance
This study presents immature granulocyte (IG) count as a predictor for complications (cAD) in
right-sided diverticulitis. However, the study faces significant issues regarding both its novelty
and clinical significance. The use of IG count as a diagnostic marker for severe infections is
already well-established, and the study does not clearly articulate what new insights it offers
by focusing specifically on right-sided diverticulitis. Additionally, while the study proposes IG
count as an alternative to CT scans, the potential clinical impact of this approach is inadequately
discussed. The paper does not sufficiently explain how IG count influences clinical decision-
making, such as its role in guiding antibiotic use or early surgical intervention. A more detailed
discussion on the practical applications of IG count in clinical settings, including its specific
impact on patient outcomes, is necessary to emphasize its relevance in medical practice.
Furthermore, the study mentions the utility of IG count in children and pregnant women, but
these groups are either excluded from the study or not clearly identified (e.g., no mention of
pregnancy status). As a result, these claims lack solid grounding, and the overall clinical value of
using IG count as a substitute or complement to CT remains unclear. The discussion also contains
inconsistencies, further complicating the ability of readers to fully understand and accept the
study's conclusions.
2. Minor Points
2.1 Small Sample Size in the cAD Group
With only 31 patients in the complicated acute diverticulitis (cAD) group, there may be a lack of
statistical power, increasing the risk of overfitting in regression analyses. This could affect the
reliability of the results, and this limitation should be carefully considered in the interpretation
of the study's findings.
2.2 Lack of Univariate Analysis Results in Tables
Although both univariable and multivariable logistic regression analyses were conducted, the
provided tables do not clearly distinguish between the results of these analyses. Including
univariate analysis results explicitly would make the interpretation of the findings easier and
more transparent.
assistant