Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 1 Date: 12 Nov 2024
Reviewer's report:
This is a retrospective cohort study, including CD patients with ileostomy who had undergone
FCal measurment between 2015 and 2022. Patients were divided in two major groups: those
with inflammation (shown by imaging or endoscopy) or those without signs of inflammation.
Patients with active inflammation had higher levels of FCal. The optimal cut off of FCal was
63.3 ug/g by FC-POCT and 40.1 ug/g by FC-ELISA.
Major comments:
• A total of 101 patients with 224 measurements of FCal were included. If I am understanding it
right, this means that each patient underwent FCal measurement in 2 different timepoints. What
was the difference between these 2 timepoints? This may lead to sample duplication? Please
consider explaining when were the FCal measurements performed in each patient.
• Small intestinal inflammation was defined by mural enhancement with wall thickening,
ulcers, perienteric edema/infiltration, pseudo-sacculation of the bowel die to shortening of the
mesenteric border and engorged vasa recta. Could you please clarify if the patients had at least
one of these findings or more than one? Which cut-off was used for bowel wall thickening?
Were the CT/MRE images reviewed by a radiologist or this information was retrieved from
medical charts?
• Only 44 patients underwent endoscopy. Could you please clarify why? Besides, mild
inflammation may not be detected by CT/MRE. How do you address this situation? Consider
adding to the limitations of the study.
• Consider analyzing separately the group of patients that had endoscopy performed and those
that was only based on imaging to see if the values of FCal varied.
• Consider evaluating the value of FCal and the severity of endoscopic or imaging activity.
Minor comments
• Page 9, line 153: fifty-five (should be 55% and not 54%)
Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 1 Date: 12 Nov 2024
Reviewer's report:
This is a retrospective cohort study, including CD patients with ileostomy who had undergone
FCal measurment between 2015 and 2022. Patients were divided in two major groups: those
with inflammation (shown by imaging or endoscopy) or those without signs of inflammation.
Patients with active inflammation had higher levels of FCal. The optimal cut off of FCal was
63.3 ug/g by FC-POCT and 40.1 ug/g by FC-ELISA.
Major comments:
• A total of 101 patients with 224 measurements of FCal were included. If I am understanding it
right, this means that each patient underwent FCal measurement in 2 different timepoints. What
was the difference between these 2 timepoints? This may lead to sample duplication? Please
consider explaining when were the FCal measurements performed in each patient.
• Small intestinal inflammation was defined by mural enhancement with wall thickening,
ulcers, perienteric edema/infiltration, pseudo-sacculation of the bowel die to shortening of the
mesenteric border and engorged vasa recta. Could you please clarify if the patients had at least
one of these findings or more than one? Which cut-off was used for bowel wall thickening?
Were the CT/MRE images reviewed by a radiologist or this information was retrieved from
medical charts?
• Only 44 patients underwent endoscopy. Could you please clarify why? Besides, mild
inflammation may not be detected by CT/MRE. How do you address this situation? Consider
adding to the limitations of the study.
• Consider analyzing separately the group of patients that had endoscopy performed and those
that was only based on imaging to see if the values of FCal varied.
• Consider evaluating the value of FCal and the severity of endoscopic or imaging activity.
Minor comments
• Page 9, line 153: fifty-five (should be 55% and not 54%)
Please review this paper.
user
Title: Fecal Calprotectin from Ileostomy Output in Patients with Crohn’s Disease
Version: 1 Date: 12 Nov 2024
Reviewer's report:
This is a retrospective cohort study, including CD patients with ileostomy who had undergone
FCal measurment between 2015 and 2022. Patients were divided in two major groups: those
with inflammation (shown by imaging or endoscopy) or those without signs of inflammation.
Patients with active inflammation had higher levels of FCal. The optimal cut off of FCal was
63.3 ug/g by FC-POCT and 40.1 ug/g by FC-ELISA.
Major comments:
• A total of 101 patients with 224 measurements of FCal were included. If I am understanding it
right, this means that each patient underwent FCal measurement in 2 different timepoints. What
was the difference between these 2 timepoints? This may lead to sample duplication? Please
consider explaining when were the FCal measurements performed in each patient.
• Small intestinal inflammation was defined by mural enhancement with wall thickening,
ulcers, perienteric edema/infiltration, pseudo-sacculation of the bowel die to shortening of the
mesenteric border and engorged vasa recta. Could you please clarify if the patients had at least
one of these findings or more than one? Which cut-off was used for bowel wall thickening?
Were the CT/MRE images reviewed by a radiologist or this information was retrieved from
medical charts?
• Only 44 patients underwent endoscopy. Could you please clarify why? Besides, mild
inflammation may not be detected by CT/MRE. How do you address this situation? Consider
adding to the limitations of the study.
• Consider analyzing separately the group of patients that had endoscopy performed and those
that was only based on imaging to see if the values of FCal varied.
• Consider evaluating the value of FCal and the severity of endoscopic or imaging activity.
Minor comments
• Page 9, line 153: fifty-five (should be 55% and not 54%)
assistant