Reviewer's report 
 A National Survey on the Patterns of Treatment of Inflammatory Bowel Disease in Canada Title: 
Authors: 
Dr Robert J Hilsden ( rhilsden@ucalgary.ca )
Dr Marja J Verhoef ( mverhoef@ucalgary.ca )
Allan Best ( abest@vanhosp.bc.ca )
Gaia Pocobelli ( gpocobel@ucalgary.ca )
 1  2 Apr 2003 Version: Date: 
 Jacques Cosnes Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Accept after discretionary revisions Advice on publication: 
This is an interesting study givng a photography of a large population of Canadian patients with IBD 
in 2001. The paper is clearly presented and well written. I have only some minor comments: 1degrees I am not sure that the present study did evaluate if responding members of the Canadian 
Association were or were not representative of Canadians with IBD. In fact, there was no 
comparison made between members of the Association and non-members, nor between responders 
to the questionnaire and non responders. As indicated in the discussion, members of an Association 
are usually better-educated and highly motivated; they also may have had a more severe disease 
(needing more operations for example). The pilot study addressed only the point of the proportion of 
members with IBD and did not give much information. 
2degrees The response rate to the questionnaire was 75%, not very high if one considers that it was sent to a very selected population. Do the members of the Association pay an annual subscription? 
In return, do they receive a journal or various informations upon new therapies and so on? We need 
more information on the implication of the members within the Association. 3degrees How was defined the disease activity? during which period of time? I am surprised by the low level of disease inactivity (20-30%), while cohort studies have reported that every year more 
than 50% of the patients are in remission (Munkolm et al Scand J GE 1995; Langholz et al 
Gastroenterology 1994) 4degrees The treatment policy of IBD has changed dramatically during the last decade. Immunosuppressants are used earlier, in a larger proportion of patients, and particularly in young 
patients with the hope to modify the natural history of the disease. I believe this change may explain 
why young patients were receiving immunosuppressants more often. This should be discussed in 
more details. 
Competing interests: 
None declared. 
Reviewer's report 
 A National Survey on the Patterns of Treatment of Inflammatory Bowel Disease in Canada Title: 
Authors: 
Dr Robert J Hilsden ( rhilsden@ucalgary.ca )
Dr Marja J Verhoef ( mverhoef@ucalgary.ca )
Allan Best ( abest@vanhosp.bc.ca )
Gaia Pocobelli ( gpocobel@ucalgary.ca )
 1  2 Apr 2003 Version: Date: 
 Jacques Cosnes Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Accept after discretionary revisions Advice on publication: 
This is an interesting study givng a photography of a large population of Canadian patients with IBD 
in 2001. The paper is clearly presented and well written. I have only some minor comments: 1degrees I am not sure that the present study did evaluate if responding members of the Canadian 
Association were or were not representative of Canadians with IBD. In fact, there was no 
comparison made between members of the Association and non-members, nor between responders 
to the questionnaire and non responders. As indicated in the discussion, members of an Association 
are usually better-educated and highly motivated; they also may have had a more severe disease 
(needing more operations for example). The pilot study addressed only the point of the proportion of 
members with IBD and did not give much information. 
2degrees The response rate to the questionnaire was 75%, not very high if one considers that it was sent to a very selected population. Do the members of the Association pay an annual subscription? 
In return, do they receive a journal or various informations upon new therapies and so on? We need 
more information on the implication of the members within the Association. 3degrees How was defined the disease activity? during which period of time? I am surprised by the low level of disease inactivity (20-30%), while cohort studies have reported that every year more 
than 50% of the patients are in remission (Munkolm et al Scand J GE 1995; Langholz et al 
Gastroenterology 1994) 4degrees The treatment policy of IBD has changed dramatically during the last decade. Immunosuppressants are used earlier, in a larger proportion of patients, and particularly in young 
patients with the hope to modify the natural history of the disease. I believe this change may explain 
why young patients were receiving immunosuppressants more often. This should be discussed in 
more details. 
Competing interests: 
None declared. 
Please review this paper.
user
Reviewer's report 
 A National Survey on the Patterns of Treatment of Inflammatory Bowel Disease in Canada Title: 
Authors: 
Dr Robert J Hilsden ( rhilsden@ucalgary.ca )
Dr Marja J Verhoef ( mverhoef@ucalgary.ca )
Allan Best ( abest@vanhosp.bc.ca )
Gaia Pocobelli ( gpocobel@ucalgary.ca )
 1  2 Apr 2003 Version: Date: 
 Jacques Cosnes Reviewer: 
 A paper whose findings are important to those with closely related research Level of interest: 
interests 
 Accept after discretionary revisions Advice on publication: 
This is an interesting study givng a photography of a large population of Canadian patients with IBD 
in 2001. The paper is clearly presented and well written. I have only some minor comments: 1degrees I am not sure that the present study did evaluate if responding members of the Canadian 
Association were or were not representative of Canadians with IBD. In fact, there was no 
comparison made between members of the Association and non-members, nor between responders 
to the questionnaire and non responders. As indicated in the discussion, members of an Association 
are usually better-educated and highly motivated; they also may have had a more severe disease 
(needing more operations for example). The pilot study addressed only the point of the proportion of 
members with IBD and did not give much information. 
2degrees The response rate to the questionnaire was 75%, not very high if one considers that it was sent to a very selected population. Do the members of the Association pay an annual subscription? 
In return, do they receive a journal or various informations upon new therapies and so on? We need 
more information on the implication of the members within the Association. 3degrees How was defined the disease activity? during which period of time? I am surprised by the low level of disease inactivity (20-30%), while cohort studies have reported that every year more 
than 50% of the patients are in remission (Munkolm et al Scand J GE 1995; Langholz et al 
Gastroenterology 1994) 4degrees The treatment policy of IBD has changed dramatically during the last decade. Immunosuppressants are used earlier, in a larger proportion of patients, and particularly in young 
patients with the hope to modify the natural history of the disease. I believe this change may explain 
why young patients were receiving immunosuppressants more often. This should be discussed in 
more details. 
Competing interests: 
None declared. 
assistant