Submited on: 12 Sep 2010 02:18:04 PM GMT
Published on: 12 Sep 2010 07:21:59 PM GMT
 

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? No
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    The article is quite informative and opting ofr a practical approach on a common problem in emergency medicine. Some minor issues should be adressed. Inline with review nr. 2 the conclusion that a metaldetector might supercede the gold-standard remains speculative as the evidence for this fact is missing. (Doyle D.Review of the use of metal detectors for foreign body detection[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by ].WebmedCentral 1970;1(12):REVIEW_REF_NUM292)

    It must be mentioned here, that the detection of a metal body by metal detector not reveals the potentially interesting anatomical position within the intestinesbut more the general localisation, as well (as mentioned by the author) leaves some doubt regarding if the ingested metal body is situated in the epigastric area. As some patients might present with preexisting metallic foreign body not tied to the actual complaint nor mentioned in the anamnesis, one should be careful to omit radiography if metaldetectors cannot distinguish between several foreign bodies in close proximity in the detection field. It might be worth to mention how hand-held metal detectors actually work - the short and long term effects of magnetic induction on organisms should be named when discussing the potential harm of radiography.

    The flow-chart in figure 1 would benefit from the insertion of piles or lines connecting the different steps, as the number of different boxes presented might seem a little confusing for the reader about how to proceed. 

     The conclusion is very weak, as the further development cannot be foreseen by the author. A better conclusion would be that metal detectors have the potential to find ingested metallic foreign bodies but that their place in the clinical management still needs to be defined. It might be that metal detectors could be a supplement to X-ray or used as a screening tool if avialbility of radiology is impaired as in remote areas. In such a case, the potential role for other diagnostic techniques could be named (CT-scan, ultrasound and endoscopy for example). Finally, it might be worth mentioning that other but metallic bodies might show on radiography, an that a "negative" radiography might give information about the nature of potentially ingested foreign bodies, too.

    Reference 18 is incomplete regarding the journal where it can be found.

     

    Overall, the article is nice and worth reading but should be improved.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Senior Emergency physician

  • How to cite:  Schilling U .Review of the article: The Use Of Metal Detectors As A Tool For Diagnosing ingested metal foreign bodies - a review[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;2(9):WMCRW00921
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1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    I would like to express gratitude to the author on his work. He addresses an important and practical topic that is commonly encountered and managed without any strong evidence benchmark.

     

    I feel the article explains the potential benefits and disadvantages of using X- rays and metal detectors. It may not deliver the final blow but the attempt to find an answer was positive enough.

     

    I felt the mangement algorith using metal detectors was a useful and a strong contribution to the article, giving practical guidelines to clinicians.

     

    The conclusion in its present form is vague and disappointing. It was not solid and did not have any basis from the studies researched with in the article. Instead it relies on the development of technology in the future, which may or may not occur. If this was tightened up,this would of been a study of exceptional quality.

     

     

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Surgery, assessment and medical education

  • How to cite:  Arshad I .The use of metal detectors as a tool for diagnosing ingested metal foreign bodies A Review [Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;2(3):WMCRW00548
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1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? No
9 Are the illustrations and tables necessary and acceptable? No
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

     

    This is a potentially useful article in need of improvement. It should be noted that a metal detector will fail to detect nonmetallic foreign bodies that are radio-opaque, and thus readily apparent radiographically. I cannot agree that “If the history of a metal object ingestion is definite then a metal detector may even supercede the gold standard of X-Rays.” Reference 18 is incomplete. Table 2 is missing. So are Table 1 and Figure 1, apparently. Finally, the manuscript should be edited for content and clarity.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    None

  • How to cite:  Doyle D .Review of the use of metal detectors for foreign body detection[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;1(12):WMCRW00292
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1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This is an interesting article on an issue which one can encounter within the Emergency Department. Extensive effort has been made to search the various literature sources available and seek out the relevant information from several locations, and the author should be commended for this.

     

    Points to consider:

     

    • Both abstract and introduction in this article are identical.  The abstract does state a short summary of the scholarly article but lacks a conclusion.
    • Stating that X-Radiographs have been considered as the gold standard of detecting any swallowed metal foreign bodies would stand in better order if referenced.
    • It would be interesting to find out the percentage of patients who have non operative intervention compared to those who require surgery, as well as the mortality rate following metal foreign body ingestion.
    • X-Radiographs should be corrected to X-radiographs.
    • Highlight importance of greater awareness in children, as the duration of the foreign body in the oesophagus may be unknown and presentation may only be with the onset of symptoms.
    • Comment on other investigation and therapeutic options available to the physician and their associated problems e.g. a contrast examination should not be performed routinely because of the risk of aspiration and because coating of the foreign body and oesophageal mucosa compromises subsequent endoscopy.  CT scanning may be useful in some cases but may be negative with radiolucent objects. Persistent symptoms related to the oesophagus in cases of suspected foreign body ingestion should be pursued with endoscopy even after an apparently unrevealing radiographic evaluation.
    • What is the availability of hand held metal detectors? What percentage of e.g. UK Emergency Departments have access to the device or are using a hand held metal detector? 
    • Within the discussion section, there is no mention of quantity or the type of  metal foreign body ingested e.g. pins, sharp objects, batteries.  It would be better to explain this further then stating that ‘If a patient is asymptomatic and a metal foreign body is detected below the oesophagus then the child should be discharged with the possibility of a follow up appointment in 1 week….’  Once through the oesophagus, the majority of ingested foreign bodies pass through the alimentary tract uneventfully, including sharp-pointed objects.  However, the risk of perforation is higher when sharp or pointed metallic objects, and a period of close observation would be more appropriate.

     

  • Competing interests:
    No
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    None

  • How to cite:  Rahbour G .Review of 'The use of metal detectors as a tool for diagnosing ingested metal foreign bodies A Review'[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;1(12):WMCRW00217
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The Issues of Incapacity to Consent
Posted by Dr. William J Maloney on 09 Feb 2014 10:25:22 PM GMT Reviewed by Interested Peers

  • What are the main claims of the paper and how important are they?

    The author's aim is to highlightthe reasons for a limb amputation and the issues surrounding the incapacity to consent.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes- It would be a very good lecture for any healthcare professional providing direct patient care.


  • Other Comments:

    The author discusses various methods by which an individual's capacity to consent is assessed. The author stresses that autonomy is the most fundamental point of consent and that incapacitated patients have, essentially, a non-existent level of outonomy.  The author advises surgeons to be aware of the local laws regarding consent.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:

    None

  • Experience and credentials in the specific area of science:

    Clinical associate professor

  • How to cite:  Maloney W J.The Issues of Incapacity to Consent[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;5(2):WMCRW002963
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1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? No
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This is a useful, if rather unpolished, contribution to the literature. Although this paper is classified under "Quality and Patient Safety", it is especially likely to be interest resders looking in the "Medical Ethics" section. The author notes that issues of consent have "become an extremely contentious issue in recent years especially due to the Alder Hey and Bristol scandals." Unfortunately, these events are unlikely to be well known to clinicians outside the UK, so a reference or two in this regard would be helpful. (For instance: English V, Sommerville A. Presumed consent for transplantation: a dead issue after Alder Hey? J Med Ethics. 2003 Jun;29(3):147-52.) A similar situaltion exists with the author's reference to the "Bournewood case." Abbreviations such as GMC,PRHO and QOL should be listed in a table for easy reference. The section "Author's Contributions" should be revised; as it stands the section explains the objectives of the article. The references are incomplete in many cases. Reference 31 referring to the 10 commandments might benefit from a more appropriate reference. Reference 32 contains a spelling error. Finally, I recommend polishing of the paper for content and clarity.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:
    Doyle DJ. An Introduction to Bioethics and Ethical Theory. Ethics in Biology, Engineering and Medicine. 1:19-41 (2010)
  • Experience and credentials in the specific area of science:

    Certificate in Bioethics, Cleveland State University.

  • How to cite:  Doyle D .Review of "The Issues of Incapacity to Give Consent"[Review of the article 'The Use of Metal Detectors as a Tool for Diagnosing Ingested Metal Foreign Bodies- A Review ' by Siddiqui M].WebmedCentral 2011;1(12):WMCRW00289
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