Reviewer ’s report  
 
Title: How to select patients and timing for rectal indomethacin to prevent post -ERCP  
pancreatitis: A systematic review and meta -analysis  
 
Version: 0 Date: 13 Jan 2017  
 
Reviewer: Cheng -Hsin Chu  
 
Reviewer's report:  
 
1. Could you give us a precisely PRIMSA ( protocol ), retrieve case study/references 
protocol  in this study  
 
 
2. Do you had registered in PROSPERO for study following  
 
 
3. In current RCT appraisal, we favor of Cochrane Handbook (Risk of bias) than using the 
Jadad score  
 
 
4. Total cases seem to double counting of analysis  In the Figure 3 (mild AP and M/S AP 
group ), why ?  
 
 
5. In the Figure 4; what is the reason of the total cases of average risk (1136 patients) with 
high risk (527 patients) over than the study ca ses number (total: 1513 patients)  
 
 
6. Clinically; it is hard to defined and explain indomethacin in the  immediately before 
ERCP, during ERCP and immediately after ERCP (above procedure may be within 30 
minuets of ERCP)  
 
 
7. Please defined and categorized the  High risk group before ERCP. Because it is clinical 
need.  
 
 
8. Based on the personal recognition ; prophylactic rectal indomethacin is not suitable for 
all patients undergoing ERCP but it is safe and possible reduction of PEP in high -risk 
patients.  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review 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:  
 
Acceptable  
 
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 fut ure? 
 
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 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 acce pted 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 Creative 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: How to select patients and timing for rectal indomethacin to prevent post -ERCP  
pancreatitis: A systematic review and meta -analysis  
 
Version: 0 Date: 13 Jan 2017  
 
Reviewer: Cheng -Hsin Chu  
 
Reviewer's report:  
 
1. Could you give us a precisely PRIMSA ( protocol ), retrieve case study/references 
protocol  in this study  
 
 
2. Do you had registered in PROSPERO for study following  
 
 
3. In current RCT appraisal, we favor of Cochrane Handbook (Risk of bias) than using the 
Jadad score  
 
 
4. Total cases seem to double counting of analysis  In the Figure 3 (mild AP and M/S AP 
group ), why ?  
 
 
5. In the Figure 4; what is the reason of the total cases of average risk (1136 patients) with 
high risk (527 patients) over than the study ca ses number (total: 1513 patients)  
 
 
6. Clinically; it is hard to defined and explain indomethacin in the  immediately before 
ERCP, during ERCP and immediately after ERCP (above procedure may be within 30 
minuets of ERCP)  
 
 
7. Please defined and categorized the  High risk group before ERCP. Because it is clinical 
need.  
 
 
8. Based on the personal recognition ; prophylactic rectal indomethacin is not suitable for 
all patients undergoing ERCP but it is safe and possible reduction of PEP in high -risk 
patients.  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review 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:  
 
Acceptable  
 
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 fut ure? 
 
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 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 acce pted 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 Creative 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: How to select patients and timing for rectal indomethacin to prevent post -ERCP  
pancreatitis: A systematic review and meta -analysis  
 
Version: 0 Date: 13 Jan 2017  
 
Reviewer: Cheng -Hsin Chu  
 
Reviewer's report:  
 
1. Could you give us a precisely PRIMSA ( protocol ), retrieve case study/references 
protocol  in this study  
 
 
2. Do you had registered in PROSPERO for study following  
 
 
3. In current RCT appraisal, we favor of Cochrane Handbook (Risk of bias) than using the 
Jadad score  
 
 
4. Total cases seem to double counting of analysis  In the Figure 3 (mild AP and M/S AP 
group ), why ?  
 
 
5. In the Figure 4; what is the reason of the total cases of average risk (1136 patients) with 
high risk (527 patients) over than the study ca ses number (total: 1513 patients)  
 
 
6. Clinically; it is hard to defined and explain indomethacin in the  immediately before 
ERCP, during ERCP and immediately after ERCP (above procedure may be within 30 
minuets of ERCP)  
 
 
7. Please defined and categorized the  High risk group before ERCP. Because it is clinical 
need.  
 
 
8. Based on the personal recognition ; prophylactic rectal indomethacin is not suitable for 
all patients undergoing ERCP but it is safe and possible reduction of PEP in high -risk 
patients.  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review 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:  
 
Acceptable  
 
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 fut ure? 
 
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 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 acce pted 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 Creative 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