Reviewer's report
Title:The study of visceral hypersensitivity and psychological stress in
gastroesophageal reflux disease
Version: 2Date:21 February 2011
Reviewer: Daniel Sifrim
Reviewer's report:
The manuscript is much improved. The study focus and narrative is more clearly
defined and communicated, and the written English is now excellent.
Specific comments:
• The study question is now well defined, and scientifically relevant.
• The methods are well described. The acid/saline/anticipation protocol might
have been better in a random fashion. For example, the psychological
anticipation to a perfusion that “may cause heartburn” is likely to be altered
depending on whether or not they actually felt heartburn during the prior acid
infusion.
• The authors’ use of the NERD-SI- group is accepted. The group is still likely to
include those with FH. It would also be of interest to know the SI in the other
groups.
• The data appears sound. The dramatic reduction in the reported recruitment
numbers presumably reflects the elimination of a large part of the psychological
data.
• The conclusions now fit the data more accurately. Obviously a large volume of
data has been filtered to make these conclusions, and this must be remembered
in interpreting the results. However the principle that brain activation between the
groups may differ is an interesting one and deserves further study.
Discussion of limitations:
This is a useful addition. I agree that the checking of PPI responsiveness in all
groups would have been appropriate. I feel that the authors sell themselves short
by making this the last section of the article. It could be put earlier in the
discussion, leaving the final paragraph as a positive statement about their
interesting findings.
Importance:
The content of the paper is of significant interest to people interested in the
pathogenesis of GERD.
Major compulsory revisions:
Nil
Minor compulsory revisions
Nil
Discretionary revisions
1. Place the comments of limitations earlier in discussion.
Recommendation
• Accept after discretionary revisions
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
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:The study of visceral hypersensitivity and psychological stress in
gastroesophageal reflux disease
Version: 2Date:21 February 2011
Reviewer: Daniel Sifrim
Reviewer's report:
The manuscript is much improved. The study focus and narrative is more clearly
defined and communicated, and the written English is now excellent.
Specific comments:
• The study question is now well defined, and scientifically relevant.
• The methods are well described. The acid/saline/anticipation protocol might
have been better in a random fashion. For example, the psychological
anticipation to a perfusion that “may cause heartburn” is likely to be altered
depending on whether or not they actually felt heartburn during the prior acid
infusion.
• The authors’ use of the NERD-SI- group is accepted. The group is still likely to
include those with FH. It would also be of interest to know the SI in the other
groups.
• The data appears sound. The dramatic reduction in the reported recruitment
numbers presumably reflects the elimination of a large part of the psychological
data.
• The conclusions now fit the data more accurately. Obviously a large volume of
data has been filtered to make these conclusions, and this must be remembered
in interpreting the results. However the principle that brain activation between the
groups may differ is an interesting one and deserves further study.
Discussion of limitations:
This is a useful addition. I agree that the checking of PPI responsiveness in all
groups would have been appropriate. I feel that the authors sell themselves short
by making this the last section of the article. It could be put earlier in the
discussion, leaving the final paragraph as a positive statement about their
interesting findings.
Importance:
The content of the paper is of significant interest to people interested in the
pathogenesis of GERD.
Major compulsory revisions:
Nil
Minor compulsory revisions
Nil
Discretionary revisions
1. Place the comments of limitations earlier in discussion.
Recommendation
• Accept after discretionary revisions
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
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:The study of visceral hypersensitivity and psychological stress in
gastroesophageal reflux disease
Version: 2Date:21 February 2011
Reviewer: Daniel Sifrim
Reviewer's report:
The manuscript is much improved. The study focus and narrative is more clearly
defined and communicated, and the written English is now excellent.
Specific comments:
• The study question is now well defined, and scientifically relevant.
• The methods are well described. The acid/saline/anticipation protocol might
have been better in a random fashion. For example, the psychological
anticipation to a perfusion that “may cause heartburn” is likely to be altered
depending on whether or not they actually felt heartburn during the prior acid
infusion.
• The authors’ use of the NERD-SI- group is accepted. The group is still likely to
include those with FH. It would also be of interest to know the SI in the other
groups.
• The data appears sound. The dramatic reduction in the reported recruitment
numbers presumably reflects the elimination of a large part of the psychological
data.
• The conclusions now fit the data more accurately. Obviously a large volume of
data has been filtered to make these conclusions, and this must be remembered
in interpreting the results. However the principle that brain activation between the
groups may differ is an interesting one and deserves further study.
Discussion of limitations:
This is a useful addition. I agree that the checking of PPI responsiveness in all
groups would have been appropriate. I feel that the authors sell themselves short
by making this the last section of the article. It could be put earlier in the
discussion, leaving the final paragraph as a positive statement about their
interesting findings.
Importance:
The content of the paper is of significant interest to people interested in the
pathogenesis of GERD.
Major compulsory revisions:
Nil
Minor compulsory revisions
Nil
Discretionary revisions
1. Place the comments of limitations earlier in discussion.
Recommendation
• Accept after discretionary revisions
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
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
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