Reviewer's report 
 The Impact of Illness in Patients with Moderate to Severe Gastro Esophageal Reflux Disease Title: 
 1  8 March 2005 Version: Date: 
 Vic Velanovich Reviewer: 
Reviewer's report: 
General: Overall, this is another study demonstrating that gastroesophageal reflux disease has a 
significant quality of life impact. What is unique about this study is the attempt to correlate quality of 
life with patient-reported utility 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) I have major concerns about the statistical analysis. The data is reported as means with 95% confidence intervals and compared to data which was NOT part of this study using the Students' t-test. Firstly, although the data is continuous in nature, the authors do not test whether it 
follows a normal distribution (e.g., with a Wilk-Shapiro test). Secondly, in general, statisticians do not 
advocate taking a data set from one experiment and running tests of statistical inference with 
another data set, as the authors do here comparing SF-36 scores with Canadian and American scores from other studies. This gives the illusion of statistical objectivity which may not be justified. I 
have no problem with comparing data sets, but I would recommend doing it in a qualitative manner 
rather than with statistical tests. Lastly, the authors make value judgements definitions of symptom 
severity (Table 1) and strenght of correlations (p. 11, statistical analysis). How were these judgments 
made? Why should "cannot be ignored but does not influence my daily life" equate with a moderate 
problem? Why should a correlation of >0.5 be considered strong. 
My final concern deals with ref. #27. How different is the present study from the one the authors have in press? 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) None 
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Discretionary Revisions (which the author can choose to ignore) 
Why did the authors choose the quality of life instruments they used? I do not think this will change 
the essence of the paper, but I think it is important to know. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Reviewer's report 
 The Impact of Illness in Patients with Moderate to Severe Gastro Esophageal Reflux Disease Title: 
 1  8 March 2005 Version: Date: 
 Vic Velanovich Reviewer: 
Reviewer's report: 
General: Overall, this is another study demonstrating that gastroesophageal reflux disease has a 
significant quality of life impact. What is unique about this study is the attempt to correlate quality of 
life with patient-reported utility 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) I have major concerns about the statistical analysis. The data is reported as means with 95% confidence intervals and compared to data which was NOT part of this study using the Students' t-test. Firstly, although the data is continuous in nature, the authors do not test whether it 
follows a normal distribution (e.g., with a Wilk-Shapiro test). Secondly, in general, statisticians do not 
advocate taking a data set from one experiment and running tests of statistical inference with 
another data set, as the authors do here comparing SF-36 scores with Canadian and American scores from other studies. This gives the illusion of statistical objectivity which may not be justified. I 
have no problem with comparing data sets, but I would recommend doing it in a qualitative manner 
rather than with statistical tests. Lastly, the authors make value judgements definitions of symptom 
severity (Table 1) and strenght of correlations (p. 11, statistical analysis). How were these judgments 
made? Why should "cannot be ignored but does not influence my daily life" equate with a moderate 
problem? Why should a correlation of >0.5 be considered strong. 
My final concern deals with ref. #27. How different is the present study from the one the authors have in press? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) None 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
Why did the authors choose the quality of life instruments they used? I do not think this will change 
the essence of the paper, but I think it is important to know. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Please review this paper.
user
Reviewer's report 
 The Impact of Illness in Patients with Moderate to Severe Gastro Esophageal Reflux Disease Title: 
 1  8 March 2005 Version: Date: 
 Vic Velanovich Reviewer: 
Reviewer's report: 
General: Overall, this is another study demonstrating that gastroesophageal reflux disease has a 
significant quality of life impact. What is unique about this study is the attempt to correlate quality of 
life with patient-reported utility 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) I have major concerns about the statistical analysis. The data is reported as means with 95% confidence intervals and compared to data which was NOT part of this study using the Students' t-test. Firstly, although the data is continuous in nature, the authors do not test whether it 
follows a normal distribution (e.g., with a Wilk-Shapiro test). Secondly, in general, statisticians do not 
advocate taking a data set from one experiment and running tests of statistical inference with 
another data set, as the authors do here comparing SF-36 scores with Canadian and American scores from other studies. This gives the illusion of statistical objectivity which may not be justified. I 
have no problem with comparing data sets, but I would recommend doing it in a qualitative manner 
rather than with statistical tests. Lastly, the authors make value judgements definitions of symptom 
severity (Table 1) and strenght of correlations (p. 11, statistical analysis). How were these judgments 
made? Why should "cannot be ignored but does not influence my daily life" equate with a moderate 
problem? Why should a correlation of >0.5 be considered strong. 
My final concern deals with ref. #27. How different is the present study from the one the authors have in press? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) None 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
Why did the authors choose the quality of life instruments they used? I do not think this will change 
the essence of the paper, but I think it is important to know. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
assistant