Reviewer's report
Title:Modified Mallampati Classification as a Clinical Predictor of Peroral
Esophagogastroduodenoscopy Tolerance
Version: 1Date:25 December 2010
Reviewer: Akihiro Mori
Reviewer's report:
The aim of this study was to predict EGD tolerance in unsedated patients by
using Modified Mallampati Classification (MMC). The authors reported that MMC
may be a clinical predictor of EGD tolerance because it was significantly
correlated to gag reflex, patients’ satisfaction and change of vital signs. Their
conclusion is very interesting. However, there are some issues that concern me.
Concerns:
1. Patient satisfaction
# The authors assessed patient satisfaction by asking only easy question such
as "satisfactory" or "unsatisfactory". This question seems to be far from an
accurate reflection of patients' EGD tolerance. My question is why the authors did
not use a universally accepted instrument, for example visual analogue scale, to
evaluate the patients' acceptability of EGD. They should describe more specific
on the matter.
# There is neither result nor comment regarding willingness to repeat unsedated
EGD. Is this question necessary?
2. Did the authors use any anti-peristaltic agents like scopolamine butylbromide
or glucagon? Please mention how many patients received any of these
medications if they were used as these medications may also have influenced
the outcome of this study.
3. GIF-Q260 is slightly different from GIF-XQ260 and XQ240 in the diameter
size. The diameter of an endoscope is expected to have an influence on patients'
tolerance. They should comment how many patients were performed with Q260
and whether this usage affects their tolerance.
4. Neither the atrophic gastritis nor Helicobactor Pylori infection is included in the
main diagnosis. Please mention whether these diseases affect EGD tolerance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Modified Mallampati Classification as a Clinical Predictor of Peroral
Esophagogastroduodenoscopy Tolerance
Version: 1Date:25 December 2010
Reviewer: Akihiro Mori
Reviewer's report:
The aim of this study was to predict EGD tolerance in unsedated patients by
using Modified Mallampati Classification (MMC). The authors reported that MMC
may be a clinical predictor of EGD tolerance because it was significantly
correlated to gag reflex, patients’ satisfaction and change of vital signs. Their
conclusion is very interesting. However, there are some issues that concern me.
Concerns:
1. Patient satisfaction
# The authors assessed patient satisfaction by asking only easy question such
as "satisfactory" or "unsatisfactory". This question seems to be far from an
accurate reflection of patients' EGD tolerance. My question is why the authors did
not use a universally accepted instrument, for example visual analogue scale, to
evaluate the patients' acceptability of EGD. They should describe more specific
on the matter.
# There is neither result nor comment regarding willingness to repeat unsedated
EGD. Is this question necessary?
2. Did the authors use any anti-peristaltic agents like scopolamine butylbromide
or glucagon? Please mention how many patients received any of these
medications if they were used as these medications may also have influenced
the outcome of this study.
3. GIF-Q260 is slightly different from GIF-XQ260 and XQ240 in the diameter
size. The diameter of an endoscope is expected to have an influence on patients'
tolerance. They should comment how many patients were performed with Q260
and whether this usage affects their tolerance.
4. Neither the atrophic gastritis nor Helicobactor Pylori infection is included in the
main diagnosis. Please mention whether these diseases affect EGD tolerance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Modified Mallampati Classification as a Clinical Predictor of Peroral
Esophagogastroduodenoscopy Tolerance
Version: 1Date:25 December 2010
Reviewer: Akihiro Mori
Reviewer's report:
The aim of this study was to predict EGD tolerance in unsedated patients by
using Modified Mallampati Classification (MMC). The authors reported that MMC
may be a clinical predictor of EGD tolerance because it was significantly
correlated to gag reflex, patients’ satisfaction and change of vital signs. Their
conclusion is very interesting. However, there are some issues that concern me.
Concerns:
1. Patient satisfaction
# The authors assessed patient satisfaction by asking only easy question such
as "satisfactory" or "unsatisfactory". This question seems to be far from an
accurate reflection of patients' EGD tolerance. My question is why the authors did
not use a universally accepted instrument, for example visual analogue scale, to
evaluate the patients' acceptability of EGD. They should describe more specific
on the matter.
# There is neither result nor comment regarding willingness to repeat unsedated
EGD. Is this question necessary?
2. Did the authors use any anti-peristaltic agents like scopolamine butylbromide
or glucagon? Please mention how many patients received any of these
medications if they were used as these medications may also have influenced
the outcome of this study.
3. GIF-Q260 is slightly different from GIF-XQ260 and XQ240 in the diameter
size. The diameter of an endoscope is expected to have an influence on patients'
tolerance. They should comment how many patients were performed with Q260
and whether this usage affects their tolerance.
4. Neither the atrophic gastritis nor Helicobactor Pylori infection is included in the
main diagnosis. Please mention whether these diseases affect EGD tolerance.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant