Reviewer's report
Title:Risk factors and management strategy for ulcer hemorrhage following
gastric endoscopic submucosal dissection in patients on antithrombotic therapy
Version: 4Date:8 May 2013
Reviewer: Osamu Goto
Reviewer's report:
This is a retrospective study regarding influential factors in patients taking
antithrombotic agents (A group) on bleeding after gastric endoscopic submucosal
dissection (ESD). Although the purpose of this study would be important, it
seems that the composition of this manuscript may make readers confused and
the results are overestimated. The followings should be taken into consideration.
Major Compulsory Revisions
1. This study seems to be mainly aimed not to compare post-ESD bleeding rate
between the A group and the non-antithrombotic (NA) group, but to elucidate the
causal factors on post-ESD bleeding in the A group by comparing the bleeding
patients to the non-bleeding patients. Accordingly, Table 2 and 3 would be more
relevant than Table 1. To avoid the confusion, the authors should focus on the
main purpose, and clearly describe the main aim in the Background section and
the main outcome measure in the Methods section.
2. The abbreviated terms, “the A group” and “the NA group” are unnecessary. If
the authors create groups in this study, the patients having antithrombotic agents
should be divided into 2 groups, Bleeding group and Non-bleeding group.
3. The study design should be clearly stated. If my interpretation is right, this
should be a retrospective case-control study with consecutive data.
4. In the multivariate analysis, PPI with gastroprotective agent was not a
statistically-significant influential factor on post-ESD bleeding in the
antithrombotic users (p = 0.054). Therefore, the authors cannot conclude that it is
useful to prevent post-ESD bleeding.
5. Similarly, duration of ESD was a statistically-significant influential factor in the
analysis. The authors should mention it at least in the Discussion section.
6. Gastroprotective agent varies. The authors did not mention the details of
gastroprotective agents which had been administered to the patients. It is
overestimated to insist on its efficacy only by this study.
7. I wonder why post-ESD bleeding within Day 2 was not taken into consideration
in the analysis. The authors should make a comment of that reason.
Minor Essential Revisions
1. The number of references is inaccurate.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Risk factors and management strategy for ulcer hemorrhage following
gastric endoscopic submucosal dissection in patients on antithrombotic therapy
Version: 4Date:8 May 2013
Reviewer: Osamu Goto
Reviewer's report:
This is a retrospective study regarding influential factors in patients taking
antithrombotic agents (A group) on bleeding after gastric endoscopic submucosal
dissection (ESD). Although the purpose of this study would be important, it
seems that the composition of this manuscript may make readers confused and
the results are overestimated. The followings should be taken into consideration.
Major Compulsory Revisions
1. This study seems to be mainly aimed not to compare post-ESD bleeding rate
between the A group and the non-antithrombotic (NA) group, but to elucidate the
causal factors on post-ESD bleeding in the A group by comparing the bleeding
patients to the non-bleeding patients. Accordingly, Table 2 and 3 would be more
relevant than Table 1. To avoid the confusion, the authors should focus on the
main purpose, and clearly describe the main aim in the Background section and
the main outcome measure in the Methods section.
2. The abbreviated terms, “the A group” and “the NA group” are unnecessary. If
the authors create groups in this study, the patients having antithrombotic agents
should be divided into 2 groups, Bleeding group and Non-bleeding group.
3. The study design should be clearly stated. If my interpretation is right, this
should be a retrospective case-control study with consecutive data.
4. In the multivariate analysis, PPI with gastroprotective agent was not a
statistically-significant influential factor on post-ESD bleeding in the
antithrombotic users (p = 0.054). Therefore, the authors cannot conclude that it is
useful to prevent post-ESD bleeding.
5. Similarly, duration of ESD was a statistically-significant influential factor in the
analysis. The authors should mention it at least in the Discussion section.
6. Gastroprotective agent varies. The authors did not mention the details of
gastroprotective agents which had been administered to the patients. It is
overestimated to insist on its efficacy only by this study.
7. I wonder why post-ESD bleeding within Day 2 was not taken into consideration
in the analysis. The authors should make a comment of that reason.
Minor Essential Revisions
1. The number of references is inaccurate.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Risk factors and management strategy for ulcer hemorrhage following
gastric endoscopic submucosal dissection in patients on antithrombotic therapy
Version: 4Date:8 May 2013
Reviewer: Osamu Goto
Reviewer's report:
This is a retrospective study regarding influential factors in patients taking
antithrombotic agents (A group) on bleeding after gastric endoscopic submucosal
dissection (ESD). Although the purpose of this study would be important, it
seems that the composition of this manuscript may make readers confused and
the results are overestimated. The followings should be taken into consideration.
Major Compulsory Revisions
1. This study seems to be mainly aimed not to compare post-ESD bleeding rate
between the A group and the non-antithrombotic (NA) group, but to elucidate the
causal factors on post-ESD bleeding in the A group by comparing the bleeding
patients to the non-bleeding patients. Accordingly, Table 2 and 3 would be more
relevant than Table 1. To avoid the confusion, the authors should focus on the
main purpose, and clearly describe the main aim in the Background section and
the main outcome measure in the Methods section.
2. The abbreviated terms, “the A group” and “the NA group” are unnecessary. If
the authors create groups in this study, the patients having antithrombotic agents
should be divided into 2 groups, Bleeding group and Non-bleeding group.
3. The study design should be clearly stated. If my interpretation is right, this
should be a retrospective case-control study with consecutive data.
4. In the multivariate analysis, PPI with gastroprotective agent was not a
statistically-significant influential factor on post-ESD bleeding in the
antithrombotic users (p = 0.054). Therefore, the authors cannot conclude that it is
useful to prevent post-ESD bleeding.
5. Similarly, duration of ESD was a statistically-significant influential factor in the
analysis. The authors should mention it at least in the Discussion section.
6. Gastroprotective agent varies. The authors did not mention the details of
gastroprotective agents which had been administered to the patients. It is
overestimated to insist on its efficacy only by this study.
7. I wonder why post-ESD bleeding within Day 2 was not taken into consideration
in the analysis. The authors should make a comment of that reason.
Minor Essential Revisions
1. The number of references is inaccurate.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant