Reviewer's report
Title:Dumping syndrome following Nissen fundoplication in an adult patient
diagnosed By BreathID continuous online 13C-octanoide acid breath test a case
report.
Version: 1Date:9 March 2010
Reviewer: Simon Eaton
Reviewer's report:
Major Compulsory Revisions
(i) we are given no details about how the test was performed. What was the dose
of 13-C-octanoic acid? Was it delivered in orange juice, another liquid vehicle, or
a solid test meal? What volume was administered, and over how long a time
period? Where was the sampling cannula?
(ii) it is very unclear how the diagnosis of dumping syndrome was reached on the
basis of the displayed plot. We need to know what is the normal range for t1/2.
The plot is also very unclear and should be re-drawn using the data points and a
computer graphics package.
(iii) Breath-ID is an established methodology which has been referred to in
several papers and so should not be referenced in the title of the article.
(iv) dumping syndrome is usually diagnosed by barium meal or by scintigraphy.
The authors need to explain why they believe that the patient had dumping
syndrome, when the barium meal was negative. Was scintigraphy performed?
When evaluating a new test, it is usual to compare against the gold standard.
(v) biphasic gastric empyting, which is what I believe the graph shows, has often
been referred to in the literature, and the authors need to perform a more
thorough literature search.
(vi) I think the authors underestimate the sensitivity of the Breath ID for
13CO2/12CO2 by a factor of 1000. I think that the manufacturer's literature states
that the machine can detect 1 part per million differences, not 1 part per
thousand.
(vii) the clinical history given is too descriptive, we need more data - patient
weight, BMI pre- and post- Nissen and pre- and post gastrectomy etc.
Minor Essential Revisions
(i) octanoide is not correct nomenclature. The test is either performed with
octanoic acid or octanoate. Details should be given (see major i above)
Level of interest: An article of limited interest
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:Dumping syndrome following Nissen fundoplication in an adult patient
diagnosed By BreathID continuous online 13C-octanoide acid breath test a case
report.
Version: 1Date:9 March 2010
Reviewer: Simon Eaton
Reviewer's report:
Major Compulsory Revisions
(i) we are given no details about how the test was performed. What was the dose
of 13-C-octanoic acid? Was it delivered in orange juice, another liquid vehicle, or
a solid test meal? What volume was administered, and over how long a time
period? Where was the sampling cannula?
(ii) it is very unclear how the diagnosis of dumping syndrome was reached on the
basis of the displayed plot. We need to know what is the normal range for t1/2.
The plot is also very unclear and should be re-drawn using the data points and a
computer graphics package.
(iii) Breath-ID is an established methodology which has been referred to in
several papers and so should not be referenced in the title of the article.
(iv) dumping syndrome is usually diagnosed by barium meal or by scintigraphy.
The authors need to explain why they believe that the patient had dumping
syndrome, when the barium meal was negative. Was scintigraphy performed?
When evaluating a new test, it is usual to compare against the gold standard.
(v) biphasic gastric empyting, which is what I believe the graph shows, has often
been referred to in the literature, and the authors need to perform a more
thorough literature search.
(vi) I think the authors underestimate the sensitivity of the Breath ID for
13CO2/12CO2 by a factor of 1000. I think that the manufacturer's literature states
that the machine can detect 1 part per million differences, not 1 part per
thousand.
(vii) the clinical history given is too descriptive, we need more data - patient
weight, BMI pre- and post- Nissen and pre- and post gastrectomy etc.
Minor Essential Revisions
(i) octanoide is not correct nomenclature. The test is either performed with
octanoic acid or octanoate. Details should be given (see major i above)
Level of interest: An article of limited interest
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:Dumping syndrome following Nissen fundoplication in an adult patient
diagnosed By BreathID continuous online 13C-octanoide acid breath test a case
report.
Version: 1Date:9 March 2010
Reviewer: Simon Eaton
Reviewer's report:
Major Compulsory Revisions
(i) we are given no details about how the test was performed. What was the dose
of 13-C-octanoic acid? Was it delivered in orange juice, another liquid vehicle, or
a solid test meal? What volume was administered, and over how long a time
period? Where was the sampling cannula?
(ii) it is very unclear how the diagnosis of dumping syndrome was reached on the
basis of the displayed plot. We need to know what is the normal range for t1/2.
The plot is also very unclear and should be re-drawn using the data points and a
computer graphics package.
(iii) Breath-ID is an established methodology which has been referred to in
several papers and so should not be referenced in the title of the article.
(iv) dumping syndrome is usually diagnosed by barium meal or by scintigraphy.
The authors need to explain why they believe that the patient had dumping
syndrome, when the barium meal was negative. Was scintigraphy performed?
When evaluating a new test, it is usual to compare against the gold standard.
(v) biphasic gastric empyting, which is what I believe the graph shows, has often
been referred to in the literature, and the authors need to perform a more
thorough literature search.
(vi) I think the authors underestimate the sensitivity of the Breath ID for
13CO2/12CO2 by a factor of 1000. I think that the manufacturer's literature states
that the machine can detect 1 part per million differences, not 1 part per
thousand.
(vii) the clinical history given is too descriptive, we need more data - patient
weight, BMI pre- and post- Nissen and pre- and post gastrectomy etc.
Minor Essential Revisions
(i) octanoide is not correct nomenclature. The test is either performed with
octanoic acid or octanoate. Details should be given (see major i above)
Level of interest: An article of limited interest
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
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