Reviewer's report
Title:Patient-centered factors associated with hepatitis C treatment: a qualitative
study
Version:2Date:18 February 2015
Reviewer: Jay Kostman
Reviewer's report:
This manuscript addresses an important question regarding the factors
associated with treatment decisions for chronic hepatitis C from a patient
perspective. The authors used "semi-structured qualitative" interviews at four VA
Hospitals among three groups of patients to determine recurring themes of
participants descriptions of key decision making factors.
Major Compulsory revisions:
1. It is unclear to me from the methods and results what information is being
asked in the interviews. After the initial question that is posed that is listed on
page 4, what information was sought. The text notes that an array of topics
pertaiining to perceptions of CHC and its treatment were addressed, but it would
be helpful to know specifics. For instance, was the patient's knowledge about
HCV infection, disease progression, and available treatments assessed directly?
A patient's understanding of the disease process could clearly influence their
perceptions of the need for treatment.
2. The groups are small and were essentially selected based on their decisions
about treatment. It would be helpful to know if there were other clinical
charcteristics that were different between the groups. For instance, Did the
authors exclude people who had previously been treated for HCV? What about
co-infection with HIV or HBV? Active or past substance use, alcohol use? Were
patients in one of the groups more likely to have more advanced liver disease
(not just the perception of that)?
3. The authors correctly point out in the discussion that many of the factors
endorsed by patients may no longer be relevant in an Interferon-free era. They
point out that they are developing a tool to help patients that will still be useful.
Another way to address this in their interviews is to ask specifically if attitudes or
perceptions would be different if the regimen for treatment did not include
Interferon. Much of the negative feeling in the community about HCV treatment in
the past was related to Interferon.
Minor Essential revisions
1. Although I think that Figure 1 is a useful way to present the interactions
between the various factors reported by patients, the figure as it stands is difficult
to read and interpret.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Patient-centered factors associated with hepatitis C treatment: a qualitative
study
Version:2Date:18 February 2015
Reviewer: Jay Kostman
Reviewer's report:
This manuscript addresses an important question regarding the factors
associated with treatment decisions for chronic hepatitis C from a patient
perspective. The authors used "semi-structured qualitative" interviews at four VA
Hospitals among three groups of patients to determine recurring themes of
participants descriptions of key decision making factors.
Major Compulsory revisions:
1. It is unclear to me from the methods and results what information is being
asked in the interviews. After the initial question that is posed that is listed on
page 4, what information was sought. The text notes that an array of topics
pertaiining to perceptions of CHC and its treatment were addressed, but it would
be helpful to know specifics. For instance, was the patient's knowledge about
HCV infection, disease progression, and available treatments assessed directly?
A patient's understanding of the disease process could clearly influence their
perceptions of the need for treatment.
2. The groups are small and were essentially selected based on their decisions
about treatment. It would be helpful to know if there were other clinical
charcteristics that were different between the groups. For instance, Did the
authors exclude people who had previously been treated for HCV? What about
co-infection with HIV or HBV? Active or past substance use, alcohol use? Were
patients in one of the groups more likely to have more advanced liver disease
(not just the perception of that)?
3. The authors correctly point out in the discussion that many of the factors
endorsed by patients may no longer be relevant in an Interferon-free era. They
point out that they are developing a tool to help patients that will still be useful.
Another way to address this in their interviews is to ask specifically if attitudes or
perceptions would be different if the regimen for treatment did not include
Interferon. Much of the negative feeling in the community about HCV treatment in
the past was related to Interferon.
Minor Essential revisions
1. Although I think that Figure 1 is a useful way to present the interactions
between the various factors reported by patients, the figure as it stands is difficult
to read and interpret.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Patient-centered factors associated with hepatitis C treatment: a qualitative
study
Version:2Date:18 February 2015
Reviewer: Jay Kostman
Reviewer's report:
This manuscript addresses an important question regarding the factors
associated with treatment decisions for chronic hepatitis C from a patient
perspective. The authors used "semi-structured qualitative" interviews at four VA
Hospitals among three groups of patients to determine recurring themes of
participants descriptions of key decision making factors.
Major Compulsory revisions:
1. It is unclear to me from the methods and results what information is being
asked in the interviews. After the initial question that is posed that is listed on
page 4, what information was sought. The text notes that an array of topics
pertaiining to perceptions of CHC and its treatment were addressed, but it would
be helpful to know specifics. For instance, was the patient's knowledge about
HCV infection, disease progression, and available treatments assessed directly?
A patient's understanding of the disease process could clearly influence their
perceptions of the need for treatment.
2. The groups are small and were essentially selected based on their decisions
about treatment. It would be helpful to know if there were other clinical
charcteristics that were different between the groups. For instance, Did the
authors exclude people who had previously been treated for HCV? What about
co-infection with HIV or HBV? Active or past substance use, alcohol use? Were
patients in one of the groups more likely to have more advanced liver disease
(not just the perception of that)?
3. The authors correctly point out in the discussion that many of the factors
endorsed by patients may no longer be relevant in an Interferon-free era. They
point out that they are developing a tool to help patients that will still be useful.
Another way to address this in their interviews is to ask specifically if attitudes or
perceptions would be different if the regimen for treatment did not include
Interferon. Much of the negative feeling in the community about HCV treatment in
the past was related to Interferon.
Minor Essential revisions
1. Although I think that Figure 1 is a useful way to present the interactions
between the various factors reported by patients, the figure as it stands is difficult
to read and interpret.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant