Reviewer ’s report  
 
Title: OPTIMIZATION OF IMPEDANCE -MEASURED REFLUX EVENTS IN GORD  
UTILIZING ACID EXPOSURE TIME  
 
Version: 1 Date: 17 Jan 2020  
 
Reviewer: Nicola de Bortoli  
 
Reviewer's report:  
 
Dear Autho rs 
 
I read with interest the paper entitled "NORMATIVE VALUES TO OPTIMIZE THE 
DETECTION OF GORD WITH MULTICHANNEL INTRALUMINAL IMPEDANCE". 
The paper is very well written and I've nothing to add regarding statistic analysis. I've some 
concern regarding the a im of the study.  
 
We are in an era in which MII -pH has been redeemed thank to the introduction of new 
parameters (MNBI and PSPW index) who were considered as add on value in discriminating 
GERD from NO -GERD patients (according to the Lyone Consensus). the L yon Consensus 
proposes that AET &lt;4% be considered definitively normal (physiological) and &gt;6% be 
considered definitively abnormal with intermediate values between these limits being 
inconclusive. The Lyon GERD Consensus proposes that &gt;80reflux epi sodes per 24hours 
are definitively abnormal, while a number &lt;40 is physiological and intermediate values 
inconclusive.  
 
Your analysis should be integrated with MNBI value and PSPW index that actually are 
considered the up -and-coming parameters to detect each MII -pH analysis with an AET 
among 4 and 6%.  
 
Are the methods appropriate and well descri bed?  
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.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
 
 
 
 
 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 futu re? 
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 s alary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial 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 below.  
 
None  
 
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 manuscrip t is accepted f or publication, my 
named report including any attachments I upload will be posted on the 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://creati vecommons.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 journa l 
Reviewer ’s report  
 
Title: OPTIMIZATION OF IMPEDANCE -MEASURED REFLUX EVENTS IN GORD  
UTILIZING ACID EXPOSURE TIME  
 
Version: 1 Date: 17 Jan 2020  
 
Reviewer: Nicola de Bortoli  
 
Reviewer's report:  
 
Dear Autho rs 
 
I read with interest the paper entitled "NORMATIVE VALUES TO OPTIMIZE THE 
DETECTION OF GORD WITH MULTICHANNEL INTRALUMINAL IMPEDANCE". 
The paper is very well written and I've nothing to add regarding statistic analysis. I've some 
concern regarding the a im of the study.  
 
We are in an era in which MII -pH has been redeemed thank to the introduction of new 
parameters (MNBI and PSPW index) who were considered as add on value in discriminating 
GERD from NO -GERD patients (according to the Lyone Consensus). the L yon Consensus 
proposes that AET &lt;4% be considered definitively normal (physiological) and &gt;6% be 
considered definitively abnormal with intermediate values between these limits being 
inconclusive. The Lyon GERD Consensus proposes that &gt;80reflux epi sodes per 24hours 
are definitively abnormal, while a number &lt;40 is physiological and intermediate values 
inconclusive.  
 
Your analysis should be integrated with MNBI value and PSPW index that actually are 
considered the up -and-coming parameters to detect each MII -pH analysis with an AET 
among 4 and 6%.  
 
Are the methods appropriate and well descri bed?  
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.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
 
 
 
 
 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 futu re? 
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 s alary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial 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 below.  
 
None  
 
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 manuscrip t is accepted f or publication, my 
named report including any attachments I upload will be posted on the 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://creati vecommons.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 journa l 
Please review this paper.
user
Reviewer ’s report  
 
Title: OPTIMIZATION OF IMPEDANCE -MEASURED REFLUX EVENTS IN GORD  
UTILIZING ACID EXPOSURE TIME  
 
Version: 1 Date: 17 Jan 2020  
 
Reviewer: Nicola de Bortoli  
 
Reviewer's report:  
 
Dear Autho rs 
 
I read with interest the paper entitled "NORMATIVE VALUES TO OPTIMIZE THE 
DETECTION OF GORD WITH MULTICHANNEL INTRALUMINAL IMPEDANCE". 
The paper is very well written and I've nothing to add regarding statistic analysis. I've some 
concern regarding the a im of the study.  
 
We are in an era in which MII -pH has been redeemed thank to the introduction of new 
parameters (MNBI and PSPW index) who were considered as add on value in discriminating 
GERD from NO -GERD patients (according to the Lyone Consensus). the L yon Consensus 
proposes that AET &lt;4% be considered definitively normal (physiological) and &gt;6% be 
considered definitively abnormal with intermediate values between these limits being 
inconclusive. The Lyon GERD Consensus proposes that &gt;80reflux epi sodes per 24hours 
are definitively abnormal, while a number &lt;40 is physiological and intermediate values 
inconclusive.  
 
Your analysis should be integrated with MNBI value and PSPW index that actually are 
considered the up -and-coming parameters to detect each MII -pH analysis with an AET 
among 4 and 6%.  
 
Are the methods appropriate and well descri bed?  
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.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
 
 
 
 
 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 futu re? 
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 s alary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial 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 below.  
 
None  
 
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 manuscrip t is accepted f or publication, my 
named report including any attachments I upload will be posted on the 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://creati vecommons.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 journa l 
assistant