Reviewer ’s report  
Title: Villous atro phy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 1 Date: 27 May 2018  
 
Reviewer: Shishu Sharma  
 
Reviewer's report:  
A very pragmatic topic however this would benefit from some changes as suggested.  
 
I would advise a more catchy and specific short title.  
 
Major points: - 
 
Page 6, Line 2 -  I respectfully disagree with the claim that 'No published report... .Response to 
treatment', as there are published papers which support such relationship e.g. Utility of 
Endoscopic Examination in the Diagnosis of Acute GVHD in Lower Gastrointestinal Tract. 
Gastroenterol Res Pract 2017:2145986.  
 
51 patients had complete il eocolonoscopy hence i would expect at least 51 ileal biopsies, 
however there are only 27. Can you please describe why is it so, especially in view of the central 
theme of the topic being villous atrophy in terminal ileum?  
 
A validated scoring system, Freib urg, has been mentioned in the methodology however the 
scoring is not included in the results. It might be because its not used at your centre. I believe the 
readers would be interested to know this so that they can compare it with villous atrophy scores.  
 
Can you please provide exact p values in table 3 rather than mentioning NS(not significant).  
 
Minor points: - 
 
Abstract, Line 5 - I would rather say 'Ileocolonoscopic' rather than 'colonoscopic' in line with the 
central theme of the topic.  
 
Page 7,Line 9 - It would be helpful to the readers if you could please elaborate the 'standard 
biopsy protocols'.  
 
Page 7, Line 14 - can you please confirm if consent process was revisited in cases identified as 
this was a retrospective study and involved the use of human tissue.  
 
Readers would be interested to know the outcome of cases where inter -observer agreement was 
not be achieved. Were these cases excluded?  
 
Page 10, Line 2 - epithelium OF ileum, colon OR rectum. Please do not use comma before the 
words like AND / OR.  
 
Table 1 - I guess you meant EPITHELIUM rather than EPITHERMAL  
 
Page 12, Line 3 - I would use the term COMPLETE rather than TOTAL for ileocolonoscopy. I 
would also rephrase this paragraph as it seems to be contradictory to the statement made later 
that 6 patients out of 57 did not have complete ileocolonosopy.  
 
Table 2 - The diagnoses of a sizeable number of patients (13) requiring transplantation is 
classified as 'OTHERS'. Similarly stem cell source for good number of patients (15) is s ited as 
'OTHERS'. I am interested to know what these others were?  
 
Page 18, Line 3 - In my understanding the incidence in your study is much lower i.e. 20/261 
rather 20/51.  
 
 
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 contr ols 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.  
Unable to assess  
Are you able to assess any statistics in the manuscript or would you recomme nd 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 recommend additional statistical review  
Quality of written English  
Please indicate t he 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, 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 that may in an y 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 received reimbursements, fees, funding, or salary from an organiza tion 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 com peting interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I ha ve 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 will be included 
on my report to the aut hors 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 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 re view policy of the journal  
Reviewer ’s report  
Title: Villous atro phy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 1 Date: 27 May 2018  
 
Reviewer: Shishu Sharma  
 
Reviewer's report:  
A very pragmatic topic however this would benefit from some changes as suggested.  
 
I would advise a more catchy and specific short title.  
 
Major points: - 
 
Page 6, Line 2 -  I respectfully disagree with the claim that 'No published report... .Response to 
treatment', as there are published papers which support such relationship e.g. Utility of 
Endoscopic Examination in the Diagnosis of Acute GVHD in Lower Gastrointestinal Tract. 
Gastroenterol Res Pract 2017:2145986.  
 
51 patients had complete il eocolonoscopy hence i would expect at least 51 ileal biopsies, 
however there are only 27. Can you please describe why is it so, especially in view of the central 
theme of the topic being villous atrophy in terminal ileum?  
 
A validated scoring system, Freib urg, has been mentioned in the methodology however the 
scoring is not included in the results. It might be because its not used at your centre. I believe the 
readers would be interested to know this so that they can compare it with villous atrophy scores.  
 
Can you please provide exact p values in table 3 rather than mentioning NS(not significant).  
 
Minor points: - 
 
Abstract, Line 5 - I would rather say 'Ileocolonoscopic' rather than 'colonoscopic' in line with the 
central theme of the topic.  
 
Page 7,Line 9 - It would be helpful to the readers if you could please elaborate the 'standard 
biopsy protocols'.  
 
Page 7, Line 14 - can you please confirm if consent process was revisited in cases identified as 
this was a retrospective study and involved the use of human tissue.  
 
Readers would be interested to know the outcome of cases where inter -observer agreement was 
not be achieved. Were these cases excluded?  
 
Page 10, Line 2 - epithelium OF ileum, colon OR rectum. Please do not use comma before the 
words like AND / OR.  
 
Table 1 - I guess you meant EPITHELIUM rather than EPITHERMAL  
 
Page 12, Line 3 - I would use the term COMPLETE rather than TOTAL for ileocolonoscopy. I 
would also rephrase this paragraph as it seems to be contradictory to the statement made later 
that 6 patients out of 57 did not have complete ileocolonosopy.  
 
Table 2 - The diagnoses of a sizeable number of patients (13) requiring transplantation is 
classified as 'OTHERS'. Similarly stem cell source for good number of patients (15) is s ited as 
'OTHERS'. I am interested to know what these others were?  
 
Page 18, Line 3 - In my understanding the incidence in your study is much lower i.e. 20/261 
rather 20/51.  
 
 
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 contr ols 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.  
Unable to assess  
Are you able to assess any statistics in the manuscript or would you recomme nd 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 recommend additional statistical review  
Quality of written English  
Please indicate t he 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, 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 that may in an y 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 received reimbursements, fees, funding, or salary from an organiza tion 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 com peting interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I ha ve 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 will be included 
on my report to the aut hors 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 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 re view policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Villous atro phy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 1 Date: 27 May 2018  
 
Reviewer: Shishu Sharma  
 
Reviewer's report:  
A very pragmatic topic however this would benefit from some changes as suggested.  
 
I would advise a more catchy and specific short title.  
 
Major points: - 
 
Page 6, Line 2 -  I respectfully disagree with the claim that 'No published report... .Response to 
treatment', as there are published papers which support such relationship e.g. Utility of 
Endoscopic Examination in the Diagnosis of Acute GVHD in Lower Gastrointestinal Tract. 
Gastroenterol Res Pract 2017:2145986.  
 
51 patients had complete il eocolonoscopy hence i would expect at least 51 ileal biopsies, 
however there are only 27. Can you please describe why is it so, especially in view of the central 
theme of the topic being villous atrophy in terminal ileum?  
 
A validated scoring system, Freib urg, has been mentioned in the methodology however the 
scoring is not included in the results. It might be because its not used at your centre. I believe the 
readers would be interested to know this so that they can compare it with villous atrophy scores.  
 
Can you please provide exact p values in table 3 rather than mentioning NS(not significant).  
 
Minor points: - 
 
Abstract, Line 5 - I would rather say 'Ileocolonoscopic' rather than 'colonoscopic' in line with the 
central theme of the topic.  
 
Page 7,Line 9 - It would be helpful to the readers if you could please elaborate the 'standard 
biopsy protocols'.  
 
Page 7, Line 14 - can you please confirm if consent process was revisited in cases identified as 
this was a retrospective study and involved the use of human tissue.  
 
Readers would be interested to know the outcome of cases where inter -observer agreement was 
not be achieved. Were these cases excluded?  
 
Page 10, Line 2 - epithelium OF ileum, colon OR rectum. Please do not use comma before the 
words like AND / OR.  
 
Table 1 - I guess you meant EPITHELIUM rather than EPITHERMAL  
 
Page 12, Line 3 - I would use the term COMPLETE rather than TOTAL for ileocolonoscopy. I 
would also rephrase this paragraph as it seems to be contradictory to the statement made later 
that 6 patients out of 57 did not have complete ileocolonosopy.  
 
Table 2 - The diagnoses of a sizeable number of patients (13) requiring transplantation is 
classified as 'OTHERS'. Similarly stem cell source for good number of patients (15) is s ited as 
'OTHERS'. I am interested to know what these others were?  
 
Page 18, Line 3 - In my understanding the incidence in your study is much lower i.e. 20/261 
rather 20/51.  
 
 
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 contr ols 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.  
Unable to assess  
Are you able to assess any statistics in the manuscript or would you recomme nd 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 recommend additional statistical review  
Quality of written English  
Please indicate t he 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, 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 that may in an y 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 received reimbursements, fees, funding, or salary from an organiza tion 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 com peting interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I ha ve 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 will be included 
on my report to the aut hors 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 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 re view policy of the journal  
assistant