Reviewer's report
Title:Hormone Replacement Therapy is associated with Gastro-Oesophageal
Reflux Disease: a retrospective cohort study
Version: 1Date:10 November 2011
Reviewer: Tommy Lee
Reviewer's report:
Congratulations on a well written paper with some interesting statistical analysis.
While I appreciate the authors' attempt at clarifying an important question relation
to HRT and GORD, there are significant limitations in their study, which I think
bear further discussion.
Major Compulsory Revisions:
The weaknesses primarily stem around the definition of GORD and the use of
PPI prescription status:
1. GORD is often over-diagnosed and I am not convinced that this data is
providing a true estimation of the incidence of GORD in the population. Not
having standardized diagnostic criteria for GORD is a significant weakness,
especially considering how subjective GORD symptoms are, and how much they
overlap with dyspepsia and other gastric or esophageal pathology.
2. Similarly PPI use is not a reliable metric, as PPIs are not only generally
over-prescribed, but are also used to treat non-GORD conditions including peptic
ulcer disease, laryngopharyngeal reflux, and other forms of dyspepsia.
3. In addition, while the statistics are impressive, they could be focused more so
that it is clearer to the reader what the most relevant and important findings are.
Why are significant findings only occurring in certain analyses (univariate vs
adjusted etc.)? Can they comment further on this?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Hormone Replacement Therapy is associated with Gastro-Oesophageal
Reflux Disease: a retrospective cohort study
Version: 1Date:10 November 2011
Reviewer: Tommy Lee
Reviewer's report:
Congratulations on a well written paper with some interesting statistical analysis.
While I appreciate the authors' attempt at clarifying an important question relation
to HRT and GORD, there are significant limitations in their study, which I think
bear further discussion.
Major Compulsory Revisions:
The weaknesses primarily stem around the definition of GORD and the use of
PPI prescription status:
1. GORD is often over-diagnosed and I am not convinced that this data is
providing a true estimation of the incidence of GORD in the population. Not
having standardized diagnostic criteria for GORD is a significant weakness,
especially considering how subjective GORD symptoms are, and how much they
overlap with dyspepsia and other gastric or esophageal pathology.
2. Similarly PPI use is not a reliable metric, as PPIs are not only generally
over-prescribed, but are also used to treat non-GORD conditions including peptic
ulcer disease, laryngopharyngeal reflux, and other forms of dyspepsia.
3. In addition, while the statistics are impressive, they could be focused more so
that it is clearer to the reader what the most relevant and important findings are.
Why are significant findings only occurring in certain analyses (univariate vs
adjusted etc.)? Can they comment further on this?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Hormone Replacement Therapy is associated with Gastro-Oesophageal
Reflux Disease: a retrospective cohort study
Version: 1Date:10 November 2011
Reviewer: Tommy Lee
Reviewer's report:
Congratulations on a well written paper with some interesting statistical analysis.
While I appreciate the authors' attempt at clarifying an important question relation
to HRT and GORD, there are significant limitations in their study, which I think
bear further discussion.
Major Compulsory Revisions:
The weaknesses primarily stem around the definition of GORD and the use of
PPI prescription status:
1. GORD is often over-diagnosed and I am not convinced that this data is
providing a true estimation of the incidence of GORD in the population. Not
having standardized diagnostic criteria for GORD is a significant weakness,
especially considering how subjective GORD symptoms are, and how much they
overlap with dyspepsia and other gastric or esophageal pathology.
2. Similarly PPI use is not a reliable metric, as PPIs are not only generally
over-prescribed, but are also used to treat non-GORD conditions including peptic
ulcer disease, laryngopharyngeal reflux, and other forms of dyspepsia.
3. In addition, while the statistics are impressive, they could be focused more so
that it is clearer to the reader what the most relevant and important findings are.
Why are significant findings only occurring in certain analyses (univariate vs
adjusted etc.)? Can they comment further on this?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
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