Ultrasound Imaging Equipment for Evaluating Chronic Constipation in Home Healthcare: A Review Article

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript has potential, but its publication at this stage is not recommended without significant revisions. A revised and more rigorously supported version could make a meaningful contribution to the field and merit consideration for publication. My suggestion are listed below:

The introduction (lines 8-17) briefly mentions the purpose of the study, focusing on classifying fecal retention patterns using ultrasound. However, it fails to clearly outline the methodology or provide an adequate roadmap for the subsequent discussion, leaving readers unsure about the flow of the study.

The lack of a well-defined structure weakens the study's ability to effectively guide the reader through the theoretical and practical aspects of the research.

In Section 5.3, regarding the use of ultrasound imaging equipment, the authors claim the method is "low-cost, simple, and repeatable" (lines 156-157). However, no comparative data or evidence is provided to substantiate this claim against alternative clinical methods.

Section 5.1 on marker methods (lines 95-117) references the use of SITZMARKS, but it does not adequately integrate these references into the broader context of the analysis, leaving critical gaps in the discussion.

 

 In the conclusion (lines 250-268), the authors suggest that the proposed method will revolutionize constipation treatment. However, this optimism is unsupported by comprehensive clinical trials or robust data, making the claim appear speculative.

Drawing far-reaching conclusions without sufficient empirical evidence risks overstating the study's impact.

 Please reorganize the manuscript to establish a clear connection between the introduction, methodology, and conclusions. Eliminate vague and repetitive language, such as "a simple but effective method", "low-cost, simple, and repeatable". The authors should replace such vague statements with precise information.

Author Response

＜Comments to Reviewer 1＞

>The manuscript has potential, but its publication at this stage isnot recommended without >significant revisions. A revised andmore rigorously supported version could make a >meaningfulcontribution to the field and merit consideration for publication.My suggestion >are listed below:

>The introduction (lines 8-17) briefly mentions the purpose of thestudy, focusing on >classifying fecal retention patterns usingultrasound. However, it fails to clearly outline the >methodology orprovide an adequate roadmap for the subsequent discussion,leaving readers >unsure about the flow of the study.

 

Thank you for your comment.

I have revised the article according to the reviewer's suggestions. Lines 12 to 20 are highlighted.

 

 

＞The lack of a well-defined structure weakens the study's ability toeffectively guide the >reader through the theoretical and practicalaspects of the research.

>In Section 5.3, regarding the use of ultrasound imagingequipment, the authors claim the >method is "low-cost, simple,and repeatable" (lines 156-157). However, no comparative >dataor evidence is provided to substantiate this claim againstalternative clinical methods.

 

Thank you for your comment.

I have revised the paper in accordance with the reviewer's suggestions. I have created Table 1 to make it easier to compare with other testing methods. I have also added 24 references (Lines 172-175) that serve as the basis for the paper. As the reviewer said, I was only able to search for a few references, but I believe that the content is sufficiently conveyed to readers as a clinical judgment.

 

 

 

>Section 5.1 on marker methods (lines 95-117) references the useof SITZMARKS, but it does >not adequately integrate thesereferences into the broader context of the analysis, >leavingcritical gaps in the discussion.

 

5.1. has been significantly revised. Unnecessary context has been corrected to a proper storyline. Line 113 to Line 131 are highlighted.

 

 

>In the conclusion (lines 250-268), the authors suggest that theproposed method will >revolutionize constipation treatment.However, this optimism is unsupported by >comprehensive clinicaltrials or robust data, making the claim appear speculative.

>Drawing far-reaching conclusions without sufficient empiricalevidence risks overstating the >study's impact.

>Please reorganize the manuscript to establish a clearconnection between the introduction, >methodology, andconclusions. Eliminate vague and repetitive language, such as "asimple >but effective method", "low-cost, simple, and repeatable".The authors should replace such >vague statements with preciseinformation.

 

Following the reviewer's comments, we have significantly revised the discussion. We have placed emphasis on what we want to show in this study. We have also removed ambiguous expressions overall to avoid misunderstandings. Please see lines 261 to 275.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

The submitted manuscript "Use of Ultrasound Imaging Equipment to Evaluate Chronic Constipation in Home Health Care" is a very innovative manuscript with respect to a diagnostic approach that utilises ultrasound imaging for the assessment of chronic constipation, an increasingly common issue associated with significant effects on quality of life.
The research study nicely explains the usefulness of ultrasound in the three patterns of rectal fecal retention, thereby making appropriate interventions like avoiding unnecessary enemas, preventing complications due to hard stools, and optimizing treatment strategies with normal stool presence. This would be adding to developing new therapeutic paradigms also.
The authors have highlighted the limitation of traditional diagnostic methods, like radiopaque markers, MRI, and CT, as they are not as non-invasive, cost-effective, and repeatable as ultrasound, especially in home care settings.
I have some comments for improvement -
Despite the promise of this paper, deeper clinical validation of this approach might be necessary to validate this approach against the possible operator dependency and patient variability that may be encountered.
The similarity index needs to be checked specially for the top 6 sources shown in the report.
Finally, a discussion on how this method can be scaled up for broader healthcare implementation would strengthen its practical relevance.

Author Response

＜Comments to Reviewer 2＞

＞The submitted manuscript "Use of Ultrasound ImagingEquipment to Evaluate Chronic

Constipation in Home HealthCare" is a very innovative manuscript with respect to a diagnosticapproach that utilises ultrasound imaging for the assessment ofchronic constipation, an increasingly common issue associatedwith significant effects on quality of life.

The research study nicely explains the usefulness of ultrasoundin the three patterns of rectal fecal retention, thereby makingappropriate interventions like avoiding unnecessary enemas,preventing complications due to hard stools, and optimizingtreatment strategies with normal stool presence. This would beadding to developing new therapeutic paradigms also.

The authors have highlighted the limitation of traditionaldiagnostic methods, like radiopaque markers, MRI, and CT, asthey are not as non-invasive, cost-effective, and repeatable asultrasound, especially in home care settings.

I have some comments for improvement -

Despite the promise of this paper, deeper clinical validation ofthis approach might be necessary to validate this approachagainst the possible operator dependency and patient variabilitythat may be encountered.

 

The similarity index needs to be checked specially for the top 6sources shown in the report.

Finally, a discussion on how this method can be scaled up forbroader healthcare implementation would strengthen its practicalrelevance.

 

Thank you for your comments. I have made overall revisions in response to the reviewer's comments. I have highlighted the points that I particularly want to emphasize.

Also, in Line 161, I created and published a new Table 1. I have also added Reference 24 as evidence. I believe that this has made the content easier for readers to understand.

 

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I believe the authors have taken the reviewers' recommendations into account and have significantly improved the quality of the paper; therefore, I recommend its publication.