Reviewer ’s report  
 
Title: Symptom or faecal immunochemical test based referral criteria  for colorectal cancer 
detection in symptomatic patients: a diagnostic tests study.  
 
Version: 0 Date: 03 Oct 2018  
 
Reviewer: Callum George Fraser  
 
Reviewer's report:  
 
The authors of this revision have taken all of the comments of bot h of the reviewers into account. 
There is significant current interest in the use of faecal immunochemical tests for haemoglobin 
(FIT) in assessment of patients presenting with lower bowel symptoms either alone, as the 
simple faecal haemoglobin concentrati on,  or in risk scoring approaches, compared to symptoms. 
This study, from a well known expert group who have published much of significance in the 
field,  is a most timely and important work. The work is now very up to date and should 
influence routine pr actice. The revision is well written and easy to follow. This reviewer has no 
further comments.  
 
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 manuscript or would you recommend an  
additional statisti cal review?  
If an additional statistical review is recommended, please specify 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:  
 
Acceptable  
 
 
Declaration of competing interests  
Please complete a declaration of competing interest s, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the fut ure? 
 
2. Do you hold any stocks or shares in an organisation that 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 cont ent 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 hav e 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 have acted as a consultant to Kyowa Medex Co., Ltd, Tokyo, Japan, and to Immunostics Inc., 
Ocean, NJ, USA. I have also ben funded to attend meetings by Alpha L abs Ltd, Eastleigh, Hants, 
UK. 
 
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 a ttachments 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 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: Symptom or faecal immunochemical test based referral criteria  for colorectal cancer 
detection in symptomatic patients: a diagnostic tests study.  
 
Version: 0 Date: 03 Oct 2018  
 
Reviewer: Callum George Fraser  
 
Reviewer's report:  
 
The authors of this revision have taken all of the comments of bot h of the reviewers into account. 
There is significant current interest in the use of faecal immunochemical tests for haemoglobin 
(FIT) in assessment of patients presenting with lower bowel symptoms either alone, as the 
simple faecal haemoglobin concentrati on,  or in risk scoring approaches, compared to symptoms. 
This study, from a well known expert group who have published much of significance in the 
field,  is a most timely and important work. The work is now very up to date and should 
influence routine pr actice. The revision is well written and easy to follow. This reviewer has no 
further comments.  
 
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 manuscript or would you recommend an  
additional statisti cal review?  
If an additional statistical review is recommended, please specify 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:  
 
Acceptable  
 
 
Declaration of competing interests  
Please complete a declaration of competing interest s, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the fut ure? 
 
2. Do you hold any stocks or shares in an organisation that 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 cont ent 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 hav e 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 have acted as a consultant to Kyowa Medex Co., Ltd, Tokyo, Japan, and to Immunostics Inc., 
Ocean, NJ, USA. I have also ben funded to attend meetings by Alpha L abs Ltd, Eastleigh, Hants, 
UK. 
 
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 a ttachments 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 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: Symptom or faecal immunochemical test based referral criteria  for colorectal cancer 
detection in symptomatic patients: a diagnostic tests study.  
 
Version: 0 Date: 03 Oct 2018  
 
Reviewer: Callum George Fraser  
 
Reviewer's report:  
 
The authors of this revision have taken all of the comments of bot h of the reviewers into account. 
There is significant current interest in the use of faecal immunochemical tests for haemoglobin 
(FIT) in assessment of patients presenting with lower bowel symptoms either alone, as the 
simple faecal haemoglobin concentrati on,  or in risk scoring approaches, compared to symptoms. 
This study, from a well known expert group who have published much of significance in the 
field,  is a most timely and important work. The work is now very up to date and should 
influence routine pr actice. The revision is well written and easy to follow. This reviewer has no 
further comments.  
 
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 manuscript or would you recommend an  
additional statisti cal review?  
If an additional statistical review is recommended, please specify 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:  
 
Acceptable  
 
 
Declaration of competing interests  
Please complete a declaration of competing interest s, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the fut ure? 
 
2. Do you hold any stocks or shares in an organisation that 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 cont ent 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 hav e 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 have acted as a consultant to Kyowa Medex Co., Ltd, Tokyo, Japan, and to Immunostics Inc., 
Ocean, NJ, USA. I have also ben funded to attend meetings by Alpha L abs Ltd, Eastleigh, Hants, 
UK. 
 
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 a ttachments 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 included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant