Reviewer's report
Title:Colon Capsule Endoscopy compared to Conventional Colonoscopy under
routine screening conditions
Version: 2Date:27 January 2010
Reviewer: James M Church
Reviewer's report:
Major Compulsory Revisions
The results section is a problem. It is unclear. I would like to see, plainly put in a
table, the number, size, location and histology of polyps detected by both
techniques. I would like to see the adenoma detection rates
How did the authors handle lesions seen on capsule endoscopy but not on
colonoscopy? Did patients undergo repeat colonoscopy, by another endoscopist,
and did the lesions remain undetected?
Issues of comparative cost in terms of money and resources are not addressed. I
appraciate that this was not the point of the study but some useful comments
could be made.
You mention serrated adenomas but not sessile serrated polyps, notoriously
difficult to see on colonoscopy. Were there any and were any detected by the
capsule?
The prep results are unacceptable, for the camera and the colonoscopy. The
high rate of poor preps tends to invalidate the whole study.
The Bayesian analysis is of questionable significance in the absence of a true
gold standard.
The exclusion of polyps <5 mm diameter is unrealistic, as the authors have
pointed out. Taking a size for significance from irrelevant studies of virtual
colonoscopy tends to invalidate data and conclusions. Fortunately the authors
have also included all lesions.
The overall adeno0ma detection results are inferior to fecal DNA testing and
show that there is a lot of work to do. Can the authors analyse missed polyps and
see if there is a pattern of reasons why they were missed?
Minor Essential Revisions
The English language used in the manuscript is clumsy. It needs to be rewritten
by a native English speaker.
Discretionary Revisions
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Colon Capsule Endoscopy compared to Conventional Colonoscopy under
routine screening conditions
Version: 2Date:27 January 2010
Reviewer: James M Church
Reviewer's report:
Major Compulsory Revisions
The results section is a problem. It is unclear. I would like to see, plainly put in a
table, the number, size, location and histology of polyps detected by both
techniques. I would like to see the adenoma detection rates
How did the authors handle lesions seen on capsule endoscopy but not on
colonoscopy? Did patients undergo repeat colonoscopy, by another endoscopist,
and did the lesions remain undetected?
Issues of comparative cost in terms of money and resources are not addressed. I
appraciate that this was not the point of the study but some useful comments
could be made.
You mention serrated adenomas but not sessile serrated polyps, notoriously
difficult to see on colonoscopy. Were there any and were any detected by the
capsule?
The prep results are unacceptable, for the camera and the colonoscopy. The
high rate of poor preps tends to invalidate the whole study.
The Bayesian analysis is of questionable significance in the absence of a true
gold standard.
The exclusion of polyps <5 mm diameter is unrealistic, as the authors have
pointed out. Taking a size for significance from irrelevant studies of virtual
colonoscopy tends to invalidate data and conclusions. Fortunately the authors
have also included all lesions.
The overall adeno0ma detection results are inferior to fecal DNA testing and
show that there is a lot of work to do. Can the authors analyse missed polyps and
see if there is a pattern of reasons why they were missed?
Minor Essential Revisions
The English language used in the manuscript is clumsy. It needs to be rewritten
by a native English speaker.
Discretionary Revisions
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Colon Capsule Endoscopy compared to Conventional Colonoscopy under
routine screening conditions
Version: 2Date:27 January 2010
Reviewer: James M Church
Reviewer's report:
Major Compulsory Revisions
The results section is a problem. It is unclear. I would like to see, plainly put in a
table, the number, size, location and histology of polyps detected by both
techniques. I would like to see the adenoma detection rates
How did the authors handle lesions seen on capsule endoscopy but not on
colonoscopy? Did patients undergo repeat colonoscopy, by another endoscopist,
and did the lesions remain undetected?
Issues of comparative cost in terms of money and resources are not addressed. I
appraciate that this was not the point of the study but some useful comments
could be made.
You mention serrated adenomas but not sessile serrated polyps, notoriously
difficult to see on colonoscopy. Were there any and were any detected by the
capsule?
The prep results are unacceptable, for the camera and the colonoscopy. The
high rate of poor preps tends to invalidate the whole study.
The Bayesian analysis is of questionable significance in the absence of a true
gold standard.
The exclusion of polyps <5 mm diameter is unrealistic, as the authors have
pointed out. Taking a size for significance from irrelevant studies of virtual
colonoscopy tends to invalidate data and conclusions. Fortunately the authors
have also included all lesions.
The overall adeno0ma detection results are inferior to fecal DNA testing and
show that there is a lot of work to do. Can the authors analyse missed polyps and
see if there is a pattern of reasons why they were missed?
Minor Essential Revisions
The English language used in the manuscript is clumsy. It needs to be rewritten
by a native English speaker.
Discretionary Revisions
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
assistant