Reviewer ’s report  
 
Title: Self-reported dietary adherence, disease -specific symptoms, and quality of life are  
associated with healthcare provider follow -up in celiac disease  
 
Version: 0 Date: 22 May 2017  
 
Reviewer: Patrizia Zentilin  
 
Reviewer's report:  
 
The Authors conducted a survey of members of Beyond Celiac, a national patient advocacy 
groups in USA, collecting responses from a large number of adults who reported having celiac 
disease, evaluating dietary adherence, disease -specific symptoms, and quality of life and  
association with healthcare provider follow -up in celiac disease. The research original, novel and 
the Authors have done a good job, especially for the number of respondents. Methodology is 
accurate. General logic and justification  of interpretations and conclusions are obvious.  
The same authors suggest the limitations of the study. It could suffer from self -selection bias 
based on who received notification of the survey; the information are reported by patients and 
there is no doc umentation for controlling the veracity of the data;  the study is cross -sectional 
and observational, so it is not possible to determine causality in the associations observed. These 
are essential limitations, but it cannot be left out of the large number of participants.  
Supplementary material  
Figure S4: It is amazing that autoimmune thyroiditis does not appear in autoimmune diseases 
related with celiac disease, because the presence of CD  could favor the appearance of 
autoimmune thyroiditis (Naiyer AJ et al. Tissue transglutaminase antibodies in individuals with 
celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid 
dysfunction. Thyroid 2008; 18:1171 -8; Leerner A et al.Gut -thyroid axis and celiac disease. 
Endocrine Connections 2017; 6:R52 -8). 
Page 11, line 29: .. associated with improvement (?) of….  
Figure 1 legend: explain more clearly "Pr (visited HCP)".  
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing  interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents rel ating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interes ts? 
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any at tachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Self-reported dietary adherence, disease -specific symptoms, and quality of life are  
associated with healthcare provider follow -up in celiac disease  
 
Version: 0 Date: 22 May 2017  
 
Reviewer: Patrizia Zentilin  
 
Reviewer's report:  
 
The Authors conducted a survey of members of Beyond Celiac, a national patient advocacy 
groups in USA, collecting responses from a large number of adults who reported having celiac 
disease, evaluating dietary adherence, disease -specific symptoms, and quality of life and  
association with healthcare provider follow -up in celiac disease. The research original, novel and 
the Authors have done a good job, especially for the number of respondents. Methodology is 
accurate. General logic and justification  of interpretations and conclusions are obvious.  
The same authors suggest the limitations of the study. It could suffer from self -selection bias 
based on who received notification of the survey; the information are reported by patients and 
there is no doc umentation for controlling the veracity of the data;  the study is cross -sectional 
and observational, so it is not possible to determine causality in the associations observed. These 
are essential limitations, but it cannot be left out of the large number of participants.  
Supplementary material  
Figure S4: It is amazing that autoimmune thyroiditis does not appear in autoimmune diseases 
related with celiac disease, because the presence of CD  could favor the appearance of 
autoimmune thyroiditis (Naiyer AJ et al. Tissue transglutaminase antibodies in individuals with 
celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid 
dysfunction. Thyroid 2008; 18:1171 -8; Leerner A et al.Gut -thyroid axis and celiac disease. 
Endocrine Connections 2017; 6:R52 -8). 
Page 11, line 29: .. associated with improvement (?) of….  
Figure 1 legend: explain more clearly "Pr (visited HCP)".  
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing  interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents rel ating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interes ts? 
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any at tachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Self-reported dietary adherence, disease -specific symptoms, and quality of life are  
associated with healthcare provider follow -up in celiac disease  
 
Version: 0 Date: 22 May 2017  
 
Reviewer: Patrizia Zentilin  
 
Reviewer's report:  
 
The Authors conducted a survey of members of Beyond Celiac, a national patient advocacy 
groups in USA, collecting responses from a large number of adults who reported having celiac 
disease, evaluating dietary adherence, disease -specific symptoms, and quality of life and  
association with healthcare provider follow -up in celiac disease. The research original, novel and 
the Authors have done a good job, especially for the number of respondents. Methodology is 
accurate. General logic and justification  of interpretations and conclusions are obvious.  
The same authors suggest the limitations of the study. It could suffer from self -selection bias 
based on who received notification of the survey; the information are reported by patients and 
there is no doc umentation for controlling the veracity of the data;  the study is cross -sectional 
and observational, so it is not possible to determine causality in the associations observed. These 
are essential limitations, but it cannot be left out of the large number of participants.  
Supplementary material  
Figure S4: It is amazing that autoimmune thyroiditis does not appear in autoimmune diseases 
related with celiac disease, because the presence of CD  could favor the appearance of 
autoimmune thyroiditis (Naiyer AJ et al. Tissue transglutaminase antibodies in individuals with 
celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid 
dysfunction. Thyroid 2008; 18:1171 -8; Leerner A et al.Gut -thyroid axis and celiac disease. 
Endocrine Connections 2017; 6:R52 -8). 
Page 11, line 29: .. associated with improvement (?) of….  
Figure 1 legend: explain more clearly "Pr (visited HCP)".  
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of  competing  interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents rel ating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interes ts? 
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any at tachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant