Title: Elevated Average Maximum Intrabolus Pressure on High-Resolution Manometry is
Associated with Esophageal Dysmotility and Delayed Esophageal Emptying on Timed Barium
Esophagram
Version: 2 Date: 03 Jan 2022
Reviewer's report:
The study  evaluated the association between the elevated average maximal intrabolus pressure
and esophageal dysmotility , as well as the delayed esophageal emptying on timed barium
esophagram. It showed that the  abnormal AM-IBP  was associated with a higher probability of
retaining liquid bolus or barium tablet arrest on TBE and esophageal dysmotility on HRM. IBP
has been neglected in CC 3.0, and re-introduced in CC4.0.  I have the following concerns.
1.   The current study used the timed barium esophagram as a comparison to confirm the clinical
implication of IBP.  However, the clinical significance of elevated IBP would rely on the scenario
where IRP was elevated with clinical associated symptom including dysphagia and chest pain.
Thus the inclusion and sub-grouping of the included patients should be re-arranged according
to both the IRP and symptom, because the IBP alone would not be the determined factor in
clinical decision.
2. The symptoms and the past history of the included patients have not been introduced in detail.
3.Using excel as the statistical analysis tool is not usual, maybe the authors should think
about shifting using  the SPSS or SAS. During the logistic regression, two many factors were
introduced in the model, the sample size might not be enough for the analysis.
Title: Elevated Average Maximum Intrabolus Pressure on High-Resolution Manometry is
Associated with Esophageal Dysmotility and Delayed Esophageal Emptying on Timed Barium
Esophagram
Version: 2 Date: 03 Jan 2022
Reviewer's report:
The study  evaluated the association between the elevated average maximal intrabolus pressure
and esophageal dysmotility , as well as the delayed esophageal emptying on timed barium
esophagram. It showed that the  abnormal AM-IBP  was associated with a higher probability of
retaining liquid bolus or barium tablet arrest on TBE and esophageal dysmotility on HRM. IBP
has been neglected in CC 3.0, and re-introduced in CC4.0.  I have the following concerns.
1.   The current study used the timed barium esophagram as a comparison to confirm the clinical
implication of IBP.  However, the clinical significance of elevated IBP would rely on the scenario
where IRP was elevated with clinical associated symptom including dysphagia and chest pain.
Thus the inclusion and sub-grouping of the included patients should be re-arranged according
to both the IRP and symptom, because the IBP alone would not be the determined factor in
clinical decision.
2. The symptoms and the past history of the included patients have not been introduced in detail.
3.Using excel as the statistical analysis tool is not usual, maybe the authors should think
about shifting using  the SPSS or SAS. During the logistic regression, two many factors were
introduced in the model, the sample size might not be enough for the analysis.
Please review this paper.
user
Title: Elevated Average Maximum Intrabolus Pressure on High-Resolution Manometry is
Associated with Esophageal Dysmotility and Delayed Esophageal Emptying on Timed Barium
Esophagram
Version: 2 Date: 03 Jan 2022
Reviewer's report:
The study  evaluated the association between the elevated average maximal intrabolus pressure
and esophageal dysmotility , as well as the delayed esophageal emptying on timed barium
esophagram. It showed that the  abnormal AM-IBP  was associated with a higher probability of
retaining liquid bolus or barium tablet arrest on TBE and esophageal dysmotility on HRM. IBP
has been neglected in CC 3.0, and re-introduced in CC4.0.  I have the following concerns.
1.   The current study used the timed barium esophagram as a comparison to confirm the clinical
implication of IBP.  However, the clinical significance of elevated IBP would rely on the scenario
where IRP was elevated with clinical associated symptom including dysphagia and chest pain.
Thus the inclusion and sub-grouping of the included patients should be re-arranged according
to both the IRP and symptom, because the IBP alone would not be the determined factor in
clinical decision.
2. The symptoms and the past history of the included patients have not been introduced in detail.
3.Using excel as the statistical analysis tool is not usual, maybe the authors should think
about shifting using  the SPSS or SAS. During the logistic regression, two many factors were
introduced in the model, the sample size might not be enough for the analysis.
assistant