Title: An adjusted Asia-Pacific colorectal screening score system to predict advanced colorectal
neoplasia in asymptomatic Chinese patients
Version: 4 Date: 06 Apr 2023
Reviewer's report:
In the manuscript, “An adjusted Asia-Pacific colorectal screening score system to predict
advanced colorectal neoplasia in asymptomatic Chinese patients”, Chenchen et al. describe that
adjusted Asia-Pacific Colorectal Screening (A-APCS) score, a cost-effective screening approach
for colonoscopy, may be useful in clinical application for predicting advanced colorectal
neoplasia (CAN) than previous APCS score. However, the A-APCS score could be overfitted
to the Second hospital, Cheeloo College of Medicine, Shandong University in this study. The
c-statistic of validation data from the same hospital was marginally not significant.
Major)
The authors need to add Cohen's kappa value between A-APCS and APCS scores in each dataset.
To visualize the distribution of the stratification group by each score, the authors should draw
Venn diagrams between A-APCS and APCS in the patients with ACN.
As the authors wrote in the discussion, this study is conducted in a single center and validation
is not satisfying statistical significance.  If another validation in a different center is satisfying
the statistical test, it would be more convincing results.
Minor)
The flags of Figure 1 are a, b, c, and d but the flags of Figure 3 are A and B, even though the
description is pointing them as a and b. Unification of format is needed.
Title: An adjusted Asia-Pacific colorectal screening score system to predict advanced colorectal
neoplasia in asymptomatic Chinese patients
Version: 4 Date: 06 Apr 2023
Reviewer's report:
In the manuscript, “An adjusted Asia-Pacific colorectal screening score system to predict
advanced colorectal neoplasia in asymptomatic Chinese patients”, Chenchen et al. describe that
adjusted Asia-Pacific Colorectal Screening (A-APCS) score, a cost-effective screening approach
for colonoscopy, may be useful in clinical application for predicting advanced colorectal
neoplasia (CAN) than previous APCS score. However, the A-APCS score could be overfitted
to the Second hospital, Cheeloo College of Medicine, Shandong University in this study. The
c-statistic of validation data from the same hospital was marginally not significant.
Major)
The authors need to add Cohen's kappa value between A-APCS and APCS scores in each dataset.
To visualize the distribution of the stratification group by each score, the authors should draw
Venn diagrams between A-APCS and APCS in the patients with ACN.
As the authors wrote in the discussion, this study is conducted in a single center and validation
is not satisfying statistical significance.  If another validation in a different center is satisfying
the statistical test, it would be more convincing results.
Minor)
The flags of Figure 1 are a, b, c, and d but the flags of Figure 3 are A and B, even though the
description is pointing them as a and b. Unification of format is needed.
Please review this paper.
user
Title: An adjusted Asia-Pacific colorectal screening score system to predict advanced colorectal
neoplasia in asymptomatic Chinese patients
Version: 4 Date: 06 Apr 2023
Reviewer's report:
In the manuscript, “An adjusted Asia-Pacific colorectal screening score system to predict
advanced colorectal neoplasia in asymptomatic Chinese patients”, Chenchen et al. describe that
adjusted Asia-Pacific Colorectal Screening (A-APCS) score, a cost-effective screening approach
for colonoscopy, may be useful in clinical application for predicting advanced colorectal
neoplasia (CAN) than previous APCS score. However, the A-APCS score could be overfitted
to the Second hospital, Cheeloo College of Medicine, Shandong University in this study. The
c-statistic of validation data from the same hospital was marginally not significant.
Major)
The authors need to add Cohen's kappa value between A-APCS and APCS scores in each dataset.
To visualize the distribution of the stratification group by each score, the authors should draw
Venn diagrams between A-APCS and APCS in the patients with ACN.
As the authors wrote in the discussion, this study is conducted in a single center and validation
is not satisfying statistical significance.  If another validation in a different center is satisfying
the statistical test, it would be more convincing results.
Minor)
The flags of Figure 1 are a, b, c, and d but the flags of Figure 3 are A and B, even though the
description is pointing them as a and b. Unification of format is needed.
assistant