Reviewer's report 
 Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary Title: 
care hospital-A 10 years review. 
 1  15 May 2007 Version: Date: 
 C. Mel Wilcox Reviewer: 
Reviewer's report: 
General 
Your study evaluates endoscopic findings in patients with dysphagia. Your results mirror prior reports in 
suggesting the utility of upper endoscopy as a first line diagnostic strategy. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
1. Introduction. What does “surgical outpatient clinic” mean? 
2. Who did the interviewing for the database? Specifically, one would like to know that the definition of dysphagia, as it was recorded in the database, was similar amongst the investigators. We now recognize 
the importance of eosinophilic esophagitis as a cause of dysphagia and thus it’s peculiar that you found no 
cases. This may warrant comment. 
3. Please break out the types of esophageal cancer – squamous versus adeno. 
4. One would think there would be a correlation between heartburn as an additional symptom and presence 
of reflux as an endoscopic finding. 
5. Some have recommended barium study in patients with dysphagia as it may help delineate a motility disturbance which may not then warrant endoscopy or show a tight irregular stricture which then might 
warrant endoscopy using a different technique or with fluorscopy. Please comment. It was surprising that a 
large number of gastric cancers were identified. Perhaps these were the patients who had the additional 
symptoms. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Reviewer's report 
 Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary Title: 
care hospital-A 10 years review. 
 1  15 May 2007 Version: Date: 
 C. Mel Wilcox Reviewer: 
Reviewer's report: 
General 
Your study evaluates endoscopic findings in patients with dysphagia. Your results mirror prior reports in 
suggesting the utility of upper endoscopy as a first line diagnostic strategy. 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
1. Introduction. What does “surgical outpatient clinic” mean? 
2. Who did the interviewing for the database? Specifically, one would like to know that the definition of dysphagia, as it was recorded in the database, was similar amongst the investigators. We now recognize 
the importance of eosinophilic esophagitis as a cause of dysphagia and thus it’s peculiar that you found no 
cases. This may warrant comment. 
3. Please break out the types of esophageal cancer – squamous versus adeno. 
4. One would think there would be a correlation between heartburn as an additional symptom and presence 
of reflux as an endoscopic finding. 
5. Some have recommended barium study in patients with dysphagia as it may help delineate a motility disturbance which may not then warrant endoscopy or show a tight irregular stricture which then might 
warrant endoscopy using a different technique or with fluorscopy. Please comment. It was surprising that a 
large number of gastric cancers were identified. Perhaps these were the patients who had the additional 
symptoms. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary Title: 
care hospital-A 10 years review. 
 1  15 May 2007 Version: Date: 
 C. Mel Wilcox Reviewer: 
Reviewer's report: 
General 
Your study evaluates endoscopic findings in patients with dysphagia. Your results mirror prior reports in 
suggesting the utility of upper endoscopy as a first line diagnostic strategy. 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
1. Introduction. What does “surgical outpatient clinic” mean? 
2. Who did the interviewing for the database? Specifically, one would like to know that the definition of dysphagia, as it was recorded in the database, was similar amongst the investigators. We now recognize 
the importance of eosinophilic esophagitis as a cause of dysphagia and thus it’s peculiar that you found no 
cases. This may warrant comment. 
3. Please break out the types of esophageal cancer – squamous versus adeno. 
4. One would think there would be a correlation between heartburn as an additional symptom and presence 
of reflux as an endoscopic finding. 
5. Some have recommended barium study in patients with dysphagia as it may help delineate a motility disturbance which may not then warrant endoscopy or show a tight irregular stricture which then might 
warrant endoscopy using a different technique or with fluorscopy. Please comment. It was surprising that a 
large number of gastric cancers were identified. Perhaps these were the patients who had the additional 
symptoms. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
assistant