Reviewer ’s report  
 
Title: Ileal intubation is not associated with higher detecti on rate of right -sided conventional 
adenomas and serrated polyps compared to cecal intubation after  adjustment for overall adenoma 
detection rate  
 
Version: 0 Date: 25 Jul 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are minor issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
 
No - there are minor issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the re sults reasonable and not 
overstated?  
 
No - there are minor issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
 
This study sets out to investigate whether ileal intubation is associated with higher detection rate 
of right -sided conventional adenomas and serrated polyps compared with cecal intubation after 
adjustment for some i nfluencing factors. The paper is well written and referenced, with a clear 
objective and analysis. As highlighted in the limitations, some potential important influencing 
factors are not accounted for in the analysis, and I think this weakens the strength of the firm 
conclusion currently provided.  
 
 
REQUESTED REVISIONS:  
 
The study is largely clear, however two questions/comments for the authors:  
 
1) Some more detail on the retrospective identification of cases included is warranted in order to 
understand the validity of these. Was this a prospective case database? Clinical or 
administrative? etc  
 
2) There is little discussion of the limitations at t he end of the discussion, particularly the 
potential impact of these on the findings presented e.g. discuss how withdrawal time may 
influence the findings presented (I note photo documentation already discussed earlier). My 
understanding is that both can h ave a significant impact on detection rate. Therefore the omission 
of these from adjustment may have a material impact on the results presented. I believe this 
means that the current conclusion over -states the certainty of which it is currently stated "Ile al 
intubation does not provide any benefit...".  
 
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 cont rols?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Qualit y of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 content 
of the manuscript?  
 
4. Have you recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research Sq uare. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a sma ll honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 under an Open Acce ss 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 in cluded 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: Ileal intubation is not associated with higher detecti on rate of right -sided conventional 
adenomas and serrated polyps compared to cecal intubation after  adjustment for overall adenoma 
detection rate  
 
Version: 0 Date: 25 Jul 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are minor issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
 
No - there are minor issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the re sults reasonable and not 
overstated?  
 
No - there are minor issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
 
This study sets out to investigate whether ileal intubation is associated with higher detection rate 
of right -sided conventional adenomas and serrated polyps compared with cecal intubation after 
adjustment for some i nfluencing factors. The paper is well written and referenced, with a clear 
objective and analysis. As highlighted in the limitations, some potential important influencing 
factors are not accounted for in the analysis, and I think this weakens the strength of the firm 
conclusion currently provided.  
 
 
REQUESTED REVISIONS:  
 
The study is largely clear, however two questions/comments for the authors:  
 
1) Some more detail on the retrospective identification of cases included is warranted in order to 
understand the validity of these. Was this a prospective case database? Clinical or 
administrative? etc  
 
2) There is little discussion of the limitations at t he end of the discussion, particularly the 
potential impact of these on the findings presented e.g. discuss how withdrawal time may 
influence the findings presented (I note photo documentation already discussed earlier). My 
understanding is that both can h ave a significant impact on detection rate. Therefore the omission 
of these from adjustment may have a material impact on the results presented. I believe this 
means that the current conclusion over -states the certainty of which it is currently stated "Ile al 
intubation does not provide any benefit...".  
 
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 cont rols?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Qualit y of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 content 
of the manuscript?  
 
4. Have you recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research Sq uare. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a sma ll honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 under an Open Acce ss 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 in cluded 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: Ileal intubation is not associated with higher detecti on rate of right -sided conventional 
adenomas and serrated polyps compared to cecal intubation after  adjustment for overall adenoma 
detection rate  
 
Version: 0 Date: 25 Jul 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
 
Yes - there is a clear objective  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
No - there are minor issues  
 
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
 
No - there are minor issues  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
Yes - appropriate statistical analyses have been used in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the re sults reasonable and not 
overstated?  
 
No - there are minor issues  
 
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
 
This study sets out to investigate whether ileal intubation is associated with higher detection rate 
of right -sided conventional adenomas and serrated polyps compared with cecal intubation after 
adjustment for some i nfluencing factors. The paper is well written and referenced, with a clear 
objective and analysis. As highlighted in the limitations, some potential important influencing 
factors are not accounted for in the analysis, and I think this weakens the strength of the firm 
conclusion currently provided.  
 
 
REQUESTED REVISIONS:  
 
The study is largely clear, however two questions/comments for the authors:  
 
1) Some more detail on the retrospective identification of cases included is warranted in order to 
understand the validity of these. Was this a prospective case database? Clinical or 
administrative? etc  
 
2) There is little discussion of the limitations at t he end of the discussion, particularly the 
potential impact of these on the findings presented e.g. discuss how withdrawal time may 
influence the findings presented (I note photo documentation already discussed earlier). My 
understanding is that both can h ave a significant impact on detection rate. Therefore the omission 
of these from adjustment may have a material impact on the results presented. I believe this 
means that the current conclusion over -states the certainty of which it is currently stated "Ile al 
intubation does not provide any benefit...".  
 
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 cont rols?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Qualit y of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation t hat 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 content 
of the manuscript?  
 
4. Have you recei ved 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.  
 
This reviewer has been recruited by a partner organization, Research Sq uare. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a sma ll honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 under an Open Acce ss 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant