Reviewer ’s report  
 
Title: Clinical impact of the perioperative management of oral anticoagu lants in bleeding after 
colonic endoscopic mucosal resection  
 
Version: 1 Date: 15 Sep 2019  
 
Reviewer: Jessica Yu  
 
Reviewer's report:  
 
1) The authors should refer to their diagram of anticoagulation manageme nt schema (figure 
3) in their methods section  
 
2) Please clarify in the methods section (statistical analysis, last sentence)  if risk ratios or 
odds ratios were calculated. Do the authors mean: "the risk of bleeding were calculated 
by odds ratios". Also, was this a multivariate analysis?  
 
3) The multivariate analyses presented in the third paragraph of the results section is 
confusing. They note there no patient factors associated with bleeding after EMR, yet 
they later discuss the increased rate of bleeding with HBT and anticoagulant use. Please 
reconcile this.  I do not think this analysis adds to the study and the authors shoul d 
consider removing this.  
 
4) It would be useful to present the actual bleeding rates and odds ratios of bleeding  in the 
text of the results sections "bleeding according to antithrombotic agents" and " bleeding 
according to actual management of anticoagula nts" 
 
5) What are the days to bleeding events for warfarin and HBT groups. It would be useful to 
see this along with the days to bleeding for the DOAC already presented in the 2nd to last 
paragraph of the results section.  
 
6) In the discussion section, the a uthors discuss the high risk of bleeding with DOAC use. 
How do the authors interpret the equally high risk of bleeding with warfarin. Please also 
discuss the low risk of bleeding with antiplatelet use and the high risk of bleeding with 
HBT.  
 
7) It would be useful to have percentages in addition to proportions presented in the results 
tables  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in y our comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend 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 am able to assess the statistics  
 
Quality of written English  
Please indicate the 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 t hat may in any 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 organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financia l competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details be low. 
 
No 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on t he 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Clinical impact of the perioperative management of oral anticoagu lants in bleeding after 
colonic endoscopic mucosal resection  
 
Version: 1 Date: 15 Sep 2019  
 
Reviewer: Jessica Yu  
 
Reviewer's report:  
 
1) The authors should refer to their diagram of anticoagulation manageme nt schema (figure 
3) in their methods section  
 
2) Please clarify in the methods section (statistical analysis, last sentence)  if risk ratios or 
odds ratios were calculated. Do the authors mean: "the risk of bleeding were calculated 
by odds ratios". Also, was this a multivariate analysis?  
 
3) The multivariate analyses presented in the third paragraph of the results section is 
confusing. They note there no patient factors associated with bleeding after EMR, yet 
they later discuss the increased rate of bleeding with HBT and anticoagulant use. Please 
reconcile this.  I do not think this analysis adds to the study and the authors shoul d 
consider removing this.  
 
4) It would be useful to present the actual bleeding rates and odds ratios of bleeding  in the 
text of the results sections "bleeding according to antithrombotic agents" and " bleeding 
according to actual management of anticoagula nts" 
 
5) What are the days to bleeding events for warfarin and HBT groups. It would be useful to 
see this along with the days to bleeding for the DOAC already presented in the 2nd to last 
paragraph of the results section.  
 
6) In the discussion section, the a uthors discuss the high risk of bleeding with DOAC use. 
How do the authors interpret the equally high risk of bleeding with warfarin. Please also 
discuss the low risk of bleeding with antiplatelet use and the high risk of bleeding with 
HBT.  
 
7) It would be useful to have percentages in addition to proportions presented in the results 
tables  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in y our comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend 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 am able to assess the statistics  
 
Quality of written English  
Please indicate the 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 t hat may in any 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 organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financia l competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details be low. 
 
No 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on t he 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Clinical impact of the perioperative management of oral anticoagu lants in bleeding after 
colonic endoscopic mucosal resection  
 
Version: 1 Date: 15 Sep 2019  
 
Reviewer: Jessica Yu  
 
Reviewer's report:  
 
1) The authors should refer to their diagram of anticoagulation manageme nt schema (figure 
3) in their methods section  
 
2) Please clarify in the methods section (statistical analysis, last sentence)  if risk ratios or 
odds ratios were calculated. Do the authors mean: "the risk of bleeding were calculated 
by odds ratios". Also, was this a multivariate analysis?  
 
3) The multivariate analyses presented in the third paragraph of the results section is 
confusing. They note there no patient factors associated with bleeding after EMR, yet 
they later discuss the increased rate of bleeding with HBT and anticoagulant use. Please 
reconcile this.  I do not think this analysis adds to the study and the authors shoul d 
consider removing this.  
 
4) It would be useful to present the actual bleeding rates and odds ratios of bleeding  in the 
text of the results sections "bleeding according to antithrombotic agents" and " bleeding 
according to actual management of anticoagula nts" 
 
5) What are the days to bleeding events for warfarin and HBT groups. It would be useful to 
see this along with the days to bleeding for the DOAC already presented in the 2nd to last 
paragraph of the results section.  
 
6) In the discussion section, the a uthors discuss the high risk of bleeding with DOAC use. 
How do the authors interpret the equally high risk of bleeding with warfarin. Please also 
discuss the low risk of bleeding with antiplatelet use and the high risk of bleeding with 
HBT.  
 
7) It would be useful to have percentages in addition to proportions presented in the results 
tables  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in y our comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend 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 am able to assess the statistics  
 
Quality of written English  
Please indicate the 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 t hat may in any 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 organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financia l competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details be low. 
 
No 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on t he 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant