Title: Initial Development and Validation of a Disease-Specific Resilience Measure for
Inflammatory Bowel Disease: The RISE-IBD Instrument
Version: 0 Date: 06 Apr 2025
Reviewer's report:
This novel study developed an IBD-specific tool to assess resilience based on qualitative
analyses from patients living with this disease and contributions from healthcare providers.
This was a well designed and conducted study with clear messaging that culminated in the
development of a 14-item resilience index (RISE-IBD) which was reliable and valid when
compared with other generic measures of resilience, quality of life and psychological distress.
This appears to be a promising index that will benefit from uptake by researchers and clinicians
to fully assess the potential benefits in day-to-day practice. Identifying patients with low levels
of resilience or particular domains that can be effectively targeted through greater educational
tools or psychological supports will be a powerful future tool.
The development and initial validation phases of this study appear to be robust and I have few
comments for the authors:
1. I would recommend the authors consider adding in a figure or table with the final 14 item
RISE-IBD index as I did not see this throughout the manuscript. Additionally, it may be helpful
to have a figure with the 4 key domains identified in this study separate to this.
2. Was any greater granular detail collected from patients regarding their disease activity status
than if they were in a state of self-reported flare or remission? Is there any biomarker data that
is available to the study authors? It would be useful to assess the association of clinical and
biochemical disease activity on the RISE-IBD score and individual domains. I think this would
be helpful to assess this in future studies as well and could be discussed further in the limitations.
3. I note that both parametric and non-parametric measures have been utilised for analyses
throughout this manuscript for a relatively small sample size. For the ANOVA and t-tests, was
this data normally distributed or would a Kruskal-Wallis and Mann-Whitney U be required?
4. Did the authors assess for differences in the RISE-IBD score between those living with IBD
for <5 and >5 or >10 years? Is resilience a “learnt” trait as per this index or largely “innate”?
5. Were RISE-IBD scores different between individuals with self reported active disease vs.
those who reported their disease was in remission? How about those who had a previous
resection compared to those who did not?
6. How was fatigue and depression measured in this study as reported in the discriminant ability
section of the results?
7.  As stated in the limitations, further validating this tool in patient cohorts at other centres (both
regional and tertiary) will be helpful.
8. Test-retest reliability was assessed over a mean of 40 days - were there any changes to
medications or clinical disease status for patients over this time? Regardless, this index appears
to be very reliable.
Minor
- Please consider adjusting anti-TNF trade names to generic versions
Title: Initial Development and Validation of a Disease-Specific Resilience Measure for
Inflammatory Bowel Disease: The RISE-IBD Instrument
Version: 0 Date: 06 Apr 2025
Reviewer's report:
This novel study developed an IBD-specific tool to assess resilience based on qualitative
analyses from patients living with this disease and contributions from healthcare providers.
This was a well designed and conducted study with clear messaging that culminated in the
development of a 14-item resilience index (RISE-IBD) which was reliable and valid when
compared with other generic measures of resilience, quality of life and psychological distress.
This appears to be a promising index that will benefit from uptake by researchers and clinicians
to fully assess the potential benefits in day-to-day practice. Identifying patients with low levels
of resilience or particular domains that can be effectively targeted through greater educational
tools or psychological supports will be a powerful future tool.
The development and initial validation phases of this study appear to be robust and I have few
comments for the authors:
1. I would recommend the authors consider adding in a figure or table with the final 14 item
RISE-IBD index as I did not see this throughout the manuscript. Additionally, it may be helpful
to have a figure with the 4 key domains identified in this study separate to this.
2. Was any greater granular detail collected from patients regarding their disease activity status
than if they were in a state of self-reported flare or remission? Is there any biomarker data that
is available to the study authors? It would be useful to assess the association of clinical and
biochemical disease activity on the RISE-IBD score and individual domains. I think this would
be helpful to assess this in future studies as well and could be discussed further in the limitations.
3. I note that both parametric and non-parametric measures have been utilised for analyses
throughout this manuscript for a relatively small sample size. For the ANOVA and t-tests, was
this data normally distributed or would a Kruskal-Wallis and Mann-Whitney U be required?
4. Did the authors assess for differences in the RISE-IBD score between those living with IBD
for <5 and >5 or >10 years? Is resilience a “learnt” trait as per this index or largely “innate”?
5. Were RISE-IBD scores different between individuals with self reported active disease vs.
those who reported their disease was in remission? How about those who had a previous
resection compared to those who did not?
6. How was fatigue and depression measured in this study as reported in the discriminant ability
section of the results?
7.  As stated in the limitations, further validating this tool in patient cohorts at other centres (both
regional and tertiary) will be helpful.
8. Test-retest reliability was assessed over a mean of 40 days - were there any changes to
medications or clinical disease status for patients over this time? Regardless, this index appears
to be very reliable.
Minor
- Please consider adjusting anti-TNF trade names to generic versions
Please review this paper.
user
Title: Initial Development and Validation of a Disease-Specific Resilience Measure for
Inflammatory Bowel Disease: The RISE-IBD Instrument
Version: 0 Date: 06 Apr 2025
Reviewer's report:
This novel study developed an IBD-specific tool to assess resilience based on qualitative
analyses from patients living with this disease and contributions from healthcare providers.
This was a well designed and conducted study with clear messaging that culminated in the
development of a 14-item resilience index (RISE-IBD) which was reliable and valid when
compared with other generic measures of resilience, quality of life and psychological distress.
This appears to be a promising index that will benefit from uptake by researchers and clinicians
to fully assess the potential benefits in day-to-day practice. Identifying patients with low levels
of resilience or particular domains that can be effectively targeted through greater educational
tools or psychological supports will be a powerful future tool.
The development and initial validation phases of this study appear to be robust and I have few
comments for the authors:
1. I would recommend the authors consider adding in a figure or table with the final 14 item
RISE-IBD index as I did not see this throughout the manuscript. Additionally, it may be helpful
to have a figure with the 4 key domains identified in this study separate to this.
2. Was any greater granular detail collected from patients regarding their disease activity status
than if they were in a state of self-reported flare or remission? Is there any biomarker data that
is available to the study authors? It would be useful to assess the association of clinical and
biochemical disease activity on the RISE-IBD score and individual domains. I think this would
be helpful to assess this in future studies as well and could be discussed further in the limitations.
3. I note that both parametric and non-parametric measures have been utilised for analyses
throughout this manuscript for a relatively small sample size. For the ANOVA and t-tests, was
this data normally distributed or would a Kruskal-Wallis and Mann-Whitney U be required?
4. Did the authors assess for differences in the RISE-IBD score between those living with IBD
for <5 and >5 or >10 years? Is resilience a “learnt” trait as per this index or largely “innate”?
5. Were RISE-IBD scores different between individuals with self reported active disease vs.
those who reported their disease was in remission? How about those who had a previous
resection compared to those who did not?
6. How was fatigue and depression measured in this study as reported in the discriminant ability
section of the results?
7.  As stated in the limitations, further validating this tool in patient cohorts at other centres (both
regional and tertiary) will be helpful.
8. Test-retest reliability was assessed over a mean of 40 days - were there any changes to
medications or clinical disease status for patients over this time? Regardless, this index appears
to be very reliable.
Minor
- Please consider adjusting anti-TNF trade names to generic versions
assistant