Title: Clinical value of using double balloon enteroscopy combined with endoscopic ultrasound
to evaluate Crohn’s disease of the small bowel: a retrospective study
Version: 0 Date: 26 Jan 2025
Reviewer's report:
Thank you for the opportunity to review your interesting paper. This manuscript presents
compelling data on the usefulness of EUS using DBE for evaluating disease activity in small-
bowel lesions of CD patients. The main research findings are important and can contribute to
the clinical management of CD patients. While the manuscript is well written, there are several
issues that need to be addressed. Below are this reviewer’s comments:
Major Comments
#1. The authors should clearly specify how the endoscopic findings compare with the EUS
findings. The central question that this paper should emphasize is whether the addition of EUS
enhances disease assessment compared to the mucosal findings from DBE alone.
#2. To better illustrate the usefulness of EUS, the inclusion of reference images from EUS would
be highly beneficial for readers.
#3. The relationship between HBI and mpSES-CD, presented in Table 1, could be made clearer
by illustrating the correlation in a figure rather than a table.
#4. The analysis in Table 3 uses the chi-square test and includes the statement: “Still, it was
significantly lower in patients with severe disease activity.” Given the small sample size, Fisher's
exact test may be more appropriate. Additionally, while significant differences in proportions
are noted among the three groups, it is unclear which group has the highest proportion. Multiple
comparisons or a residual analysis would be necessary to support such conclusions statistically.
#5. How do EUS findings correlate with prognosis? Results showing that EUS findings are more
useful than endoscopic findings in predicting recurrence would add significant novelty to the
paper.
#6. Were correlations examined with biomarkers such as CRP, LRG, and fecal calprotectin, in
addition to HBI? These relationships could strengthen the study's findings.
#7. The limitations of the study are not discussed in the Discussion section and should be
included.
Minor Comments
The specific DBE and EUS models used in this study should be listed in the Examination
Methods section.
Title: Clinical value of using double balloon enteroscopy combined with endoscopic ultrasound
to evaluate Crohn’s disease of the small bowel: a retrospective study
Version: 0 Date: 26 Jan 2025
Reviewer's report:
Thank you for the opportunity to review your interesting paper. This manuscript presents
compelling data on the usefulness of EUS using DBE for evaluating disease activity in small-
bowel lesions of CD patients. The main research findings are important and can contribute to
the clinical management of CD patients. While the manuscript is well written, there are several
issues that need to be addressed. Below are this reviewer’s comments:
Major Comments
#1. The authors should clearly specify how the endoscopic findings compare with the EUS
findings. The central question that this paper should emphasize is whether the addition of EUS
enhances disease assessment compared to the mucosal findings from DBE alone.
#2. To better illustrate the usefulness of EUS, the inclusion of reference images from EUS would
be highly beneficial for readers.
#3. The relationship between HBI and mpSES-CD, presented in Table 1, could be made clearer
by illustrating the correlation in a figure rather than a table.
#4. The analysis in Table 3 uses the chi-square test and includes the statement: “Still, it was
significantly lower in patients with severe disease activity.” Given the small sample size, Fisher's
exact test may be more appropriate. Additionally, while significant differences in proportions
are noted among the three groups, it is unclear which group has the highest proportion. Multiple
comparisons or a residual analysis would be necessary to support such conclusions statistically.
#5. How do EUS findings correlate with prognosis? Results showing that EUS findings are more
useful than endoscopic findings in predicting recurrence would add significant novelty to the
paper.
#6. Were correlations examined with biomarkers such as CRP, LRG, and fecal calprotectin, in
addition to HBI? These relationships could strengthen the study's findings.
#7. The limitations of the study are not discussed in the Discussion section and should be
included.
Minor Comments
The specific DBE and EUS models used in this study should be listed in the Examination
Methods section.
Please review this paper.
user
Title: Clinical value of using double balloon enteroscopy combined with endoscopic ultrasound
to evaluate Crohn’s disease of the small bowel: a retrospective study
Version: 0 Date: 26 Jan 2025
Reviewer's report:
Thank you for the opportunity to review your interesting paper. This manuscript presents
compelling data on the usefulness of EUS using DBE for evaluating disease activity in small-
bowel lesions of CD patients. The main research findings are important and can contribute to
the clinical management of CD patients. While the manuscript is well written, there are several
issues that need to be addressed. Below are this reviewer’s comments:
Major Comments
#1. The authors should clearly specify how the endoscopic findings compare with the EUS
findings. The central question that this paper should emphasize is whether the addition of EUS
enhances disease assessment compared to the mucosal findings from DBE alone.
#2. To better illustrate the usefulness of EUS, the inclusion of reference images from EUS would
be highly beneficial for readers.
#3. The relationship between HBI and mpSES-CD, presented in Table 1, could be made clearer
by illustrating the correlation in a figure rather than a table.
#4. The analysis in Table 3 uses the chi-square test and includes the statement: “Still, it was
significantly lower in patients with severe disease activity.” Given the small sample size, Fisher's
exact test may be more appropriate. Additionally, while significant differences in proportions
are noted among the three groups, it is unclear which group has the highest proportion. Multiple
comparisons or a residual analysis would be necessary to support such conclusions statistically.
#5. How do EUS findings correlate with prognosis? Results showing that EUS findings are more
useful than endoscopic findings in predicting recurrence would add significant novelty to the
paper.
#6. Were correlations examined with biomarkers such as CRP, LRG, and fecal calprotectin, in
addition to HBI? These relationships could strengthen the study's findings.
#7. The limitations of the study are not discussed in the Discussion section and should be
included.
Minor Comments
The specific DBE and EUS models used in this study should be listed in the Examination
Methods section.
assistant