Title: Efficacy of B - Mode and Elastography Ultrasound Technique in the Prediction of
Helicobacter Pylori: A Prospective Study
Version: 2 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Study population should be defined in methods section It should be clared different
pathologies have been evaluated Methods Using the term gastritis without pathological
verification  is anot acceptable Use of dyspepsia can replace the term gastritis Authors presume
that inflammation is present when wall thickness of the antrum is increased As study has been
designed different types of gastritis cannot be discriminated For instance it cannot be verifies
that difference in wall thickness between H. pylori positive and negative gastritis donot represent
diffrence in the severity of antral atrophy Absence of biopsies could have been overcome by
measument of PGI/PGII levels Patients with autoimmune gastritis HP (-) should have been
excluded otherwise they could have ended up included in the asymptomatic group at least in the
intial phase of the study A normal antrum in those cases is not sufficient Dyspepsia should be
defined and Rome IV criteria should be preferably used. Authors should define how gastric ulcer
and early gastric cancer have been excluded Those two groups should be excluded from the study
Instead of medical history antitTG serology, hepatatitis antibodies and fecal calprotectin would
have been preferable for GI pathology exclusion Recent use of NSAIDs and not any use should
be an exclusion criterion Also social alcohol consumption I cannot see how it can have affected
Thus it should be preferably to have provided a limit for alcohol use instead of abstinence
Definition of medical comorbidities and the level of organ impairement that is acceptable
should be defined Only melanoma, gastric and pancreatic malignancies are reported Were other
malignancies accepted as entry criterion? Why patients with coagulopathies were excluded and
level of PT, PTL or APTT were accepted? A symptom severity scale use for dyspepsia  weighting
is preferable. Stool HP Ag should be explained in more detail What test has been used Are there
any data for this test if it is a Home run one Otherwise commercial data should be provided
and if possible any data about running this test in any local population   Definition of residence
should be provided Statistical analysis of the effects of patients demographics on AUC should
be provided Chi-square 2X3 or preferably ANOVA should be used to compare three variables
Because there are no  differences in demographics they should be presented in table I and not
repeated in the text
Title: Efficacy of B - Mode and Elastography Ultrasound Technique in the Prediction of
Helicobacter Pylori: A Prospective Study
Version: 2 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Study population should be defined in methods section It should be clared different
pathologies have been evaluated Methods Using the term gastritis without pathological
verification  is anot acceptable Use of dyspepsia can replace the term gastritis Authors presume
that inflammation is present when wall thickness of the antrum is increased As study has been
designed different types of gastritis cannot be discriminated For instance it cannot be verifies
that difference in wall thickness between H. pylori positive and negative gastritis donot represent
diffrence in the severity of antral atrophy Absence of biopsies could have been overcome by
measument of PGI/PGII levels Patients with autoimmune gastritis HP (-) should have been
excluded otherwise they could have ended up included in the asymptomatic group at least in the
intial phase of the study A normal antrum in those cases is not sufficient Dyspepsia should be
defined and Rome IV criteria should be preferably used. Authors should define how gastric ulcer
and early gastric cancer have been excluded Those two groups should be excluded from the study
Instead of medical history antitTG serology, hepatatitis antibodies and fecal calprotectin would
have been preferable for GI pathology exclusion Recent use of NSAIDs and not any use should
be an exclusion criterion Also social alcohol consumption I cannot see how it can have affected
Thus it should be preferably to have provided a limit for alcohol use instead of abstinence
Definition of medical comorbidities and the level of organ impairement that is acceptable
should be defined Only melanoma, gastric and pancreatic malignancies are reported Were other
malignancies accepted as entry criterion? Why patients with coagulopathies were excluded and
level of PT, PTL or APTT were accepted? A symptom severity scale use for dyspepsia  weighting
is preferable. Stool HP Ag should be explained in more detail What test has been used Are there
any data for this test if it is a Home run one Otherwise commercial data should be provided
and if possible any data about running this test in any local population   Definition of residence
should be provided Statistical analysis of the effects of patients demographics on AUC should
be provided Chi-square 2X3 or preferably ANOVA should be used to compare three variables
Because there are no  differences in demographics they should be presented in table I and not
repeated in the text
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Title: Efficacy of B - Mode and Elastography Ultrasound Technique in the Prediction of
Helicobacter Pylori: A Prospective Study
Version: 2 Date: 13 Sep 2024
Reviewer:  Panagiotis Tsibouris
Reviewer's report:
Abstract Study population should be defined in methods section It should be clared different
pathologies have been evaluated Methods Using the term gastritis without pathological
verification  is anot acceptable Use of dyspepsia can replace the term gastritis Authors presume
that inflammation is present when wall thickness of the antrum is increased As study has been
designed different types of gastritis cannot be discriminated For instance it cannot be verifies
that difference in wall thickness between H. pylori positive and negative gastritis donot represent
diffrence in the severity of antral atrophy Absence of biopsies could have been overcome by
measument of PGI/PGII levels Patients with autoimmune gastritis HP (-) should have been
excluded otherwise they could have ended up included in the asymptomatic group at least in the
intial phase of the study A normal antrum in those cases is not sufficient Dyspepsia should be
defined and Rome IV criteria should be preferably used. Authors should define how gastric ulcer
and early gastric cancer have been excluded Those two groups should be excluded from the study
Instead of medical history antitTG serology, hepatatitis antibodies and fecal calprotectin would
have been preferable for GI pathology exclusion Recent use of NSAIDs and not any use should
be an exclusion criterion Also social alcohol consumption I cannot see how it can have affected
Thus it should be preferably to have provided a limit for alcohol use instead of abstinence
Definition of medical comorbidities and the level of organ impairement that is acceptable
should be defined Only melanoma, gastric and pancreatic malignancies are reported Were other
malignancies accepted as entry criterion? Why patients with coagulopathies were excluded and
level of PT, PTL or APTT were accepted? A symptom severity scale use for dyspepsia  weighting
is preferable. Stool HP Ag should be explained in more detail What test has been used Are there
any data for this test if it is a Home run one Otherwise commercial data should be provided
and if possible any data about running this test in any local population   Definition of residence
should be provided Statistical analysis of the effects of patients demographics on AUC should
be provided Chi-square 2X3 or preferably ANOVA should be used to compare three variables
Because there are no  differences in demographics they should be presented in table I and not
repeated in the text
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