Title: Dietary Habits as Associated Factors with Irritable Bowel Syndrome among Medical
Students: Evidence from a Cross-Sectional Study
Version: 2 Date: 30 May 2024
Reviewer's report:
Thank you for inviting me to review this paper. Here are some comments that might be beneficial
to the authors.
-In the title, "risk factors" cannot be used. Cannot infer causation from a cross-sectional study.
-In the abstract:
The rationale mentioned is not valid. State other important reasons.
In the results, state multivariable analysis results only.
Conclusion should be tailored to the multivariable analysis only.
Introduction:
-More up to date references are missing.
-Why did the authors focus on medical students specifically? Why not all university students or
the general population? This needs to be elaborated in the paper.
-The authors state "Ibb University, located in Yemen's second-largest governorate by population
and hosting students from various regions, provides an ideal setting for investigating the
prevalence and associated risk factors of IBS in a diverse and representative student population."
You cannot say that. You are still prone to selection bias. I suggest removing this idea.
Methods:
-In the statistical analysis paragraph: On what basis did you include the independent variables
in the regression model? usually, you need to include factors that showed a p < 0.250 in the
bivariate analysis in the regression model.
Results:
-The figures and table 2 can be removed...just insert those results in the text.
-In the "average marginal effects" paragraph, the authors did an analysis on females only. Why
did you do a stratification analysis? This should be introduced in the introduction (if authors
want to keep it) and mention it in the statistical analysis paragraph.
Discussion:
-your study showed a prevalence of 26%, whereas a quick search of the literature showed a
prevalence of 48.6% in Lebanon (https://pubmed.ncbi.nlm.nih.gov/37605160/). Can the authors
compare their results to those of that study and explain why they have a smaller percentage
despite using the same scale (ROME IV)?
-The majority of the discussion is based on the bivariate analysis, which should not be discussed.
Please discuss multivariable results only; you have carbonated beverages and drinking coffee
(close to significance)
-Add clinical implications paragraph: how would other researchers benefit from your study?
CONCLUSION
-in the first sentence, the authors state "a higher prevalence"....higher than what?
-Modify the conclusion based on multivariable results only.
-Authors state "In contrast, for women, the consumption of carbonated soft drinks was found
to significantly increase the risk of developing IBS symptoms in females." This is based on the
stratification analysis....please see my previous comment to see if the authors would want to
keep this idea or remove it.
I hope those comments would help the authors. Good luck with the revision.
Title: Dietary Habits as Associated Factors with Irritable Bowel Syndrome among Medical
Students: Evidence from a Cross-Sectional Study
Version: 2 Date: 30 May 2024
Reviewer's report:
Thank you for inviting me to review this paper. Here are some comments that might be beneficial
to the authors.
-In the title, "risk factors" cannot be used. Cannot infer causation from a cross-sectional study.
-In the abstract:
The rationale mentioned is not valid. State other important reasons.
In the results, state multivariable analysis results only.
Conclusion should be tailored to the multivariable analysis only.
Introduction:
-More up to date references are missing.
-Why did the authors focus on medical students specifically? Why not all university students or
the general population? This needs to be elaborated in the paper.
-The authors state "Ibb University, located in Yemen's second-largest governorate by population
and hosting students from various regions, provides an ideal setting for investigating the
prevalence and associated risk factors of IBS in a diverse and representative student population."
You cannot say that. You are still prone to selection bias. I suggest removing this idea.
Methods:
-In the statistical analysis paragraph: On what basis did you include the independent variables
in the regression model? usually, you need to include factors that showed a p < 0.250 in the
bivariate analysis in the regression model.
Results:
-The figures and table 2 can be removed...just insert those results in the text.
-In the "average marginal effects" paragraph, the authors did an analysis on females only. Why
did you do a stratification analysis? This should be introduced in the introduction (if authors
want to keep it) and mention it in the statistical analysis paragraph.
Discussion:
-your study showed a prevalence of 26%, whereas a quick search of the literature showed a
prevalence of 48.6% in Lebanon (https://pubmed.ncbi.nlm.nih.gov/37605160/). Can the authors
compare their results to those of that study and explain why they have a smaller percentage
despite using the same scale (ROME IV)?
-The majority of the discussion is based on the bivariate analysis, which should not be discussed.
Please discuss multivariable results only; you have carbonated beverages and drinking coffee
(close to significance)
-Add clinical implications paragraph: how would other researchers benefit from your study?
CONCLUSION
-in the first sentence, the authors state "a higher prevalence"....higher than what?
-Modify the conclusion based on multivariable results only.
-Authors state "In contrast, for women, the consumption of carbonated soft drinks was found
to significantly increase the risk of developing IBS symptoms in females." This is based on the
stratification analysis....please see my previous comment to see if the authors would want to
keep this idea or remove it.
I hope those comments would help the authors. Good luck with the revision.
Please review this paper.
user
Title: Dietary Habits as Associated Factors with Irritable Bowel Syndrome among Medical
Students: Evidence from a Cross-Sectional Study
Version: 2 Date: 30 May 2024
Reviewer's report:
Thank you for inviting me to review this paper. Here are some comments that might be beneficial
to the authors.
-In the title, "risk factors" cannot be used. Cannot infer causation from a cross-sectional study.
-In the abstract:
The rationale mentioned is not valid. State other important reasons.
In the results, state multivariable analysis results only.
Conclusion should be tailored to the multivariable analysis only.
Introduction:
-More up to date references are missing.
-Why did the authors focus on medical students specifically? Why not all university students or
the general population? This needs to be elaborated in the paper.
-The authors state "Ibb University, located in Yemen's second-largest governorate by population
and hosting students from various regions, provides an ideal setting for investigating the
prevalence and associated risk factors of IBS in a diverse and representative student population."
You cannot say that. You are still prone to selection bias. I suggest removing this idea.
Methods:
-In the statistical analysis paragraph: On what basis did you include the independent variables
in the regression model? usually, you need to include factors that showed a p < 0.250 in the
bivariate analysis in the regression model.
Results:
-The figures and table 2 can be removed...just insert those results in the text.
-In the "average marginal effects" paragraph, the authors did an analysis on females only. Why
did you do a stratification analysis? This should be introduced in the introduction (if authors
want to keep it) and mention it in the statistical analysis paragraph.
Discussion:
-your study showed a prevalence of 26%, whereas a quick search of the literature showed a
prevalence of 48.6% in Lebanon (https://pubmed.ncbi.nlm.nih.gov/37605160/). Can the authors
compare their results to those of that study and explain why they have a smaller percentage
despite using the same scale (ROME IV)?
-The majority of the discussion is based on the bivariate analysis, which should not be discussed.
Please discuss multivariable results only; you have carbonated beverages and drinking coffee
(close to significance)
-Add clinical implications paragraph: how would other researchers benefit from your study?
CONCLUSION
-in the first sentence, the authors state "a higher prevalence"....higher than what?
-Modify the conclusion based on multivariable results only.
-Authors state "In contrast, for women, the consumption of carbonated soft drinks was found
to significantly increase the risk of developing IBS symptoms in females." This is based on the
stratification analysis....please see my previous comment to see if the authors would want to
keep this idea or remove it.
I hope those comments would help the authors. Good luck with the revision.
assistant