Reviewer's report 
 Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- Title: 
patients and care givers perspectives. 
 1  19 August 2006 Version: Date: 
 Anthony Catto-Smith Reviewer: 
Reviewer's report: 
General 
This study addresses the "consumer" acceptability of gastrostomy placement over a 6 year period in an adult population in Pakistan. The authors have administered a structured questionnaire which revealed generalized acceptance for the procedure with the exception of concerns about cost and time spent feeding 
the recipient. The study is important in that the setting is a developing country (Pakistan) for which there is 
limited other information available in this area. The findings are ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) There are no major revisions to be undertaken. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) The manuscript would benefit from careful attention to both spelling and 
grammatical expression. 
The important findings are, I believe, the concerns expressed about cost and time spent. Since this study addresses a population in a developing country, these would appear to be important issues and must be 
addressed in the discussion. Does the additional cost of the procedure, tubing, supplies and specialist 
feeds realistically place this technology out of the reach of the "average" Pakistani? What components of 
the feeding regimen have lead to additional time spent since presumably these patients previously were fed 
either orally (in the presence of dysphagia) or by nasogastric tube. Comments to address these findings 
need to be added to the discussion. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests 
Reviewer's report 
 Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- Title: 
patients and care givers perspectives. 
 1  19 August 2006 Version: Date: 
 Anthony Catto-Smith Reviewer: 
Reviewer's report: 
General 
This study addresses the "consumer" acceptability of gastrostomy placement over a 6 year period in an adult population in Pakistan. The authors have administered a structured questionnaire which revealed generalized acceptance for the procedure with the exception of concerns about cost and time spent feeding 
the recipient. The study is important in that the setting is a developing country (Pakistan) for which there is 
limited other information available in this area. The findings are ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) There are no major revisions to be undertaken. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) The manuscript would benefit from careful attention to both spelling and 
grammatical expression. 
The important findings are, I believe, the concerns expressed about cost and time spent. Since this study addresses a population in a developing country, these would appear to be important issues and must be 
addressed in the discussion. Does the additional cost of the procedure, tubing, supplies and specialist 
feeds realistically place this technology out of the reach of the "average" Pakistani? What components of 
the feeding regimen have lead to additional time spent since presumably these patients previously were fed 
either orally (in the presence of dysphagia) or by nasogastric tube. Comments to address these findings 
need to be added to the discussion. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- Title: 
patients and care givers perspectives. 
 1  19 August 2006 Version: Date: 
 Anthony Catto-Smith Reviewer: 
Reviewer's report: 
General 
This study addresses the "consumer" acceptability of gastrostomy placement over a 6 year period in an adult population in Pakistan. The authors have administered a structured questionnaire which revealed generalized acceptance for the procedure with the exception of concerns about cost and time spent feeding 
the recipient. The study is important in that the setting is a developing country (Pakistan) for which there is 
limited other information available in this area. The findings are ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) There are no major revisions to be undertaken. 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) The manuscript would benefit from careful attention to both spelling and 
grammatical expression. 
The important findings are, I believe, the concerns expressed about cost and time spent. Since this study addresses a population in a developing country, these would appear to be important issues and must be 
addressed in the discussion. Does the additional cost of the procedure, tubing, supplies and specialist 
feeds realistically place this technology out of the reach of the "average" Pakistani? What components of 
the feeding regimen have lead to additional time spent since presumably these patients previously were fed 
either orally (in the presence of dysphagia) or by nasogastric tube. Comments to address these findings 
need to be added to the discussion. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests 
assistant