Title: Effect of Different Working Periods on Missed Diagnosis of Colorectal Polyps in
Colonoscopy
Version: 1 Date: 18 Jun 2024
Reviewer's report:
In their work, the authors study an important issue related to endoscopy services and more
importantly to patient management. The issue of endoscopist fatigue or lack of time can have a
significant impact on the diagnosis and treatment of patients with colorectal polyps or cancers.
However, prior to further consideration of acceptance for publication I suggest major revisions
with language and grammar check. Furthermore, I have the following comments:
1. Throughout the abstract the outcome is reported as ”miss rate of patients”. This is a bit
misleading, as I believe the authors are looking at “missed diagnosis of colorectal polyps” as
stated in the title. The definition in the methods section of the manuscript does explain this, but
when reading the abstract this is not presented. I still recommend changing the phrasing to miss
rate of polyps / diagnosis in stead of miss rate of patients.
2. The authors state that The different working periods had no significant effect on the miss
rate of patients #P=0.849) (page 1, line 14-15) and The number of missed polyps was not
significantly affected by different working periods (P=0.849). (page 6, line 7-8).  I recommend
specifying whether this is referring to statistical or clinical significance.
3. In the methods section I would recommend describing that patients with no polyp findings
in the first colonoscopy are not analyzed in this study. This is only mentioned in the discussion
as a limitation to the study.
4. The following paragraph is a bit unclear: The analysis of different weeks of colonoscopy,
doctor's gender, whether performance assessment, whether same endoscopist or same
department, and the size of the largest polyp also did not significantly affect the miss rate of
patients. (page 5, line 15-18).
I would suggest to clarify the meaning of performance assessment and to specify that whether
same endoscopist or same department refer to the first and second colonoscopy being performed
by the same endoscopist or in the same department. I cannot find comparisons on doctors gender
in table one, and I need an argument for why the gender of the endoscopist should be considered
in this regard. I suggest removing this.
5. Throughout the manuscript, the authors report some results as only p-values. I would
recommend to report the point estimate as well or omit the p-value in the text, as it is difficult
for the reader to evaluate whether the result is clinically significant based only on the p-value.
Title: Effect of Different Working Periods on Missed Diagnosis of Colorectal Polyps in
Colonoscopy
Version: 1 Date: 18 Jun 2024
Reviewer's report:
In their work, the authors study an important issue related to endoscopy services and more
importantly to patient management. The issue of endoscopist fatigue or lack of time can have a
significant impact on the diagnosis and treatment of patients with colorectal polyps or cancers.
However, prior to further consideration of acceptance for publication I suggest major revisions
with language and grammar check. Furthermore, I have the following comments:
1. Throughout the abstract the outcome is reported as ”miss rate of patients”. This is a bit
misleading, as I believe the authors are looking at “missed diagnosis of colorectal polyps” as
stated in the title. The definition in the methods section of the manuscript does explain this, but
when reading the abstract this is not presented. I still recommend changing the phrasing to miss
rate of polyps / diagnosis in stead of miss rate of patients.
2. The authors state that The different working periods had no significant effect on the miss
rate of patients #P=0.849) (page 1, line 14-15) and The number of missed polyps was not
significantly affected by different working periods (P=0.849). (page 6, line 7-8).  I recommend
specifying whether this is referring to statistical or clinical significance.
3. In the methods section I would recommend describing that patients with no polyp findings
in the first colonoscopy are not analyzed in this study. This is only mentioned in the discussion
as a limitation to the study.
4. The following paragraph is a bit unclear: The analysis of different weeks of colonoscopy,
doctor's gender, whether performance assessment, whether same endoscopist or same
department, and the size of the largest polyp also did not significantly affect the miss rate of
patients. (page 5, line 15-18).
I would suggest to clarify the meaning of performance assessment and to specify that whether
same endoscopist or same department refer to the first and second colonoscopy being performed
by the same endoscopist or in the same department. I cannot find comparisons on doctors gender
in table one, and I need an argument for why the gender of the endoscopist should be considered
in this regard. I suggest removing this.
5. Throughout the manuscript, the authors report some results as only p-values. I would
recommend to report the point estimate as well or omit the p-value in the text, as it is difficult
for the reader to evaluate whether the result is clinically significant based only on the p-value.
Please review this paper.
user
Title: Effect of Different Working Periods on Missed Diagnosis of Colorectal Polyps in
Colonoscopy
Version: 1 Date: 18 Jun 2024
Reviewer's report:
In their work, the authors study an important issue related to endoscopy services and more
importantly to patient management. The issue of endoscopist fatigue or lack of time can have a
significant impact on the diagnosis and treatment of patients with colorectal polyps or cancers.
However, prior to further consideration of acceptance for publication I suggest major revisions
with language and grammar check. Furthermore, I have the following comments:
1. Throughout the abstract the outcome is reported as ”miss rate of patients”. This is a bit
misleading, as I believe the authors are looking at “missed diagnosis of colorectal polyps” as
stated in the title. The definition in the methods section of the manuscript does explain this, but
when reading the abstract this is not presented. I still recommend changing the phrasing to miss
rate of polyps / diagnosis in stead of miss rate of patients.
2. The authors state that The different working periods had no significant effect on the miss
rate of patients #P=0.849) (page 1, line 14-15) and The number of missed polyps was not
significantly affected by different working periods (P=0.849). (page 6, line 7-8).  I recommend
specifying whether this is referring to statistical or clinical significance.
3. In the methods section I would recommend describing that patients with no polyp findings
in the first colonoscopy are not analyzed in this study. This is only mentioned in the discussion
as a limitation to the study.
4. The following paragraph is a bit unclear: The analysis of different weeks of colonoscopy,
doctor's gender, whether performance assessment, whether same endoscopist or same
department, and the size of the largest polyp also did not significantly affect the miss rate of
patients. (page 5, line 15-18).
I would suggest to clarify the meaning of performance assessment and to specify that whether
same endoscopist or same department refer to the first and second colonoscopy being performed
by the same endoscopist or in the same department. I cannot find comparisons on doctors gender
in table one, and I need an argument for why the gender of the endoscopist should be considered
in this regard. I suggest removing this.
5. Throughout the manuscript, the authors report some results as only p-values. I would
recommend to report the point estimate as well or omit the p-value in the text, as it is difficult
for the reader to evaluate whether the result is clinically significant based only on the p-value.
assistant