Reviewer ’s report  
 
Title: Therapeutic preferences and outcomes in newly diagnosed patien ts with Crohn's disease in  
the biological era in Hungary. A nationwide study based on the National Health Insurance Fund  
database  
 
Version: 0 Date: 26 Nov 2017  
 
Reviewer: Hai Yun Shi  
 
Reviewer's report:  
 
Kurti et al. demonstrated a nat ionwide description about the therapeutic strategy and outcomes in 
newly diagnosed patients with CD in the biological era in Hungary.  
 
 
 
 
Comments:  
 
1. Only CD patients were included in this study, therefore the title should be changed to "… 
patients with Cro hn's disease…".  
 
 
2. What were the indications for hospitalization and surgery? Are the indications different 
before and after 2009?  
 
 
3. Please provide the p value for "Probability of early steroid exposure was different 
according to the maximum treatment ste p but not according to the year of diagnosis".  
 
 
4. Please provide the overall probability of hospitalization and the proportions according to 
the maximal treatment step in the manuscript.  
 
 
5. What was the definition for "surgery at around the time of diagno sis"?  
 
 
6. The conclusion "IS and biological exposure became more frequent in parallel with 
decreased hospitalization" can not be drawn, because although IS and biological exposure 
became more frequent while the hospitalization rates decreased after vs. befo re 2009, the 
hospitalization rates of patients on anti -TNF were comparable. Please discuss the 
findings.  
 
 
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review   
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an org anization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all o f the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the websi te along with the authors'  
responses. I agree for my report to be made available under a n Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my name d report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Therapeutic preferences and outcomes in newly diagnosed patien ts with Crohn's disease in  
the biological era in Hungary. A nationwide study based on the National Health Insurance Fund  
database  
 
Version: 0 Date: 26 Nov 2017  
 
Reviewer: Hai Yun Shi  
 
Reviewer's report:  
 
Kurti et al. demonstrated a nat ionwide description about the therapeutic strategy and outcomes in 
newly diagnosed patients with CD in the biological era in Hungary.  
 
 
 
 
Comments:  
 
1. Only CD patients were included in this study, therefore the title should be changed to "… 
patients with Cro hn's disease…".  
 
 
2. What were the indications for hospitalization and surgery? Are the indications different 
before and after 2009?  
 
 
3. Please provide the p value for "Probability of early steroid exposure was different 
according to the maximum treatment ste p but not according to the year of diagnosis".  
 
 
4. Please provide the overall probability of hospitalization and the proportions according to 
the maximal treatment step in the manuscript.  
 
 
5. What was the definition for "surgery at around the time of diagno sis"?  
 
 
6. The conclusion "IS and biological exposure became more frequent in parallel with 
decreased hospitalization" can not be drawn, because although IS and biological exposure 
became more frequent while the hospitalization rates decreased after vs. befo re 2009, the 
hospitalization rates of patients on anti -TNF were comparable. Please discuss the 
findings.  
 
 
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review   
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an org anization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all o f the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the websi te along with the authors'  
responses. I agree for my report to be made available under a n Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my name d report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Therapeutic preferences and outcomes in newly diagnosed patien ts with Crohn's disease in  
the biological era in Hungary. A nationwide study based on the National Health Insurance Fund  
database  
 
Version: 0 Date: 26 Nov 2017  
 
Reviewer: Hai Yun Shi  
 
Reviewer's report:  
 
Kurti et al. demonstrated a nat ionwide description about the therapeutic strategy and outcomes in 
newly diagnosed patients with CD in the biological era in Hungary.  
 
 
 
 
Comments:  
 
1. Only CD patients were included in this study, therefore the title should be changed to "… 
patients with Cro hn's disease…".  
 
 
2. What were the indications for hospitalization and surgery? Are the indications different 
before and after 2009?  
 
 
3. Please provide the p value for "Probability of early steroid exposure was different 
according to the maximum treatment ste p but not according to the year of diagnosis".  
 
 
4. Please provide the overall probability of hospitalization and the proportions according to 
the maximal treatment step in the manuscript.  
 
 
5. What was the definition for "surgery at around the time of diagno sis"?  
 
 
6. The conclusion "IS and biological exposure became more frequent in parallel with 
decreased hospitalization" can not be drawn, because although IS and biological exposure 
became more frequent while the hospitalization rates decreased after vs. befo re 2009, the 
hospitalization rates of patients on anti -TNF were comparable. Please discuss the 
findings.  
 
 
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review   
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an org anization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all o f the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the websi te along with the authors'  
responses. I agree for my report to be made available under a n Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my name d report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant