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Article
Peer-Review Record

Rapid Remote Online Evaluation in Endoscopic Diagnostics: An Analysis of Biopsy-Proven Respiratory Cytopathology

Diagnostics 2023, 13(21), 3329; https://doi.org/10.3390/diagnostics13213329
by Hatice Elmas 1,*, Binnur Önal 2, Stefan Steurer 1, Birgit Hantzsch-Kuhn 3,4, Martin Claussen 3,4, Elnur Mehdi 5, Ümit Ince 2, Klaus F. Rabe 3,4, Guido Sauter 1 and Lutz Welker 1,4
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Diagnostics 2023, 13(21), 3329; https://doi.org/10.3390/diagnostics13213329
Submission received: 21 September 2023 / Revised: 23 October 2023 / Accepted: 23 October 2023 / Published: 28 October 2023
(This article belongs to the Special Issue Cyto-Histological Correlations in Pathology Diagnosis)

Round 1

Reviewer 1 Report

This is an interesting study that shows the feasibility of using a remote setup for analysis of cytopathology specimens. If available, it may be helpful to provide details on what remote transmission settings were used in the study (resolution, frames per second).

 

I found some typographical errors:

Figure 2c: "Assistant staff" was spelled as "Assistent staff"

Table 2a - Malignant was spelled as "Malign"

 

Author Response

Dear Sir/Madame, To whom it may concern,

  • This is an interesting study that shows the feasibility of using a remote setup for analysis of cytopathology specimens. If available, it may be helpful to provide details on what remote transmission settings were used in the study (resolution, frames per second).

Answer: Transmission resolutions can vary from high-definition (1920x1200) to 4K (3840x3840) to adapt to different bandwidth requirements. Adjustable frame rate between 15 and 60 FPS ensures performance on connections between 15 and 80 Mbps.

  • Quality of English Language

Figure 2c: "Assistant staff" was spelled as "Assistent staff"

Answer: The text in Fig. 2c has been changed from "Assistant staff" to "Assistant staff".

 

  • Table 2a - Malignant was spelled as "Malign"

Answer: The text in Fig. 2a has been changed from "Malign" to "Malignant".

Other changes

  1. 1, Line 20: grammar corrected
  2. 1, Line 25-28: figures checked again
  3. 4, Figure 2a,b: Image ncreased (due to copyright)
  4. 4, Line 69: structure improved.
  5. 4, Line 81: grammar corrected
  6. 3, Line 105, Table 1b: grammar corrected.
  7. 4, Figure 2a,b: resolution quality increased
  8. 4, Figure 3: has been changed from "Assistant staff" to "Assistant staff".
  9. 5, Line 148,157: content expanded
  10. 6, Line 163: content expanded
  11. 7, Line 184: figures checked again
  12. 7, Line 197, Table 2a: grammar corrected, content expanded
  13. 7, Line 197, Table 2b: figures checked again
  14. 7, Line 197, Table 2a: grammar corrected, content expanded
  15. 8, Line 212, Table 3a,b: grammar corrected, content expanded, figures checked again
  16. 10, Line 296: content expanded
  17. 10, Line 311, Table 5: simplified

"Please see the attachment."

Thank you for this correct.

Kind regard

---------------------------------------------------------------

Reviewer 2 Report

General remarks

In the present paper, the authors evaluated the usefulness of the Rapid Remote Online Evaluation in endoscopic diagnosis. The paper is overall useful for the cytologist.

Specific remarks

In the table 2a, it is seen that out of 86 benign diagnoses reported by endoscopy, a large number (20) cases were malignant. The finding is quite unexpected. The authors should explain this discrepancy. The finding must affect the sensitivity and specificity.

 

The authors got high diagnostic accuracy because they removed a large number of inadequate diagnosis (38). They should discuss details of these cases. 

 

Author Response

Dear Sir/Madame, To whom it may concern,

In the present paper, the authors evaluated the usefulness of the Rapid Remote Online Evaluation in endoscopic diagnosis. The paper is overall useful for the cytologist.

Specific remarks

In the table 2a, it is seen that out of 86 benign diagnoses reported by endoscopy, a large number (20) cases were malignant. The finding is quite unexpected. The authors should explain this discrepancy. The finding must affect the sensitivity and specificity.

Answer:

Specificity is the percentage of correctly negative tests in all healthy subjects, i.e. RN/(FP+RN).

The number of false negative findings in a group of patients suffering on malignant tumours did not affected the specificity per definition. However, it is of course relevant for the sensitivity. The sensitivity is reduced in this situation to overall 78.6% Tab. 2b.

 

Other Question:

The authors got high diagnostic accuracy because they removed a large number of inadequate diagnosis (38). They should discuss details of these cases.  They should discuss details of these cases.

  1. 6, Line 163:

figures checked again

Of the 37 undefined samples, 11 were still unclear at the end according to cytological crite-ria and four of these according to histological criteria. One major reason for the large num-ber of unclear samples is the lack of representative cell and tissue fragments. The results of the rapid cytological assessment prompted the endoscopists in this situation to intensify biopsy diagnostics and to perform repeated biopsies per sampling site. Accordingly, the number of inconclusive biopsies is reduced to six in the end (Table 2a).

 

Other changes

  1. 1, Line 20: grammar corrected
  2. 1, Line 25-28: figures checked again
  3. 4, Figure 2a,b: Image ncreased (due to copyright)
  4. 4, Line 69: structure improved.
  5. 4, Line 81: grammar corrected
  6. 3, Line 105, Table 1b: grammar corrected.
  7. 4, Figure 2a,b: resolution quality increased
  8. 4, Figure 3: has been changed from "Assistant staff" to "Assistant staff".
  9. 5, Line 148,157: content expanded
  10. 6, Line 163: content expanded
  11. 7, Line 184: figures checked again
  12. 7, Line 197, Table 2a: grammar corrected, content expanded
  13. 7, Line 197, Table 2b: figures checked again
  14. 7, Line 197, Table 2a: grammar corrected, content expanded
  15. 8, Line 212, Table 3a,b: grammar corrected, content expanded, figures checked again
  16. 10, Line 296: content expanded
  17. 10, Line 311, Table 5: simplified 

"Please see the attachment."

Sincerely yours, 

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