Title: Utility of monocyte distribution width in the differential diagnosis between simple and
complicated diverticulitis: a retrospective cohort study
Version: 0 Date: 07 Jan 2023
Reviewer's report:
Thank you for asking me to review the manuscript entitled, ‘Utility of MDW for diagnosing
colonic diverticulitis in the emergency department: a retrospective cohort study’. This is an
interesting study. The authors have studied the MDW in relation to the identification of patients
with complicated diverticulitis. However, I do have some concerns which I have divided in to
major and minor categories. They are as follows:
Major concerns:
1. Sample size- The main concern here is that only 21 cases were defined as complicated
diverticulitis. There is no sample size calculation. Please provide this.
2. Please provide a table of test characteristics (sensitivity, specificity, PPV, NPV) for the
standard cut-off for MDW and their cut off for MDW.
3. From my calculations, it looks like the PPV is low, but the NPV is high. The authors could
play to this strength, if the sample size is adequate.
4. Was there an improvement in test characteristics when the MDW was combined with the
WCC?
5. Please provide the calibration statistic for the multivariate logistic regression model.
Minor concerns:
(i) Title- The title should state ‘diagnosing complicated colonic diverticulitis’ not just
‘diagnosing colonic diverticulitis’.
(ii) Please provide the diagnostic criteria for complicated diverticulitis in the methods section.
(iii) The first paragraph of the discussion should be a summary of the study findings.
(iv) The content of the first two paragraphs of the discussion should probably be in the
introduction.
Title: Utility of monocyte distribution width in the differential diagnosis between simple and
complicated diverticulitis: a retrospective cohort study
Version: 0 Date: 07 Jan 2023
Reviewer's report:
Thank you for asking me to review the manuscript entitled, ‘Utility of MDW for diagnosing
colonic diverticulitis in the emergency department: a retrospective cohort study’. This is an
interesting study. The authors have studied the MDW in relation to the identification of patients
with complicated diverticulitis. However, I do have some concerns which I have divided in to
major and minor categories. They are as follows:
Major concerns:
1. Sample size- The main concern here is that only 21 cases were defined as complicated
diverticulitis. There is no sample size calculation. Please provide this.
2. Please provide a table of test characteristics (sensitivity, specificity, PPV, NPV) for the
standard cut-off for MDW and their cut off for MDW.
3. From my calculations, it looks like the PPV is low, but the NPV is high. The authors could
play to this strength, if the sample size is adequate.
4. Was there an improvement in test characteristics when the MDW was combined with the
WCC?
5. Please provide the calibration statistic for the multivariate logistic regression model.
Minor concerns:
(i) Title- The title should state ‘diagnosing complicated colonic diverticulitis’ not just
‘diagnosing colonic diverticulitis’.
(ii) Please provide the diagnostic criteria for complicated diverticulitis in the methods section.
(iii) The first paragraph of the discussion should be a summary of the study findings.
(iv) The content of the first two paragraphs of the discussion should probably be in the
introduction.
Please review this paper.
user
Title: Utility of monocyte distribution width in the differential diagnosis between simple and
complicated diverticulitis: a retrospective cohort study
Version: 0 Date: 07 Jan 2023
Reviewer's report:
Thank you for asking me to review the manuscript entitled, ‘Utility of MDW for diagnosing
colonic diverticulitis in the emergency department: a retrospective cohort study’. This is an
interesting study. The authors have studied the MDW in relation to the identification of patients
with complicated diverticulitis. However, I do have some concerns which I have divided in to
major and minor categories. They are as follows:
Major concerns:
1. Sample size- The main concern here is that only 21 cases were defined as complicated
diverticulitis. There is no sample size calculation. Please provide this.
2. Please provide a table of test characteristics (sensitivity, specificity, PPV, NPV) for the
standard cut-off for MDW and their cut off for MDW.
3. From my calculations, it looks like the PPV is low, but the NPV is high. The authors could
play to this strength, if the sample size is adequate.
4. Was there an improvement in test characteristics when the MDW was combined with the
WCC?
5. Please provide the calibration statistic for the multivariate logistic regression model.
Minor concerns:
(i) Title- The title should state ‘diagnosing complicated colonic diverticulitis’ not just
‘diagnosing colonic diverticulitis’.
(ii) Please provide the diagnostic criteria for complicated diverticulitis in the methods section.
(iii) The first paragraph of the discussion should be a summary of the study findings.
(iv) The content of the first two paragraphs of the discussion should probably be in the
introduction.
assistant