Reviewer's report
Title:The clinical characteristics of patients with free perforation in Korean
Crohn's disease: results from the CONNECT study
Version:2Date:10 January 2015
Reviewer: david ong
Reviewer's report:
My conclusion is that it is a well written paper that should be accepted with minor
revisions.
The question posed is original as there is as yet a paucity of such data coming
out of Asia. The fact that it is retrospective is acceptable as it would be difficult to
accumulate such a large number of cases in a prospective manner seeing that
IBD is still relatively low in incidence compared to the west (even though it is
increasing rapidly)
The data is important and highlights the need for clinicians to think about IBD
before perforation occurs. Treatment for IBD may avoid such complications.
Data is sound and numbers are large enough in this setting.
Interpretation is fair and well supported by the data shown.
Methods are sound - the methodology is straightforward being a retropsective
study.
It is well written and quality of languange is high.
I would however recommend the following revisions:
Introduction 2nd paragraph:
should read:
Free perforation is relatively rare among the major complications of CD that
include stenoses, fistulae and perforations.
(can leave as it is but I think reads better this way...)
Results:
The sentence:
free perforation was the presenting sign that was associated with a diagnosis of
CD in 46 patients (52%) and free perforation developed after the diagnosis of CD
in 42 patients (48%).
Is there any way of rephrasing this? appears to give impression that 52% of ALL
patients with CD presented in this way......it becomes clear later on but I think the
authors should rephrase this to make it clearer.
Discussion:
Paragraph 5 - Reports from previous studies......
Can you ask the authors to clarify this paragraph? As it is a retrospective study, I
am not sure that it is accurate to make comments on the effect of drugs on the
free perforation...unless the authors are certain that they know what drugs the
patients were on at the time of perforation or thereabouts.
As we know patients with IBD usually have a stepwise approach to their drugs so
they might have been on a variety of drugs over the course of the disease and
hence the authors need to be aware of exactly what drug the patient was on at
the time of perforation to be able to make the comments that they have made....
They did try to address the above points in the second last paragraph but I feel if
that was the case, then they are in a sense contradicting themselves here....
I would suggest they remove the paragraph relating to " our findings did not
suggest that any drugs....."and just keep the comments on the anti TNFs.
Reviewer's report
Title:The clinical characteristics of patients with free perforation in Korean
Crohn's disease: results from the CONNECT study
Version:2Date:10 January 2015
Reviewer: david ong
Reviewer's report:
My conclusion is that it is a well written paper that should be accepted with minor
revisions.
The question posed is original as there is as yet a paucity of such data coming
out of Asia. The fact that it is retrospective is acceptable as it would be difficult to
accumulate such a large number of cases in a prospective manner seeing that
IBD is still relatively low in incidence compared to the west (even though it is
increasing rapidly)
The data is important and highlights the need for clinicians to think about IBD
before perforation occurs. Treatment for IBD may avoid such complications.
Data is sound and numbers are large enough in this setting.
Interpretation is fair and well supported by the data shown.
Methods are sound - the methodology is straightforward being a retropsective
study.
It is well written and quality of languange is high.
I would however recommend the following revisions:
Introduction 2nd paragraph:
should read:
Free perforation is relatively rare among the major complications of CD that
include stenoses, fistulae and perforations.
(can leave as it is but I think reads better this way...)
Results:
The sentence:
free perforation was the presenting sign that was associated with a diagnosis of
CD in 46 patients (52%) and free perforation developed after the diagnosis of CD
in 42 patients (48%).
Is there any way of rephrasing this? appears to give impression that 52% of ALL
patients with CD presented in this way......it becomes clear later on but I think the
authors should rephrase this to make it clearer.
Discussion:
Paragraph 5 - Reports from previous studies......
Can you ask the authors to clarify this paragraph? As it is a retrospective study, I
am not sure that it is accurate to make comments on the effect of drugs on the
free perforation...unless the authors are certain that they know what drugs the
patients were on at the time of perforation or thereabouts.
As we know patients with IBD usually have a stepwise approach to their drugs so
they might have been on a variety of drugs over the course of the disease and
hence the authors need to be aware of exactly what drug the patient was on at
the time of perforation to be able to make the comments that they have made....
They did try to address the above points in the second last paragraph but I feel if
that was the case, then they are in a sense contradicting themselves here....
I would suggest they remove the paragraph relating to " our findings did not
suggest that any drugs....."and just keep the comments on the anti TNFs.
Please review this paper.
user
Reviewer's report
Title:The clinical characteristics of patients with free perforation in Korean
Crohn's disease: results from the CONNECT study
Version:2Date:10 January 2015
Reviewer: david ong
Reviewer's report:
My conclusion is that it is a well written paper that should be accepted with minor
revisions.
The question posed is original as there is as yet a paucity of such data coming
out of Asia. The fact that it is retrospective is acceptable as it would be difficult to
accumulate such a large number of cases in a prospective manner seeing that
IBD is still relatively low in incidence compared to the west (even though it is
increasing rapidly)
The data is important and highlights the need for clinicians to think about IBD
before perforation occurs. Treatment for IBD may avoid such complications.
Data is sound and numbers are large enough in this setting.
Interpretation is fair and well supported by the data shown.
Methods are sound - the methodology is straightforward being a retropsective
study.
It is well written and quality of languange is high.
I would however recommend the following revisions:
Introduction 2nd paragraph:
should read:
Free perforation is relatively rare among the major complications of CD that
include stenoses, fistulae and perforations.
(can leave as it is but I think reads better this way...)
Results:
The sentence:
free perforation was the presenting sign that was associated with a diagnosis of
CD in 46 patients (52%) and free perforation developed after the diagnosis of CD
in 42 patients (48%).
Is there any way of rephrasing this? appears to give impression that 52% of ALL
patients with CD presented in this way......it becomes clear later on but I think the
authors should rephrase this to make it clearer.
Discussion:
Paragraph 5 - Reports from previous studies......
Can you ask the authors to clarify this paragraph? As it is a retrospective study, I
am not sure that it is accurate to make comments on the effect of drugs on the
free perforation...unless the authors are certain that they know what drugs the
patients were on at the time of perforation or thereabouts.
As we know patients with IBD usually have a stepwise approach to their drugs so
they might have been on a variety of drugs over the course of the disease and
hence the authors need to be aware of exactly what drug the patient was on at
the time of perforation to be able to make the comments that they have made....
They did try to address the above points in the second last paragraph but I feel if
that was the case, then they are in a sense contradicting themselves here....
I would suggest they remove the paragraph relating to " our findings did not
suggest that any drugs....."and just keep the comments on the anti TNFs.
assistant