Title: A Cross-Sectional Study Describing Peripheral Neuropathy in Patients with Symptoms of
Gastroparesis: Associations with Etiology, Gastrointestinal Symptoms, and Gastric Emptying
Version: 2 Date: 11 Apr 2022
Reviewer's report:
The authors should be commended on investigating an important area of PN in idiopathic
gastroparesis. Little is known about idiopathic gastroparesis and to evaluate the prevalence co-
morbidities such as PN is of great importance.
However, this reviewer believes that the data is insufficient in addressing all study aims.
Study aim 1 (Determine prevalence of PN in IG) can be assessed with the current data. But
the data has insufficient statistically power to provide compelling analysis using idiopathic
gastroparesis with delayed emptying + PN (n=7) against other subgroups. Given aims 2 and 3
are based around this target group, a larger cohort (similar in size to its comparator groups) is
required for meaningful results.
Minor issues:
Abstract: Line 74 – Define IG
Line 293, 302, 380, 381: Peripheral neuropathy use abbreviation PN
Line 326: incomplete sentence “Almost twice as many patients with symptoms of…”
The use of HADS score for anxiety and depression as a measure of psychosocial symptoms
should be defined in the primary or secondary objectives of the study.
Major issues:
Q1 Please justify the use of NTSS-6 as a diagnostic tool for NP. Give your use of symptom
questionnaires (PAGI-SYM and GCSI) in this study to determine severity of gastroparesis, while
scintigraphy is used to diagnose gastroparesis. Would it not be more appropriate to use a nerve
function test and/or electromyography to diagnose NP?
Q2 There is a 5 times disparity in sample size between idiopathic gastroparetic patients with PN
(n=7) and without PN (n=36); and also a 5 times disparity in sample size between idiopathic
gastroparestic patients with normal emptying with PN (n=9) and without PN (n=47). How do
you account of potential bias in the PN group data?
Q3 Abdominal distention was significantly higher in idiopathic gastroparesis patients with PN.
However, distention is not significant higher in any other PN+ gastroparesis groups. Can the
authors explain the discrepancy in this result, shouldn’t abdominal distention be present in all PN
+ gastroparesis groups? Otherwise, is distention associated with PN or idiopathic gastroparesis?
Title: A Cross-Sectional Study Describing Peripheral Neuropathy in Patients with Symptoms of
Gastroparesis: Associations with Etiology, Gastrointestinal Symptoms, and Gastric Emptying
Version: 2 Date: 11 Apr 2022
Reviewer's report:
The authors should be commended on investigating an important area of PN in idiopathic
gastroparesis. Little is known about idiopathic gastroparesis and to evaluate the prevalence co-
morbidities such as PN is of great importance.
However, this reviewer believes that the data is insufficient in addressing all study aims.
Study aim 1 (Determine prevalence of PN in IG) can be assessed with the current data. But
the data has insufficient statistically power to provide compelling analysis using idiopathic
gastroparesis with delayed emptying + PN (n=7) against other subgroups. Given aims 2 and 3
are based around this target group, a larger cohort (similar in size to its comparator groups) is
required for meaningful results.
Minor issues:
Abstract: Line 74 – Define IG
Line 293, 302, 380, 381: Peripheral neuropathy use abbreviation PN
Line 326: incomplete sentence “Almost twice as many patients with symptoms of…”
The use of HADS score for anxiety and depression as a measure of psychosocial symptoms
should be defined in the primary or secondary objectives of the study.
Major issues:
Q1 Please justify the use of NTSS-6 as a diagnostic tool for NP. Give your use of symptom
questionnaires (PAGI-SYM and GCSI) in this study to determine severity of gastroparesis, while
scintigraphy is used to diagnose gastroparesis. Would it not be more appropriate to use a nerve
function test and/or electromyography to diagnose NP?
Q2 There is a 5 times disparity in sample size between idiopathic gastroparetic patients with PN
(n=7) and without PN (n=36); and also a 5 times disparity in sample size between idiopathic
gastroparestic patients with normal emptying with PN (n=9) and without PN (n=47). How do
you account of potential bias in the PN group data?
Q3 Abdominal distention was significantly higher in idiopathic gastroparesis patients with PN.
However, distention is not significant higher in any other PN+ gastroparesis groups. Can the
authors explain the discrepancy in this result, shouldn’t abdominal distention be present in all PN
+ gastroparesis groups? Otherwise, is distention associated with PN or idiopathic gastroparesis?
Please review this paper.
user
Title: A Cross-Sectional Study Describing Peripheral Neuropathy in Patients with Symptoms of
Gastroparesis: Associations with Etiology, Gastrointestinal Symptoms, and Gastric Emptying
Version: 2 Date: 11 Apr 2022
Reviewer's report:
The authors should be commended on investigating an important area of PN in idiopathic
gastroparesis. Little is known about idiopathic gastroparesis and to evaluate the prevalence co-
morbidities such as PN is of great importance.
However, this reviewer believes that the data is insufficient in addressing all study aims.
Study aim 1 (Determine prevalence of PN in IG) can be assessed with the current data. But
the data has insufficient statistically power to provide compelling analysis using idiopathic
gastroparesis with delayed emptying + PN (n=7) against other subgroups. Given aims 2 and 3
are based around this target group, a larger cohort (similar in size to its comparator groups) is
required for meaningful results.
Minor issues:
Abstract: Line 74 – Define IG
Line 293, 302, 380, 381: Peripheral neuropathy use abbreviation PN
Line 326: incomplete sentence “Almost twice as many patients with symptoms of…”
The use of HADS score for anxiety and depression as a measure of psychosocial symptoms
should be defined in the primary or secondary objectives of the study.
Major issues:
Q1 Please justify the use of NTSS-6 as a diagnostic tool for NP. Give your use of symptom
questionnaires (PAGI-SYM and GCSI) in this study to determine severity of gastroparesis, while
scintigraphy is used to diagnose gastroparesis. Would it not be more appropriate to use a nerve
function test and/or electromyography to diagnose NP?
Q2 There is a 5 times disparity in sample size between idiopathic gastroparetic patients with PN
(n=7) and without PN (n=36); and also a 5 times disparity in sample size between idiopathic
gastroparestic patients with normal emptying with PN (n=9) and without PN (n=47). How do
you account of potential bias in the PN group data?
Q3 Abdominal distention was significantly higher in idiopathic gastroparesis patients with PN.
However, distention is not significant higher in any other PN+ gastroparesis groups. Can the
authors explain the discrepancy in this result, shouldn’t abdominal distention be present in all PN
+ gastroparesis groups? Otherwise, is distention associated with PN or idiopathic gastroparesis?
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