Reviewer’s report
Title: 
Ten-day bismuth-containing quadruple therapy versus 7-day proton pump
inhibitor-clarithromycin containing triple therapy as first-line empirical therapy
for the Helicobacter pylori infection in Korea: A randomized open-label trial
Version: 
1 
Date: 
18 Oct 2020
Reviewer's report:
Dear Editor in chief
I reviewed the manuscript entitled as "Ten-day bismuth-containing quadruple
therapy versus 7-day proton pump inhibitor clarithromycin containing triple
therapy as first-line empirical therapy for the Helicobacter pylori infection in
Korea".
The work is valuable due to the importance of introducing suitable regimens for
H. pylori eradication in every country according to the pattern of H. pylori
resistance to antibiotics in every geographical region.
However, there are some minor points to be mentioned. And the manuscript
seems suitable for publication after these minor revisions.
In Methods and Results:
The severity of side effects is not described. It is not clear how the authors
classified side effects as: mild, moderate or severe! Also, it seems better to show
the kinds and rates of mild, moderate or severe side effects in a table.
In Results:
It is better to draw a flowchart that shows the number of patients in each analysis
step (The whole patients - The number of patients included in intention to treat
analysis - the number of patients that were deleted due to poor compliance or
not performing UBT while analyzing modified intention to treat analysis - The
number of patients in Modified intention to treat analysis - the number of
patients that were deleted while analyzing per-protocol analysis and the reason
of their deletion 
- The number of patients remained for per-protocol analysis -
 the number of patients that received second-line regimen and the final results.
In Discussion:
It is mentioned that "The lower eradication rate in the ITT analysis was observed
in this study because of a higher than expected rate of participants who declined
to participate in the study due to chronic gastritis". Since all the patients had
given informed consents before starting the protocol, this justification /
explanation seems to be unaccountable.
It is mentioned that "An interesting finding was that the eradication rate of the
BQT remained high as much as 83%, even in participants who consumed at least
50% but less than 80% of the study drugs." Since the eradication rate was less
than 85%, according to reference number 17, this rate of eradication is "poor"
and therefore, is not interesting!
At the end of discussion, it is written that "this study was planned to evaluate the
eradication rates in the empirical treatment setting that did not require
endoscopic evaluation". Since most patients had undergone endoscopy, this
phrase "did not require endoscopic evaluation" is better to be deleted.
Publons Reviewer Recognition
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registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
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Yes
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Ten-day bismuth-containing quadruple therapy versus 7-day proton pump
inhibitor-clarithromycin containing triple therapy as first-line empirical therapy
for the Helicobacter pylori infection in Korea: A randomized open-label trial
Version: 
1 
Date: 
18 Oct 2020
Reviewer's report:
Dear Editor in chief
I reviewed the manuscript entitled as "Ten-day bismuth-containing quadruple
therapy versus 7-day proton pump inhibitor clarithromycin containing triple
therapy as first-line empirical therapy for the Helicobacter pylori infection in
Korea".
The work is valuable due to the importance of introducing suitable regimens for
H. pylori eradication in every country according to the pattern of H. pylori
resistance to antibiotics in every geographical region.
However, there are some minor points to be mentioned. And the manuscript
seems suitable for publication after these minor revisions.
In Methods and Results:
The severity of side effects is not described. It is not clear how the authors
classified side effects as: mild, moderate or severe! Also, it seems better to show
the kinds and rates of mild, moderate or severe side effects in a table.
In Results:
It is better to draw a flowchart that shows the number of patients in each analysis
step (The whole patients - The number of patients included in intention to treat
analysis - the number of patients that were deleted due to poor compliance or
not performing UBT while analyzing modified intention to treat analysis - The
number of patients in Modified intention to treat analysis - the number of
patients that were deleted while analyzing per-protocol analysis and the reason
of their deletion 
- The number of patients remained for per-protocol analysis -
 the number of patients that received second-line regimen and the final results.
In Discussion:
It is mentioned that "The lower eradication rate in the ITT analysis was observed
in this study because of a higher than expected rate of participants who declined
to participate in the study due to chronic gastritis". Since all the patients had
given informed consents before starting the protocol, this justification /
explanation seems to be unaccountable.
It is mentioned that "An interesting finding was that the eradication rate of the
BQT remained high as much as 83%, even in participants who consumed at least
50% but less than 80% of the study drugs." Since the eradication rate was less
than 85%, according to reference number 17, this rate of eradication is "poor"
and therefore, is not interesting!
At the end of discussion, it is written that "this study was planned to evaluate the
eradication rates in the empirical treatment setting that did not require
endoscopic evaluation". Since most patients had undergone endoscopy, this
phrase "did not require endoscopic evaluation" is better to be deleted.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Ten-day bismuth-containing quadruple therapy versus 7-day proton pump
inhibitor-clarithromycin containing triple therapy as first-line empirical therapy
for the Helicobacter pylori infection in Korea: A randomized open-label trial
Version: 
1 
Date: 
18 Oct 2020
Reviewer's report:
Dear Editor in chief
I reviewed the manuscript entitled as "Ten-day bismuth-containing quadruple
therapy versus 7-day proton pump inhibitor clarithromycin containing triple
therapy as first-line empirical therapy for the Helicobacter pylori infection in
Korea".
The work is valuable due to the importance of introducing suitable regimens for
H. pylori eradication in every country according to the pattern of H. pylori
resistance to antibiotics in every geographical region.
However, there are some minor points to be mentioned. And the manuscript
seems suitable for publication after these minor revisions.
In Methods and Results:
The severity of side effects is not described. It is not clear how the authors
classified side effects as: mild, moderate or severe! Also, it seems better to show
the kinds and rates of mild, moderate or severe side effects in a table.
In Results:
It is better to draw a flowchart that shows the number of patients in each analysis
step (The whole patients - The number of patients included in intention to treat
analysis - the number of patients that were deleted due to poor compliance or
not performing UBT while analyzing modified intention to treat analysis - The
number of patients in Modified intention to treat analysis - the number of
patients that were deleted while analyzing per-protocol analysis and the reason
of their deletion 
- The number of patients remained for per-protocol analysis -
 the number of patients that received second-line regimen and the final results.
In Discussion:
It is mentioned that "The lower eradication rate in the ITT analysis was observed
in this study because of a higher than expected rate of participants who declined
to participate in the study due to chronic gastritis". Since all the patients had
given informed consents before starting the protocol, this justification /
explanation seems to be unaccountable.
It is mentioned that "An interesting finding was that the eradication rate of the
BQT remained high as much as 83%, even in participants who consumed at least
50% but less than 80% of the study drugs." Since the eradication rate was less
than 85%, according to reference number 17, this rate of eradication is "poor"
and therefore, is not interesting!
At the end of discussion, it is written that "this study was planned to evaluate the
eradication rates in the empirical treatment setting that did not require
endoscopic evaluation". Since most patients had undergone endoscopy, this
phrase "did not require endoscopic evaluation" is better to be deleted.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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