Reviewer's report
Title:Linear Echoendoscope-Guided ERCP for the Diagnosis of Occult Common
Bile Duct Stone
Version: 1Date:9 September 2012
Reviewer: Werner Hartwig
Reviewer's report:
The study by Hoi-Hung Chan et al. is a prospective observational study in that
linear endoscopic ultrasound was assessed in 30 patients with clinical suspicion
of common bile duct stones. Sensitivity and specificity rates as well as adverse
effects of linear EUS are provided. The issue of the study is not new, and the
study has some flaws which need clarification:
Major Compulsory Revisions:
1. As it has been demonstrated by several studies before, EUS is well
established in several centers in the evaluation of patients with suspected bile
duct stones. This is true for radial (several randomized studies that compared
EUS with ERCP for detection of CBD stones) as well as linear EUS (e.g. Kohut
et al, World J Gastroenterol 2003 or Endoscopy 2002). It is unclear to the
reviewer: what are the real new findings of the study? Please discuss.
2. There is no “gold standard” for the detection of CBD stones in the study. Since
ERCP has been only performed in EUS CBD-stone positive patients and
follow-up of patients has in parts been done by telephone only, the rate of false
negative findings may be underestimated. Another shortcoming of the study is
that EUS and ERCP have been performed by the same investigator and no
blinding has been performed. The authors should include a paragraph in the
discussion where the shortcomings of the study are detailed.
3. Diagnostic studies should also provide data about positive and negative
predicted values. Please provide data.
4. In the discussion, the authors tend to neglect possible disadvantages of EUS,
e.g. the invasiveness of EUS compared to MRCP. Why do the authors think that
MRCP needs more manpower as compared to invasive EUS?
5. No abstract has been available to the reviewer. Please provide.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
no cometing interests
Reviewer's report
Title:Linear Echoendoscope-Guided ERCP for the Diagnosis of Occult Common
Bile Duct Stone
Version: 1Date:9 September 2012
Reviewer: Werner Hartwig
Reviewer's report:
The study by Hoi-Hung Chan et al. is a prospective observational study in that
linear endoscopic ultrasound was assessed in 30 patients with clinical suspicion
of common bile duct stones. Sensitivity and specificity rates as well as adverse
effects of linear EUS are provided. The issue of the study is not new, and the
study has some flaws which need clarification:
Major Compulsory Revisions:
1. As it has been demonstrated by several studies before, EUS is well
established in several centers in the evaluation of patients with suspected bile
duct stones. This is true for radial (several randomized studies that compared
EUS with ERCP for detection of CBD stones) as well as linear EUS (e.g. Kohut
et al, World J Gastroenterol 2003 or Endoscopy 2002). It is unclear to the
reviewer: what are the real new findings of the study? Please discuss.
2. There is no “gold standard” for the detection of CBD stones in the study. Since
ERCP has been only performed in EUS CBD-stone positive patients and
follow-up of patients has in parts been done by telephone only, the rate of false
negative findings may be underestimated. Another shortcoming of the study is
that EUS and ERCP have been performed by the same investigator and no
blinding has been performed. The authors should include a paragraph in the
discussion where the shortcomings of the study are detailed.
3. Diagnostic studies should also provide data about positive and negative
predicted values. Please provide data.
4. In the discussion, the authors tend to neglect possible disadvantages of EUS,
e.g. the invasiveness of EUS compared to MRCP. Why do the authors think that
MRCP needs more manpower as compared to invasive EUS?
5. No abstract has been available to the reviewer. Please provide.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
no cometing interests
Please review this paper.
user
Reviewer's report
Title:Linear Echoendoscope-Guided ERCP for the Diagnosis of Occult Common
Bile Duct Stone
Version: 1Date:9 September 2012
Reviewer: Werner Hartwig
Reviewer's report:
The study by Hoi-Hung Chan et al. is a prospective observational study in that
linear endoscopic ultrasound was assessed in 30 patients with clinical suspicion
of common bile duct stones. Sensitivity and specificity rates as well as adverse
effects of linear EUS are provided. The issue of the study is not new, and the
study has some flaws which need clarification:
Major Compulsory Revisions:
1. As it has been demonstrated by several studies before, EUS is well
established in several centers in the evaluation of patients with suspected bile
duct stones. This is true for radial (several randomized studies that compared
EUS with ERCP for detection of CBD stones) as well as linear EUS (e.g. Kohut
et al, World J Gastroenterol 2003 or Endoscopy 2002). It is unclear to the
reviewer: what are the real new findings of the study? Please discuss.
2. There is no “gold standard” for the detection of CBD stones in the study. Since
ERCP has been only performed in EUS CBD-stone positive patients and
follow-up of patients has in parts been done by telephone only, the rate of false
negative findings may be underestimated. Another shortcoming of the study is
that EUS and ERCP have been performed by the same investigator and no
blinding has been performed. The authors should include a paragraph in the
discussion where the shortcomings of the study are detailed.
3. Diagnostic studies should also provide data about positive and negative
predicted values. Please provide data.
4. In the discussion, the authors tend to neglect possible disadvantages of EUS,
e.g. the invasiveness of EUS compared to MRCP. Why do the authors think that
MRCP needs more manpower as compared to invasive EUS?
5. No abstract has been available to the reviewer. Please provide.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
no cometing interests
assistant