Reviewer ’s report  
Title: Sex and Ethnic/Racial -specific Risk Factors for Gallbladder Disease  
 
Version: 0 Date: 04 Sep 2016  
 
Reviewer: Jayaprakash Sreenarasimhaiah  
 
Reviewer's report:  
The study does not seem unique except in its subject size. This does not add new information - 
the epidemiology and risk factors of gallbladder disease has been very well described and studied 
as the authors also express in the introduction. Not sure how much more this paper adds. The 
novelty of this paper should be clarified.  
Inclusion of all chocystectomies for this study may not be as accurate. Not all patients have 
cholelithiasis and the rest have been called gallbladder disease because they had 
cholecystectomy. Is there pathology to show these were chronic cholecystitis at least. Many 
cholecystectomies are unnecessarily done (up to 40% in some studies) for gallbladder dyskinesia 
which is a controversial cause of abdominal pain as many will still have pain after 
cholecystectomy and should never have had this in the first place. It would be best to clarify the 
pathology or exclude those that were not with stones.  
Otherwise, a very large series and good statistical analysis  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 recommende d, please specify what aspects require 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 interest s 
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 pub lication 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 cu rrently applying for any patents relating 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 interests?  
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 belo w. 
 
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 attachments I up load 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 no t 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: Sex and Ethnic/Racial -specific Risk Factors for Gallbladder Disease  
 
Version: 0 Date: 04 Sep 2016  
 
Reviewer: Jayaprakash Sreenarasimhaiah  
 
Reviewer's report:  
The study does not seem unique except in its subject size. This does not add new information - 
the epidemiology and risk factors of gallbladder disease has been very well described and studied 
as the authors also express in the introduction. Not sure how much more this paper adds. The 
novelty of this paper should be clarified.  
Inclusion of all chocystectomies for this study may not be as accurate. Not all patients have 
cholelithiasis and the rest have been called gallbladder disease because they had 
cholecystectomy. Is there pathology to show these were chronic cholecystitis at least. Many 
cholecystectomies are unnecessarily done (up to 40% in some studies) for gallbladder dyskinesia 
which is a controversial cause of abdominal pain as many will still have pain after 
cholecystectomy and should never have had this in the first place. It would be best to clarify the 
pathology or exclude those that were not with stones.  
Otherwise, a very large series and good statistical analysis  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 recommende d, please specify what aspects require 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 interest s 
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 pub lication 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 cu rrently applying for any patents relating 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 interests?  
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 belo w. 
 
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 attachments I up load 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 no t 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: Sex and Ethnic/Racial -specific Risk Factors for Gallbladder Disease  
 
Version: 0 Date: 04 Sep 2016  
 
Reviewer: Jayaprakash Sreenarasimhaiah  
 
Reviewer's report:  
The study does not seem unique except in its subject size. This does not add new information - 
the epidemiology and risk factors of gallbladder disease has been very well described and studied 
as the authors also express in the introduction. Not sure how much more this paper adds. The 
novelty of this paper should be clarified.  
Inclusion of all chocystectomies for this study may not be as accurate. Not all patients have 
cholelithiasis and the rest have been called gallbladder disease because they had 
cholecystectomy. Is there pathology to show these were chronic cholecystitis at least. Many 
cholecystectomies are unnecessarily done (up to 40% in some studies) for gallbladder dyskinesia 
which is a controversial cause of abdominal pain as many will still have pain after 
cholecystectomy and should never have had this in the first place. It would be best to clarify the 
pathology or exclude those that were not with stones.  
Otherwise, a very large series and good statistical analysis  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 recommende d, please specify what aspects require 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 interest s 
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 pub lication 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 cu rrently applying for any patents relating 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 interests?  
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 belo w. 
 
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 attachments I up load 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 no t 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