Title: Reply to comment on “Ultrasonographic scores for ileal Crohn’s disease assessment:
Better, worse or the same as contrast#enhanced ultrasound?
Version: 1 Date: 07 May 2023
Reviewer's report:
Your response letter to Nylund et al. is well written. However, I have some recommendations:
1) You state that endoscopy examinations were performed by an operator without experience
in ultrasound, “meaning that the operator did not have the knowledge to interpret ultrasound
findings”. I assume that the endoscopist was a certified gastroenterologist and knowledge of
ultrasound findings in GI diseases is essential for board certification in many countries. Even if
the person does not perform ultrasound exams by him or herself, I doubt that he or she cannot
interpret frequent ultrasound findings such as bowel wall thickening. Please try to find a more
plausible explanation.
2) Considering the SES-CD activity grading, you refer to a paper from 2009 (Ref. #5). Although
validation of inflammation activity scores is complicated, more recent papers have used SES-
CD in different approaches and with lower cut-offs. I would recommend acknowledging the
point of Nylund et al., that the cut-off SES-CD #7 is relatively high, and a lower value might
have also been justified.
Title: Reply to comment on “Ultrasonographic scores for ileal Crohn’s disease assessment:
Better, worse or the same as contrast#enhanced ultrasound?
Version: 1 Date: 07 May 2023
Reviewer's report:
Your response letter to Nylund et al. is well written. However, I have some recommendations:
1) You state that endoscopy examinations were performed by an operator without experience
in ultrasound, “meaning that the operator did not have the knowledge to interpret ultrasound
findings”. I assume that the endoscopist was a certified gastroenterologist and knowledge of
ultrasound findings in GI diseases is essential for board certification in many countries. Even if
the person does not perform ultrasound exams by him or herself, I doubt that he or she cannot
interpret frequent ultrasound findings such as bowel wall thickening. Please try to find a more
plausible explanation.
2) Considering the SES-CD activity grading, you refer to a paper from 2009 (Ref. #5). Although
validation of inflammation activity scores is complicated, more recent papers have used SES-
CD in different approaches and with lower cut-offs. I would recommend acknowledging the
point of Nylund et al., that the cut-off SES-CD #7 is relatively high, and a lower value might
have also been justified.
Please review this paper.
user
Title: Reply to comment on “Ultrasonographic scores for ileal Crohn’s disease assessment:
Better, worse or the same as contrast#enhanced ultrasound?
Version: 1 Date: 07 May 2023
Reviewer's report:
Your response letter to Nylund et al. is well written. However, I have some recommendations:
1) You state that endoscopy examinations were performed by an operator without experience
in ultrasound, “meaning that the operator did not have the knowledge to interpret ultrasound
findings”. I assume that the endoscopist was a certified gastroenterologist and knowledge of
ultrasound findings in GI diseases is essential for board certification in many countries. Even if
the person does not perform ultrasound exams by him or herself, I doubt that he or she cannot
interpret frequent ultrasound findings such as bowel wall thickening. Please try to find a more
plausible explanation.
2) Considering the SES-CD activity grading, you refer to a paper from 2009 (Ref. #5). Although
validation of inflammation activity scores is complicated, more recent papers have used SES-
CD in different approaches and with lower cut-offs. I would recommend acknowledging the
point of Nylund et al., that the cut-off SES-CD #7 is relatively high, and a lower value might
have also been justified.
assistant