Title: Symptoms, burden, and unmet needs of patients living with exocrine pancreatic
insufficiency: a narrative review of the patient experience
Version: 0 Date: 27 Jul 2023
Reviewer's report:
An interesting review,  and a summary of the impact of PEI on the patient is a much needed
topic for research, however, I have some concerns regarding your methodology.
Within your search terms, you have made some choices that have restricted your search results.
PEI AND pancreas
EPI AND pancreas
The use of the AND within this will exclude any studies that make reference to EPI / PEI and
a disease/surgical procedure, but as we should not see an abbreviation without the full text in a
title or abstract, I doubt this made a difference.
However,  "exocrine pancreas insufficiency" and "pancreas exocrine insufficiency" should have
been included
By not including the treatment within your search criteria you may have excluded interventions
studies, I would recommend the use of pancreatic enzyme replacement therapy, pancreatin,
pancrealipase, and pharmacological product names etc. within your MESH terms.  I assume
from the section within the text that you have done this,  and your table is a mistake (S6)
The inclusion of epigastric pain and the English spelling of diarrhoea / steatorrhoea and
coeliac disease, nutrition, oral intake, patient reported outcomes, mental health,  unmet needs,
osteopathy, would have been more inclusive search terms This is illustrated by the absence
of any studies on anxiety and depression, when these are frequent outcome measures in PEI
intervention trials so should have been identified from your inclusion criteria.  Certainly they
have been identified in other systematic reviews.
Your numbers don't add up, you reference 6 papers in the first section and 18 results in the
second section, but there are only 15 refences used by the time you complete the results section
of section 2.  Even assuming a 100%  cross over you have not described all 18 results
Search S5 and 6 appear to duplicate and should include adverse events, complications, side-
effects and should include aetiology  not just cause/risk.
Line 238 Complications, there are a lot of conflicting  and controversial data on fibrosing
colonopathy, one reference is insufficient to discuss this rare but catastrophic potential
complication. .
Lines 250-260 - please place references next to their appropriate statement rather than leaving
them all at the end of the paragraph.
It would be nice to summarise the results you do have, appreciating there are very different
methodologies and meta-analysis is not applicable, this paper doesn't really tell me very much
about the papers you found.  When you talk about common effects, it would be nice to put some
figures to these  - how common is common?
All in all, I am afraid I do not believe that your literature search is sufficient to have captured all
the relevant literature on this subject, and the provision of data is not specific enough to meet
the requirements for publication at this time.
Title: Symptoms, burden, and unmet needs of patients living with exocrine pancreatic
insufficiency: a narrative review of the patient experience
Version: 0 Date: 27 Jul 2023
Reviewer's report:
An interesting review,  and a summary of the impact of PEI on the patient is a much needed
topic for research, however, I have some concerns regarding your methodology.
Within your search terms, you have made some choices that have restricted your search results.
PEI AND pancreas
EPI AND pancreas
The use of the AND within this will exclude any studies that make reference to EPI / PEI and
a disease/surgical procedure, but as we should not see an abbreviation without the full text in a
title or abstract, I doubt this made a difference.
However,  "exocrine pancreas insufficiency" and "pancreas exocrine insufficiency" should have
been included
By not including the treatment within your search criteria you may have excluded interventions
studies, I would recommend the use of pancreatic enzyme replacement therapy, pancreatin,
pancrealipase, and pharmacological product names etc. within your MESH terms.  I assume
from the section within the text that you have done this,  and your table is a mistake (S6)
The inclusion of epigastric pain and the English spelling of diarrhoea / steatorrhoea and
coeliac disease, nutrition, oral intake, patient reported outcomes, mental health,  unmet needs,
osteopathy, would have been more inclusive search terms This is illustrated by the absence
of any studies on anxiety and depression, when these are frequent outcome measures in PEI
intervention trials so should have been identified from your inclusion criteria.  Certainly they
have been identified in other systematic reviews.
Your numbers don't add up, you reference 6 papers in the first section and 18 results in the
second section, but there are only 15 refences used by the time you complete the results section
of section 2.  Even assuming a 100%  cross over you have not described all 18 results
Search S5 and 6 appear to duplicate and should include adverse events, complications, side-
effects and should include aetiology  not just cause/risk.
Line 238 Complications, there are a lot of conflicting  and controversial data on fibrosing
colonopathy, one reference is insufficient to discuss this rare but catastrophic potential
complication. .
Lines 250-260 - please place references next to their appropriate statement rather than leaving
them all at the end of the paragraph.
It would be nice to summarise the results you do have, appreciating there are very different
methodologies and meta-analysis is not applicable, this paper doesn't really tell me very much
about the papers you found.  When you talk about common effects, it would be nice to put some
figures to these  - how common is common?
All in all, I am afraid I do not believe that your literature search is sufficient to have captured all
the relevant literature on this subject, and the provision of data is not specific enough to meet
the requirements for publication at this time.
Please review this paper.
user
Title: Symptoms, burden, and unmet needs of patients living with exocrine pancreatic
insufficiency: a narrative review of the patient experience
Version: 0 Date: 27 Jul 2023
Reviewer's report:
An interesting review,  and a summary of the impact of PEI on the patient is a much needed
topic for research, however, I have some concerns regarding your methodology.
Within your search terms, you have made some choices that have restricted your search results.
PEI AND pancreas
EPI AND pancreas
The use of the AND within this will exclude any studies that make reference to EPI / PEI and
a disease/surgical procedure, but as we should not see an abbreviation without the full text in a
title or abstract, I doubt this made a difference.
However,  "exocrine pancreas insufficiency" and "pancreas exocrine insufficiency" should have
been included
By not including the treatment within your search criteria you may have excluded interventions
studies, I would recommend the use of pancreatic enzyme replacement therapy, pancreatin,
pancrealipase, and pharmacological product names etc. within your MESH terms.  I assume
from the section within the text that you have done this,  and your table is a mistake (S6)
The inclusion of epigastric pain and the English spelling of diarrhoea / steatorrhoea and
coeliac disease, nutrition, oral intake, patient reported outcomes, mental health,  unmet needs,
osteopathy, would have been more inclusive search terms This is illustrated by the absence
of any studies on anxiety and depression, when these are frequent outcome measures in PEI
intervention trials so should have been identified from your inclusion criteria.  Certainly they
have been identified in other systematic reviews.
Your numbers don't add up, you reference 6 papers in the first section and 18 results in the
second section, but there are only 15 refences used by the time you complete the results section
of section 2.  Even assuming a 100%  cross over you have not described all 18 results
Search S5 and 6 appear to duplicate and should include adverse events, complications, side-
effects and should include aetiology  not just cause/risk.
Line 238 Complications, there are a lot of conflicting  and controversial data on fibrosing
colonopathy, one reference is insufficient to discuss this rare but catastrophic potential
complication. .
Lines 250-260 - please place references next to their appropriate statement rather than leaving
them all at the end of the paragraph.
It would be nice to summarise the results you do have, appreciating there are very different
methodologies and meta-analysis is not applicable, this paper doesn't really tell me very much
about the papers you found.  When you talk about common effects, it would be nice to put some
figures to these  - how common is common?
All in all, I am afraid I do not believe that your literature search is sufficient to have captured all
the relevant literature on this subject, and the provision of data is not specific enough to meet
the requirements for publication at this time.
assistant