Reviewer's report
Title:Gender aspects suggestive of gastroparesis in patients with diabetes
mellitus: A cross-sectional survey
Version:4Date:10 December 2013
Reviewer: Karen Bielefeldt
Reviewer's report:
I appreciate the changes made by the authors. It may make sense for the
authors to closely review the manuscript yet one more time. The changes disrupt
the flow and introduce an unusual disconnect between mechanistic speculations
with a focus on motility (intro and discussion), but virtually no support for those
speculations in the data. The terminology was changed to avoid referring to
gastroparesis. Yet, new terms are odd and confusing. You are basically reporting
dyspeptic symptoms. Why not sticking to that terminology rather than using
cardinal symptoms (referring to a research instrument)?
MORE SPECIFIC COMMENTS:
Abstract:
Add ‘dyspeptic’ symptoms to your last sentence in the background section. Your
conclusion is a summary, which may be okay (should perhaps be reformulated
nonetheless), but still restates the results yet one more time.
Discussion:
You refer to an ongoing study, but do not provide data or references.
Your revised discussion is also a bit confusing as written now. First, you now
mention (triggered by comments) the relatively low prevalence of delayed
emptying in prior studies, which obviously argues against sex-specific changes in
motility as a relevant explanation for your observations. Then, you explain some
experimental data that provide mechanisms for slower emptying in women,
before emphasizing again that the higher age in your cohort makes sex specific
motor dysfunction less likely. Finally, you move to HRT and the fact that obesity
could be a marker of different estrogen levels. So, ‘no, could, shouldn’t, but
perhaps it could’ leaves the reader with a confusing message. I have my own
biases and can get stuck with them. For the reader, a clear and consistent
message would be better.
I had mentioned in my prior review that the bar was set low to define illness. With
a relatively minor symptom severity and no indicators of symptom duration, many
of these individuals may not meet current consensus criteria for functional
dyspepsia. I still consider this an important weakness.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
none
Reviewer's report
Title:Gender aspects suggestive of gastroparesis in patients with diabetes
mellitus: A cross-sectional survey
Version:4Date:10 December 2013
Reviewer: Karen Bielefeldt
Reviewer's report:
I appreciate the changes made by the authors. It may make sense for the
authors to closely review the manuscript yet one more time. The changes disrupt
the flow and introduce an unusual disconnect between mechanistic speculations
with a focus on motility (intro and discussion), but virtually no support for those
speculations in the data. The terminology was changed to avoid referring to
gastroparesis. Yet, new terms are odd and confusing. You are basically reporting
dyspeptic symptoms. Why not sticking to that terminology rather than using
cardinal symptoms (referring to a research instrument)?
MORE SPECIFIC COMMENTS:
Abstract:
Add ‘dyspeptic’ symptoms to your last sentence in the background section. Your
conclusion is a summary, which may be okay (should perhaps be reformulated
nonetheless), but still restates the results yet one more time.
Discussion:
You refer to an ongoing study, but do not provide data or references.
Your revised discussion is also a bit confusing as written now. First, you now
mention (triggered by comments) the relatively low prevalence of delayed
emptying in prior studies, which obviously argues against sex-specific changes in
motility as a relevant explanation for your observations. Then, you explain some
experimental data that provide mechanisms for slower emptying in women,
before emphasizing again that the higher age in your cohort makes sex specific
motor dysfunction less likely. Finally, you move to HRT and the fact that obesity
could be a marker of different estrogen levels. So, ‘no, could, shouldn’t, but
perhaps it could’ leaves the reader with a confusing message. I have my own
biases and can get stuck with them. For the reader, a clear and consistent
message would be better.
I had mentioned in my prior review that the bar was set low to define illness. With
a relatively minor symptom severity and no indicators of symptom duration, many
of these individuals may not meet current consensus criteria for functional
dyspepsia. I still consider this an important weakness.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
none
Please review this paper.
user
Reviewer's report
Title:Gender aspects suggestive of gastroparesis in patients with diabetes
mellitus: A cross-sectional survey
Version:4Date:10 December 2013
Reviewer: Karen Bielefeldt
Reviewer's report:
I appreciate the changes made by the authors. It may make sense for the
authors to closely review the manuscript yet one more time. The changes disrupt
the flow and introduce an unusual disconnect between mechanistic speculations
with a focus on motility (intro and discussion), but virtually no support for those
speculations in the data. The terminology was changed to avoid referring to
gastroparesis. Yet, new terms are odd and confusing. You are basically reporting
dyspeptic symptoms. Why not sticking to that terminology rather than using
cardinal symptoms (referring to a research instrument)?
MORE SPECIFIC COMMENTS:
Abstract:
Add ‘dyspeptic’ symptoms to your last sentence in the background section. Your
conclusion is a summary, which may be okay (should perhaps be reformulated
nonetheless), but still restates the results yet one more time.
Discussion:
You refer to an ongoing study, but do not provide data or references.
Your revised discussion is also a bit confusing as written now. First, you now
mention (triggered by comments) the relatively low prevalence of delayed
emptying in prior studies, which obviously argues against sex-specific changes in
motility as a relevant explanation for your observations. Then, you explain some
experimental data that provide mechanisms for slower emptying in women,
before emphasizing again that the higher age in your cohort makes sex specific
motor dysfunction less likely. Finally, you move to HRT and the fact that obesity
could be a marker of different estrogen levels. So, ‘no, could, shouldn’t, but
perhaps it could’ leaves the reader with a confusing message. I have my own
biases and can get stuck with them. For the reader, a clear and consistent
message would be better.
I had mentioned in my prior review that the bar was set low to define illness. With
a relatively minor symptom severity and no indicators of symptom duration, many
of these individuals may not meet current consensus criteria for functional
dyspepsia. I still consider this an important weakness.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
none
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