Reviewer ’s report  
 
Title: The Effect of Quality of Segmental Bowel preparation on Adenoma Detection Rate  
 
Version: 1 Date: 09 Dec 2018  
 
Reviewer: Benjamin Avidan  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or ot her aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
THERE ARE MAJOR COMMENTS: 1) REFERENCES WERE USED INCORRECTLY. E.G - 
PAGE 3 PARAGRAPH 1 -"MANY STUDIES PROVIDE THE CORR ELATION....TO HIGH 
ADR". FOR THAT STATEMENT THE AUTHORS CITE REF 8 -12 WHILE SOME OF THEM 
DID NOT FOCUS OR DEALT WITH THE RELATIONSHIP BETWEEN THE QUALITY OF 
BOWEL PREP AND ADR ( REF NO 9 FOR EXAMPLE). REF 21 IS THE ESGE GUIDELINE 
FOR BOWEL PREP RATHER THAN  A PAPER ON THE IMPACT OF THE PRESENCE OF 
BUBBLES AND THE RATE OF ADENOMA DETECTION. REF 25 -28 WERE NOT 
MENTIONED IN THE PAPER. I ASSUME THEY WERE REFERED TO THE SENTENCE 
ON PAGE 3 PARAGRAPH 3 ( AFTER REF.21). IT SHOULDNT BE MENTIONED AT ALL 
SINCE IT THEY DEALT WITH SMALL BOWEL PREP FOR CAPSULE ENDOSCOPY.  
2) THER IS NO DIFFERENCE BETWEEN THE SENTENCE " MANY STUDIES PROVED 
THE CORRELATIION ....ON THE FIRST PARAGRAPH AND " MANY STUDIES HAD 
FOCUSES ON TE ASSOCIATION.... ON PARAGRAPH 2  
3) WHAT WAS THE REASON F OR EXCLUDING PATIENTS IN WHOM OTHER AGENTS 
WERE USED FOR PREP? THE USAGE OF PEG IN THE SECOND SPLIT DOSE WAS 
INCORRECT ( 1.5 LITERS OF PEG USING 250 CC EVERY 10 MINUTE LASTS 1 HOUR).  
4) SCORING SYSTEM USED THE BBPS WHICH HAS SCORES BETWEEN 0 -9 BUR ON 
THE R ESULTS SECTION OF THE INTRODUCTION SCORES OF 0 -3 WAS USED FOR 
PRESENTATION. IT IS CONFUSING.  
5) SEVERAL SIGNIFICAT ENGLIGH MUSTAKES PROMPT AN ENGLISH SPOKEN ( 
NATIVE OR NOT) TO HAVE CHECKED THE MANUSCRIPT  
6) IN THE STATISCTICAL SECTION: HOW WAS THE MPACT O F BBPS ON ADR IN 
THE DIFFERENT SEGMENTS WA CALCULATED? THE PRESENTATION IS 
COMPLICATED AND CUMBERSOME FOR READERS. THE COMPARISONS BBPS 2 
VS.3 ECC IS DIFFICULT TO UNDERSTANF OR FOLLOW FOR THE READER. IF 
ANOVA WAS USED IT SHOULD BE PRESENTED ACCORDINGLY.  
ALL FIGURES OF <0/001 ARE CONSIDERED SIGNIFICAT, THEREFORE THE SIGNS 
FOR EACH AND AVERUONE ON THE TABLE ARE USELESS.  
7) RESULTS SECTION:  A) PAGE 6 LAST PARAGRAPH. THE DIFFERENCE BETWEEN 
ADR AND AADR AMONGST ENDOSCOPISTS' SENIORITY SHOLD BE PRESENTED BY 
NUMBERS  B) FREQUENCIES SHOULD BE PRESENTED WITH EVEN NUMBERS  
C) THE LINES ARE NOT ALIGNED WELL IN TABLE 1, FIGURE NO 1 SHOULD BE 
DELEATED, FIGURE 3 SHOUKD HAVE STATISTICS PRESENTED WITHIN. D) TEH 
IMPACT OF BBPS AND BBS SHOULD HAVE BEEN CALCULATES USING A LO GISTIC 
REGRESSION MODEL WHERE ADR AND AADR WERE THE DEPENDENT VARABLE 
AND BBPS' BBS AMONG AND OTHER APRAMETERS ( SUCH AS SENIORITY OF 
ENDOSCOPISTS ECC ) AS INDEPENDENT VARIABLE.   
Are the methods appropriate an d well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclus ions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical rev iew is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
  
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 m anuscript, 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  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: The Effect of Quality of Segmental Bowel preparation on Adenoma Detection Rate  
 
Version: 1 Date: 09 Dec 2018  
 
Reviewer: Benjamin Avidan  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or ot her aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
THERE ARE MAJOR COMMENTS: 1) REFERENCES WERE USED INCORRECTLY. E.G - 
PAGE 3 PARAGRAPH 1 -"MANY STUDIES PROVIDE THE CORR ELATION....TO HIGH 
ADR". FOR THAT STATEMENT THE AUTHORS CITE REF 8 -12 WHILE SOME OF THEM 
DID NOT FOCUS OR DEALT WITH THE RELATIONSHIP BETWEEN THE QUALITY OF 
BOWEL PREP AND ADR ( REF NO 9 FOR EXAMPLE). REF 21 IS THE ESGE GUIDELINE 
FOR BOWEL PREP RATHER THAN  A PAPER ON THE IMPACT OF THE PRESENCE OF 
BUBBLES AND THE RATE OF ADENOMA DETECTION. REF 25 -28 WERE NOT 
MENTIONED IN THE PAPER. I ASSUME THEY WERE REFERED TO THE SENTENCE 
ON PAGE 3 PARAGRAPH 3 ( AFTER REF.21). IT SHOULDNT BE MENTIONED AT ALL 
SINCE IT THEY DEALT WITH SMALL BOWEL PREP FOR CAPSULE ENDOSCOPY.  
2) THER IS NO DIFFERENCE BETWEEN THE SENTENCE " MANY STUDIES PROVED 
THE CORRELATIION ....ON THE FIRST PARAGRAPH AND " MANY STUDIES HAD 
FOCUSES ON TE ASSOCIATION.... ON PARAGRAPH 2  
3) WHAT WAS THE REASON F OR EXCLUDING PATIENTS IN WHOM OTHER AGENTS 
WERE USED FOR PREP? THE USAGE OF PEG IN THE SECOND SPLIT DOSE WAS 
INCORRECT ( 1.5 LITERS OF PEG USING 250 CC EVERY 10 MINUTE LASTS 1 HOUR).  
4) SCORING SYSTEM USED THE BBPS WHICH HAS SCORES BETWEEN 0 -9 BUR ON 
THE R ESULTS SECTION OF THE INTRODUCTION SCORES OF 0 -3 WAS USED FOR 
PRESENTATION. IT IS CONFUSING.  
5) SEVERAL SIGNIFICAT ENGLIGH MUSTAKES PROMPT AN ENGLISH SPOKEN ( 
NATIVE OR NOT) TO HAVE CHECKED THE MANUSCRIPT  
6) IN THE STATISCTICAL SECTION: HOW WAS THE MPACT O F BBPS ON ADR IN 
THE DIFFERENT SEGMENTS WA CALCULATED? THE PRESENTATION IS 
COMPLICATED AND CUMBERSOME FOR READERS. THE COMPARISONS BBPS 2 
VS.3 ECC IS DIFFICULT TO UNDERSTANF OR FOLLOW FOR THE READER. IF 
ANOVA WAS USED IT SHOULD BE PRESENTED ACCORDINGLY.  
ALL FIGURES OF <0/001 ARE CONSIDERED SIGNIFICAT, THEREFORE THE SIGNS 
FOR EACH AND AVERUONE ON THE TABLE ARE USELESS.  
7) RESULTS SECTION:  A) PAGE 6 LAST PARAGRAPH. THE DIFFERENCE BETWEEN 
ADR AND AADR AMONGST ENDOSCOPISTS' SENIORITY SHOLD BE PRESENTED BY 
NUMBERS  B) FREQUENCIES SHOULD BE PRESENTED WITH EVEN NUMBERS  
C) THE LINES ARE NOT ALIGNED WELL IN TABLE 1, FIGURE NO 1 SHOULD BE 
DELEATED, FIGURE 3 SHOUKD HAVE STATISTICS PRESENTED WITHIN. D) TEH 
IMPACT OF BBPS AND BBS SHOULD HAVE BEEN CALCULATES USING A LO GISTIC 
REGRESSION MODEL WHERE ADR AND AADR WERE THE DEPENDENT VARABLE 
AND BBPS' BBS AMONG AND OTHER APRAMETERS ( SUCH AS SENIORITY OF 
ENDOSCOPISTS ECC ) AS INDEPENDENT VARIABLE.   
Are the methods appropriate an d well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclus ions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical rev iew is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
  
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 m anuscript, 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  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: The Effect of Quality of Segmental Bowel preparation on Adenoma Detection Rate  
 
Version: 1 Date: 09 Dec 2018  
 
Reviewer: Benjamin Avidan  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or ot her aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
THERE ARE MAJOR COMMENTS: 1) REFERENCES WERE USED INCORRECTLY. E.G - 
PAGE 3 PARAGRAPH 1 -"MANY STUDIES PROVIDE THE CORR ELATION....TO HIGH 
ADR". FOR THAT STATEMENT THE AUTHORS CITE REF 8 -12 WHILE SOME OF THEM 
DID NOT FOCUS OR DEALT WITH THE RELATIONSHIP BETWEEN THE QUALITY OF 
BOWEL PREP AND ADR ( REF NO 9 FOR EXAMPLE). REF 21 IS THE ESGE GUIDELINE 
FOR BOWEL PREP RATHER THAN  A PAPER ON THE IMPACT OF THE PRESENCE OF 
BUBBLES AND THE RATE OF ADENOMA DETECTION. REF 25 -28 WERE NOT 
MENTIONED IN THE PAPER. I ASSUME THEY WERE REFERED TO THE SENTENCE 
ON PAGE 3 PARAGRAPH 3 ( AFTER REF.21). IT SHOULDNT BE MENTIONED AT ALL 
SINCE IT THEY DEALT WITH SMALL BOWEL PREP FOR CAPSULE ENDOSCOPY.  
2) THER IS NO DIFFERENCE BETWEEN THE SENTENCE " MANY STUDIES PROVED 
THE CORRELATIION ....ON THE FIRST PARAGRAPH AND " MANY STUDIES HAD 
FOCUSES ON TE ASSOCIATION.... ON PARAGRAPH 2  
3) WHAT WAS THE REASON F OR EXCLUDING PATIENTS IN WHOM OTHER AGENTS 
WERE USED FOR PREP? THE USAGE OF PEG IN THE SECOND SPLIT DOSE WAS 
INCORRECT ( 1.5 LITERS OF PEG USING 250 CC EVERY 10 MINUTE LASTS 1 HOUR).  
4) SCORING SYSTEM USED THE BBPS WHICH HAS SCORES BETWEEN 0 -9 BUR ON 
THE R ESULTS SECTION OF THE INTRODUCTION SCORES OF 0 -3 WAS USED FOR 
PRESENTATION. IT IS CONFUSING.  
5) SEVERAL SIGNIFICAT ENGLIGH MUSTAKES PROMPT AN ENGLISH SPOKEN ( 
NATIVE OR NOT) TO HAVE CHECKED THE MANUSCRIPT  
6) IN THE STATISCTICAL SECTION: HOW WAS THE MPACT O F BBPS ON ADR IN 
THE DIFFERENT SEGMENTS WA CALCULATED? THE PRESENTATION IS 
COMPLICATED AND CUMBERSOME FOR READERS. THE COMPARISONS BBPS 2 
VS.3 ECC IS DIFFICULT TO UNDERSTANF OR FOLLOW FOR THE READER. IF 
ANOVA WAS USED IT SHOULD BE PRESENTED ACCORDINGLY.  
ALL FIGURES OF <0/001 ARE CONSIDERED SIGNIFICAT, THEREFORE THE SIGNS 
FOR EACH AND AVERUONE ON THE TABLE ARE USELESS.  
7) RESULTS SECTION:  A) PAGE 6 LAST PARAGRAPH. THE DIFFERENCE BETWEEN 
ADR AND AADR AMONGST ENDOSCOPISTS' SENIORITY SHOLD BE PRESENTED BY 
NUMBERS  B) FREQUENCIES SHOULD BE PRESENTED WITH EVEN NUMBERS  
C) THE LINES ARE NOT ALIGNED WELL IN TABLE 1, FIGURE NO 1 SHOULD BE 
DELEATED, FIGURE 3 SHOUKD HAVE STATISTICS PRESENTED WITHIN. D) TEH 
IMPACT OF BBPS AND BBS SHOULD HAVE BEEN CALCULATES USING A LO GISTIC 
REGRESSION MODEL WHERE ADR AND AADR WERE THE DEPENDENT VARABLE 
AND BBPS' BBS AMONG AND OTHER APRAMETERS ( SUCH AS SENIORITY OF 
ENDOSCOPISTS ECC ) AS INDEPENDENT VARIABLE.   
Are the methods appropriate an d well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclus ions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical rev iew is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
  
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 m anuscript, 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  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant