Title: Triage policy to postpone endoscopy for patients with low-risk varices is safe during the
lockdown period of COVID-19 pandemic
Version: 2 Date: 28 May 2023
Reviewer's report:
Comments to the authors
Chen YJ, et al. examined the safety to postpone the endoscopy for patients with esophageal
varices during the lockdown period of COVID-19. Esophageal variceal bleeding during the
lockdown period was higher than that during the normal period (9/32, 28.1% vs. 8/92, 8.7%,
p=0.006). The variceal bleeding occurred more frequently in patients who referred for urgent
EVL during the lockdown period than in those during the normal period (7/9, 77.8% vs. 2/14,
14.2%, p=0.007). What the authors tried to examine is important and interesting. However, I
have a few points to be worried and the authors should address the points below.
Major points:
1. The most interesting thing that the readers will want to know in this study is the influence
of postponed endoscopy on the subsequent variceal bleeding during the lockdown period. The
authors should describe how many years the patients with postponed endoscopy were followed-
up and how many patients had variceal bleeding after the postponed endoscopy.
2. The authors should describe how many patients who referred for urgent EVL received regular
prophylaxis program during the normal period and the lockdown period.
3. In Table 3 and Table 4, the way of including only variables with statistically significant
differences in univariate analyses into multivariate analyses is wrong and usually not
recommended. In multivariate analyses, the authors should include age, sex, variables with a
significant implication that they aim to examine, and variables that have potential association
with variceal bleeding based on the previous reports. Moreover, the results of multivariate
analyses in Table 3 and Table 4 are not reliable and meaningless because the number of patients
with variceal bleeding is small. The authors should reconsider the significance of presenting the
multivariate analyses.
Title: Triage policy to postpone endoscopy for patients with low-risk varices is safe during the
lockdown period of COVID-19 pandemic
Version: 2 Date: 28 May 2023
Reviewer's report:
Comments to the authors
Chen YJ, et al. examined the safety to postpone the endoscopy for patients with esophageal
varices during the lockdown period of COVID-19. Esophageal variceal bleeding during the
lockdown period was higher than that during the normal period (9/32, 28.1% vs. 8/92, 8.7%,
p=0.006). The variceal bleeding occurred more frequently in patients who referred for urgent
EVL during the lockdown period than in those during the normal period (7/9, 77.8% vs. 2/14,
14.2%, p=0.007). What the authors tried to examine is important and interesting. However, I
have a few points to be worried and the authors should address the points below.
Major points:
1. The most interesting thing that the readers will want to know in this study is the influence
of postponed endoscopy on the subsequent variceal bleeding during the lockdown period. The
authors should describe how many years the patients with postponed endoscopy were followed-
up and how many patients had variceal bleeding after the postponed endoscopy.
2. The authors should describe how many patients who referred for urgent EVL received regular
prophylaxis program during the normal period and the lockdown period.
3. In Table 3 and Table 4, the way of including only variables with statistically significant
differences in univariate analyses into multivariate analyses is wrong and usually not
recommended. In multivariate analyses, the authors should include age, sex, variables with a
significant implication that they aim to examine, and variables that have potential association
with variceal bleeding based on the previous reports. Moreover, the results of multivariate
analyses in Table 3 and Table 4 are not reliable and meaningless because the number of patients
with variceal bleeding is small. The authors should reconsider the significance of presenting the
multivariate analyses.
Please review this paper.
user
Title: Triage policy to postpone endoscopy for patients with low-risk varices is safe during the
lockdown period of COVID-19 pandemic
Version: 2 Date: 28 May 2023
Reviewer's report:
Comments to the authors
Chen YJ, et al. examined the safety to postpone the endoscopy for patients with esophageal
varices during the lockdown period of COVID-19. Esophageal variceal bleeding during the
lockdown period was higher than that during the normal period (9/32, 28.1% vs. 8/92, 8.7%,
p=0.006). The variceal bleeding occurred more frequently in patients who referred for urgent
EVL during the lockdown period than in those during the normal period (7/9, 77.8% vs. 2/14,
14.2%, p=0.007). What the authors tried to examine is important and interesting. However, I
have a few points to be worried and the authors should address the points below.
Major points:
1. The most interesting thing that the readers will want to know in this study is the influence
of postponed endoscopy on the subsequent variceal bleeding during the lockdown period. The
authors should describe how many years the patients with postponed endoscopy were followed-
up and how many patients had variceal bleeding after the postponed endoscopy.
2. The authors should describe how many patients who referred for urgent EVL received regular
prophylaxis program during the normal period and the lockdown period.
3. In Table 3 and Table 4, the way of including only variables with statistically significant
differences in univariate analyses into multivariate analyses is wrong and usually not
recommended. In multivariate analyses, the authors should include age, sex, variables with a
significant implication that they aim to examine, and variables that have potential association
with variceal bleeding based on the previous reports. Moreover, the results of multivariate
analyses in Table 3 and Table 4 are not reliable and meaningless because the number of patients
with variceal bleeding is small. The authors should reconsider the significance of presenting the
multivariate analyses.
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