Reviewer's report
Title:A comparison of diagnostic tests for lactose malabsorption - which one is
the best?
Version: 1Date:13 July 2009
Reviewer: Antonio Tursi
Reviewer's report:
This is an interesting study comparing several common tests to diagnose lactose
malabsorption. The authors found that the combination H2+CH4 is the best test
to diagnose malabsorption.
I mean that this study needs of Major compulsory revisions.
The most weakness is that this report did not consider the statements about this
field recently published by the Rome Consensus Conference in APT (Gasbarrini
A et al. APT 2009;29(suppl. 1): 1-49). In particular, methodology of the text (e.g.
collecting samples, diet before testing, avoiding smoke, etc.) should be
performed according to these statements. Moreover, the results should be
discussed in light of these Consensus Conference statements. For example,
Consensus statement did not find measurement of CH4 currently recommended
to improve the diagnostic accuracy of the hydrogen breath test (level of evidence:
IIa, strength of recommendation: B). At the same time, It identify that it is useful
to evaluate the onset and the severity of symptoms during the tests and up to 8
hours after, to determine lactose intolerance test (level of evidence: IIb, strength
of recommendation: B). All the methodology should be therefore performed
according to these indications, and the results should be discussed according to
these new statements.
Moreover, could be interesting whether the authors discuss better some results
(e.g., higher MBI in not-LM subjects) that may influence the symptomatic
response, also in light of the different literature’s experiences (see Landau DA et
al. J Clin Gastroenterol 2008;42(8):903-9);
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 interest"
Reviewer's report
Title:A comparison of diagnostic tests for lactose malabsorption - which one is
the best?
Version: 1Date:13 July 2009
Reviewer: Antonio Tursi
Reviewer's report:
This is an interesting study comparing several common tests to diagnose lactose
malabsorption. The authors found that the combination H2+CH4 is the best test
to diagnose malabsorption.
I mean that this study needs of Major compulsory revisions.
The most weakness is that this report did not consider the statements about this
field recently published by the Rome Consensus Conference in APT (Gasbarrini
A et al. APT 2009;29(suppl. 1): 1-49). In particular, methodology of the text (e.g.
collecting samples, diet before testing, avoiding smoke, etc.) should be
performed according to these statements. Moreover, the results should be
discussed in light of these Consensus Conference statements. For example,
Consensus statement did not find measurement of CH4 currently recommended
to improve the diagnostic accuracy of the hydrogen breath test (level of evidence:
IIa, strength of recommendation: B). At the same time, It identify that it is useful
to evaluate the onset and the severity of symptoms during the tests and up to 8
hours after, to determine lactose intolerance test (level of evidence: IIb, strength
of recommendation: B). All the methodology should be therefore performed
according to these indications, and the results should be discussed according to
these new statements.
Moreover, could be interesting whether the authors discuss better some results
(e.g., higher MBI in not-LM subjects) that may influence the symptomatic
response, also in light of the different literature’s experiences (see Landau DA et
al. J Clin Gastroenterol 2008;42(8):903-9);
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 interest"
Please review this paper.
user
Reviewer's report
Title:A comparison of diagnostic tests for lactose malabsorption - which one is
the best?
Version: 1Date:13 July 2009
Reviewer: Antonio Tursi
Reviewer's report:
This is an interesting study comparing several common tests to diagnose lactose
malabsorption. The authors found that the combination H2+CH4 is the best test
to diagnose malabsorption.
I mean that this study needs of Major compulsory revisions.
The most weakness is that this report did not consider the statements about this
field recently published by the Rome Consensus Conference in APT (Gasbarrini
A et al. APT 2009;29(suppl. 1): 1-49). In particular, methodology of the text (e.g.
collecting samples, diet before testing, avoiding smoke, etc.) should be
performed according to these statements. Moreover, the results should be
discussed in light of these Consensus Conference statements. For example,
Consensus statement did not find measurement of CH4 currently recommended
to improve the diagnostic accuracy of the hydrogen breath test (level of evidence:
IIa, strength of recommendation: B). At the same time, It identify that it is useful
to evaluate the onset and the severity of symptoms during the tests and up to 8
hours after, to determine lactose intolerance test (level of evidence: IIb, strength
of recommendation: B). All the methodology should be therefore performed
according to these indications, and the results should be discussed according to
these new statements.
Moreover, could be interesting whether the authors discuss better some results
(e.g., higher MBI in not-LM subjects) that may influence the symptomatic
response, also in light of the different literature’s experiences (see Landau DA et
al. J Clin Gastroenterol 2008;42(8):903-9);
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 interest"
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