Reviewer ’s report  
Title: Villous atrophy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 0 Date: 28 Dec 2017  
 
Reviewer: Paul Kelly  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or othe r aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
This is a very useful analysis of an important but neglected disorder. The authors state that 
guides to endoscopic ass essment would be very useful in evaluating these patients. This reviewer 
completely agrees with this claim.  
 
The manuscript requires several essential revisions before it can be accepted. These are:  
 
1 There are some phrases which need to be improved: "VIL LUS (or VILLOUS) ATROPHY" not 
"villi atrophy"; and "ileal endoscopy" not "ileum endoscopy".  
 
2 The definition of "steroid -refractory" GVHD is inappropriate - this means not responding to 
steroids, not a severity of GVHD which requires initiation of steroid s. 
 
3 The particular value of this paper is the endoscopic imaging. The legend to Figure 2 needs 
more extensive explanation to make it more valuable, and it would be better if the images 
were all paired white light and indigo carmine.  
4 In Table 2, "unrel ated" is mis -spelled.  
 
5 Table 4 displays the results of a multivariate analysis, but this is not properly explained. Ideally 
the table would include all variables which would include in the model, and then all the 
univariate results would be in one column  and the positive, final multivariate results in 
another column.  
 
6 Table 5 has a confusing (and probably inappropriate) array of statistical tests. For Tables 4 and 
5 the advice of a statistician would be very helpful.  
 
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 contr ols are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscript or would you recomme nd 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 t he 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 that may in an y 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 organiza tion 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be  included 
on my report to the authors and, if the manuscript is accepted for 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 a n 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 included as confidential comments 
to the editors, which will not be publ ished.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Villous atrophy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 0 Date: 28 Dec 2017  
 
Reviewer: Paul Kelly  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or othe r aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
This is a very useful analysis of an important but neglected disorder. The authors state that 
guides to endoscopic ass essment would be very useful in evaluating these patients. This reviewer 
completely agrees with this claim.  
 
The manuscript requires several essential revisions before it can be accepted. These are:  
 
1 There are some phrases which need to be improved: "VIL LUS (or VILLOUS) ATROPHY" not 
"villi atrophy"; and "ileal endoscopy" not "ileum endoscopy".  
 
2 The definition of "steroid -refractory" GVHD is inappropriate - this means not responding to 
steroids, not a severity of GVHD which requires initiation of steroid s. 
 
3 The particular value of this paper is the endoscopic imaging. The legend to Figure 2 needs 
more extensive explanation to make it more valuable, and it would be better if the images 
were all paired white light and indigo carmine.  
4 In Table 2, "unrel ated" is mis -spelled.  
 
5 Table 4 displays the results of a multivariate analysis, but this is not properly explained. Ideally 
the table would include all variables which would include in the model, and then all the 
univariate results would be in one column  and the positive, final multivariate results in 
another column.  
 
6 Table 5 has a confusing (and probably inappropriate) array of statistical tests. For Tables 4 and 
5 the advice of a statistician would be very helpful.  
 
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 contr ols are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscript or would you recomme nd 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 t he 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 that may in an y 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 organiza tion 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be  included 
on my report to the authors and, if the manuscript is accepted for 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 a n 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 included as confidential comments 
to the editors, which will not be publ ished.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Villous atrophy in the terminal ileum is a specific end oscopic finding correlated with 
histological evidence and poor prognosis in acute graft -versus -host disease after 
allohematopoietic stem cell transplantation  
 
Version: 0 Date: 28 Dec 2017  
 
Reviewer: Paul Kelly  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or othe r aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
This is a very useful analysis of an important but neglected disorder. The authors state that 
guides to endoscopic ass essment would be very useful in evaluating these patients. This reviewer 
completely agrees with this claim.  
 
The manuscript requires several essential revisions before it can be accepted. These are:  
 
1 There are some phrases which need to be improved: "VIL LUS (or VILLOUS) ATROPHY" not 
"villi atrophy"; and "ileal endoscopy" not "ileum endoscopy".  
 
2 The definition of "steroid -refractory" GVHD is inappropriate - this means not responding to 
steroids, not a severity of GVHD which requires initiation of steroid s. 
 
3 The particular value of this paper is the endoscopic imaging. The legend to Figure 2 needs 
more extensive explanation to make it more valuable, and it would be better if the images 
were all paired white light and indigo carmine.  
4 In Table 2, "unrel ated" is mis -spelled.  
 
5 Table 4 displays the results of a multivariate analysis, but this is not properly explained. Ideally 
the table would include all variables which would include in the model, and then all the 
univariate results would be in one column  and the positive, final multivariate results in 
another column.  
 
6 Table 5 has a confusing (and probably inappropriate) array of statistical tests. For Tables 4 and 
5 the advice of a statistician would be very helpful.  
 
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 contr ols are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscript or would you recomme nd 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 t he 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 that may in an y 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 organiza tion 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 com peting 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be  included 
on my report to the authors and, if the manuscript is accepted for 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 a n 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 included as confidential comments 
to the editors, which will not be publ ished.  
 
I agree to the open peer review policy of the journal  
assistant