Reviewer ’s report  
 
Title:  How disease extent can be included in the endoscopic activity index of ulcerative colitis: 
The panMayo Score, a promising scoring system  
 
Version: 0 Date: 06 Apr 2017 
 
Reviewer:  Bruce  Yacyshyn  
 
Reviewer’s report:  
 
The reviewed manuscript titled "How disease extent can be included in the endoscopic activity 
index of UC: the panMayo score, a promising scoring system" by Balint et al describes a new 
scoring system for UC using the stan dard and well accepted Mayo system with an additional 
score of disease extent added to the base Mayo scoring technique. This work is based upon a 
single center, prospective study based upon ECCO criteria and rated by the endoscopists doing 
the procedures. The severity was rated using panMayo, eMayo and UCEIS for each patient and 
compared.  
Biopsies and laboratory tests were also taken and submitted for assessment.  
 
Comparison between indices was made in 104 outpatients of whom 33 mild, 30 moderate and 8 
severe patients were identified.  
 
Results were compared.  
 
Comments - 
 
The scoring of the severity in this paper seems to be done by the same physicians that did their 
procedures at the time the procedures were performed. This technique, if used, carries risk o f 
additional bias if the symptoms of the UC are discussed with the patient before the study by the 
investigator.It was not clear that this was allowed by the protocol description provided.  It would 
be best to tape the procedure in its entirety, stopping a t each area of the colon used in the scoring 
system end then rating these areas by use of taped procedure technique by symptom blinded 
investigators. These persons could rate the disease while being blinded to symptom history. Also, 
rating of severity usin g a 45 point scare is also difficult and complex. A seven point Likert 
Visual analogue scale is the most accurate for such measurements.It is hard to tell by the data 
provided that this added to the current techniques for endoscopic disease severity assess ment.  
 
Also, intra -observer variation should be described in the rating of disease severity. For example 
if 3 observers are used to assess the same procedure, the variance between these individuals 
should be measured and presented.  
 
Methods used in this stu dy for each scoring system should be provided in table format so the 
similarities and differences between each could be compared at the same time.  
 
Several spelling errors and grammatical errors were found in the manuscript itself.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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 statistical review?  
If an additional statistical review is re commended, 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:  
 
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 
organisation  that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
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, e ither 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 wil l 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 und er 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 a s 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:  How disease extent can be included in the endoscopic activity index of ulcerative colitis: 
The panMayo Score, a promising scoring system  
 
Version: 0 Date: 06 Apr 2017 
 
Reviewer:  Bruce  Yacyshyn  
 
Reviewer’s report:  
 
The reviewed manuscript titled "How disease extent can be included in the endoscopic activity 
index of UC: the panMayo score, a promising scoring system" by Balint et al describes a new 
scoring system for UC using the stan dard and well accepted Mayo system with an additional 
score of disease extent added to the base Mayo scoring technique. This work is based upon a 
single center, prospective study based upon ECCO criteria and rated by the endoscopists doing 
the procedures. The severity was rated using panMayo, eMayo and UCEIS for each patient and 
compared.  
Biopsies and laboratory tests were also taken and submitted for assessment.  
 
Comparison between indices was made in 104 outpatients of whom 33 mild, 30 moderate and 8 
severe patients were identified.  
 
Results were compared.  
 
Comments - 
 
The scoring of the severity in this paper seems to be done by the same physicians that did their 
procedures at the time the procedures were performed. This technique, if used, carries risk o f 
additional bias if the symptoms of the UC are discussed with the patient before the study by the 
investigator.It was not clear that this was allowed by the protocol description provided.  It would 
be best to tape the procedure in its entirety, stopping a t each area of the colon used in the scoring 
system end then rating these areas by use of taped procedure technique by symptom blinded 
investigators. These persons could rate the disease while being blinded to symptom history. Also, 
rating of severity usin g a 45 point scare is also difficult and complex. A seven point Likert 
Visual analogue scale is the most accurate for such measurements.It is hard to tell by the data 
provided that this added to the current techniques for endoscopic disease severity assess ment.  
 
Also, intra -observer variation should be described in the rating of disease severity. For example 
if 3 observers are used to assess the same procedure, the variance between these individuals 
should be measured and presented.  
 
Methods used in this stu dy for each scoring system should be provided in table format so the 
similarities and differences between each could be compared at the same time.  
 
Several spelling errors and grammatical errors were found in the manuscript itself.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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 statistical review?  
If an additional statistical review is re commended, 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:  
 
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 
organisation  that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
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, e ither 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 wil l 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 und er 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 a s 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:  How disease extent can be included in the endoscopic activity index of ulcerative colitis: 
The panMayo Score, a promising scoring system  
 
Version: 0 Date: 06 Apr 2017 
 
Reviewer:  Bruce  Yacyshyn  
 
Reviewer’s report:  
 
The reviewed manuscript titled "How disease extent can be included in the endoscopic activity 
index of UC: the panMayo score, a promising scoring system" by Balint et al describes a new 
scoring system for UC using the stan dard and well accepted Mayo system with an additional 
score of disease extent added to the base Mayo scoring technique. This work is based upon a 
single center, prospective study based upon ECCO criteria and rated by the endoscopists doing 
the procedures. The severity was rated using panMayo, eMayo and UCEIS for each patient and 
compared.  
Biopsies and laboratory tests were also taken and submitted for assessment.  
 
Comparison between indices was made in 104 outpatients of whom 33 mild, 30 moderate and 8 
severe patients were identified.  
 
Results were compared.  
 
Comments - 
 
The scoring of the severity in this paper seems to be done by the same physicians that did their 
procedures at the time the procedures were performed. This technique, if used, carries risk o f 
additional bias if the symptoms of the UC are discussed with the patient before the study by the 
investigator.It was not clear that this was allowed by the protocol description provided.  It would 
be best to tape the procedure in its entirety, stopping a t each area of the colon used in the scoring 
system end then rating these areas by use of taped procedure technique by symptom blinded 
investigators. These persons could rate the disease while being blinded to symptom history. Also, 
rating of severity usin g a 45 point scare is also difficult and complex. A seven point Likert 
Visual analogue scale is the most accurate for such measurements.It is hard to tell by the data 
provided that this added to the current techniques for endoscopic disease severity assess ment.  
 
Also, intra -observer variation should be described in the rating of disease severity. For example 
if 3 observers are used to assess the same procedure, the variance between these individuals 
should be measured and presented.  
 
Methods used in this stu dy for each scoring system should be provided in table format so the 
similarities and differences between each could be compared at the same time.  
 
Several spelling errors and grammatical errors were found in the manuscript itself.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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 statistical review?  
If an additional statistical review is re commended, 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:  
 
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 
organisation  that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
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, e ither 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 wil l 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 und er 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 a s confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
assistant