Title: The analysis of multilevel factors affecting adenoma detection rates for colonoscopies:
A large-scale retrospective study
Version: 1 Date: 17 Jun 2021
Reviewer:  Dalbir Sandhu
Reviewer's report:
The authors should be commended on this well written and well conducted study.
Few points:
How did the authors decide to dichotomize senior and junior with the number of 3000
colonoscopies. Did this include colonoscopies done as a trainee?
Why did the authors include ESD in their division of senior and junior endoscopist?
If an endoscopists had done >3000 colonoscopies but did not do ESD - which category were
they placed in?
The authors included serrated adenomas as part of adenoma although sessile serrated polyps is
still not considered as a part of ADR. This should be discussed (as deleting it from the results
may need a great deal of alteration).
The study is from China - it will be worthwhile mentioning if there is a nationwide screening
for colon cancer program in China for the readers of this journal. Also, it will be important to
mention the age at which screening colonoscopies are offered.
What do the authors mean by 'single examiner colonoscopy' and 'dual-examiner colonoscopy'?
If dual examiner means 2 attending proceduralists - how was that information included in the
study?
The authors did not include some important factors for ADR including family history of colon
cancer/polyps, withdrawal time - this should be discussed.
In discussion - page 13 - the authors mention - "Our findings, along with recently published
guidelines (19,20), suggest that individuals with a family history of CRC should have their
first screening colonoscopy at age 45......" I'm not sure which finding in the study corroborates
these societal guidelines of starting screening colonoscopy at age 45 since information on family
history is missing in the current study. In fact on page 15, authors mention information on 'family
history' was not available.
What type of sedation was used - monitored anesthesia care (Propofol), moderate sedation,
general anesthesia or combination?
Title: The analysis of multilevel factors affecting adenoma detection rates for colonoscopies:
A large-scale retrospective study
Version: 1 Date: 17 Jun 2021
Reviewer:  Dalbir Sandhu
Reviewer's report:
The authors should be commended on this well written and well conducted study.
Few points:
How did the authors decide to dichotomize senior and junior with the number of 3000
colonoscopies. Did this include colonoscopies done as a trainee?
Why did the authors include ESD in their division of senior and junior endoscopist?
If an endoscopists had done >3000 colonoscopies but did not do ESD - which category were
they placed in?
The authors included serrated adenomas as part of adenoma although sessile serrated polyps is
still not considered as a part of ADR. This should be discussed (as deleting it from the results
may need a great deal of alteration).
The study is from China - it will be worthwhile mentioning if there is a nationwide screening
for colon cancer program in China for the readers of this journal. Also, it will be important to
mention the age at which screening colonoscopies are offered.
What do the authors mean by 'single examiner colonoscopy' and 'dual-examiner colonoscopy'?
If dual examiner means 2 attending proceduralists - how was that information included in the
study?
The authors did not include some important factors for ADR including family history of colon
cancer/polyps, withdrawal time - this should be discussed.
In discussion - page 13 - the authors mention - "Our findings, along with recently published
guidelines (19,20), suggest that individuals with a family history of CRC should have their
first screening colonoscopy at age 45......" I'm not sure which finding in the study corroborates
these societal guidelines of starting screening colonoscopy at age 45 since information on family
history is missing in the current study. In fact on page 15, authors mention information on 'family
history' was not available.
What type of sedation was used - monitored anesthesia care (Propofol), moderate sedation,
general anesthesia or combination?
Please review this paper.
user
Title: The analysis of multilevel factors affecting adenoma detection rates for colonoscopies:
A large-scale retrospective study
Version: 1 Date: 17 Jun 2021
Reviewer:  Dalbir Sandhu
Reviewer's report:
The authors should be commended on this well written and well conducted study.
Few points:
How did the authors decide to dichotomize senior and junior with the number of 3000
colonoscopies. Did this include colonoscopies done as a trainee?
Why did the authors include ESD in their division of senior and junior endoscopist?
If an endoscopists had done >3000 colonoscopies but did not do ESD - which category were
they placed in?
The authors included serrated adenomas as part of adenoma although sessile serrated polyps is
still not considered as a part of ADR. This should be discussed (as deleting it from the results
may need a great deal of alteration).
The study is from China - it will be worthwhile mentioning if there is a nationwide screening
for colon cancer program in China for the readers of this journal. Also, it will be important to
mention the age at which screening colonoscopies are offered.
What do the authors mean by 'single examiner colonoscopy' and 'dual-examiner colonoscopy'?
If dual examiner means 2 attending proceduralists - how was that information included in the
study?
The authors did not include some important factors for ADR including family history of colon
cancer/polyps, withdrawal time - this should be discussed.
In discussion - page 13 - the authors mention - "Our findings, along with recently published
guidelines (19,20), suggest that individuals with a family history of CRC should have their
first screening colonoscopy at age 45......" I'm not sure which finding in the study corroborates
these societal guidelines of starting screening colonoscopy at age 45 since information on family
history is missing in the current study. In fact on page 15, authors mention information on 'family
history' was not available.
What type of sedation was used - monitored anesthesia care (Propofol), moderate sedation,
general anesthesia or combination?
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