Title: Eosinophilic Esophagitis Patients Report Substantial Disease Burden Comparable to
More Systemic Immune-Mediated Diseases
Version: 3 Date: 06 Apr 2025
Reviewer's report:
The paper describes the disease-burden in a Swiss cohort of eosinophilic esophagitis as assessed
by patient-developed web-based questionnaire evaluating various domains of the quality of life
(leisure, social, travel) by comparison with a cohorts of patients with systemic immune-mediated
diseases, such inflammatory bowel disease (IBD), as systemic lupus erythematosus, systemic
scleroderma.
The main study finding was that perceived impairment in everyday life, particularly within
subdomains such as leisure, is substantial and comparable to that experienced by patients with
other immune-mediated disease states, including IBD.
The topic if of interest and the manuscript is generally well written.
There are some major methodological concerns
The web-based questionnaire distributed by national organisations may constitute a selection
bias favouring the enrolment of highly motivated patients with internet access.
Regarding response bias, given that the study is patient-generated, disease burden estimates may
be inflated.
There are, as the authors acknowledge, concerns about the validity of the questionnaire. A formal
validation is lacking and the definition of subdomains (such as leisure, social, travel) is not
accuracy.
Regarding study design an interesting comparison group would be the subgroup of patients with
scleroderma and oesophageal involvement.
From the statistical perspective, response rate within the cohorts is not thoroughly assessed. The
sample may not be representative of the whole cohort.
Moreover, when evaluating impairment scores across diseases adjustments for disease severity,
sex and age are not performed.
As the authors state among study execution limitation a low percentage of male SLE and SCC
took part in the study, making sex comparisons not accurate.
Title: Eosinophilic Esophagitis Patients Report Substantial Disease Burden Comparable to
More Systemic Immune-Mediated Diseases
Version: 3 Date: 06 Apr 2025
Reviewer's report:
The paper describes the disease-burden in a Swiss cohort of eosinophilic esophagitis as assessed
by patient-developed web-based questionnaire evaluating various domains of the quality of life
(leisure, social, travel) by comparison with a cohorts of patients with systemic immune-mediated
diseases, such inflammatory bowel disease (IBD), as systemic lupus erythematosus, systemic
scleroderma.
The main study finding was that perceived impairment in everyday life, particularly within
subdomains such as leisure, is substantial and comparable to that experienced by patients with
other immune-mediated disease states, including IBD.
The topic if of interest and the manuscript is generally well written.
There are some major methodological concerns
The web-based questionnaire distributed by national organisations may constitute a selection
bias favouring the enrolment of highly motivated patients with internet access.
Regarding response bias, given that the study is patient-generated, disease burden estimates may
be inflated.
There are, as the authors acknowledge, concerns about the validity of the questionnaire. A formal
validation is lacking and the definition of subdomains (such as leisure, social, travel) is not
accuracy.
Regarding study design an interesting comparison group would be the subgroup of patients with
scleroderma and oesophageal involvement.
From the statistical perspective, response rate within the cohorts is not thoroughly assessed. The
sample may not be representative of the whole cohort.
Moreover, when evaluating impairment scores across diseases adjustments for disease severity,
sex and age are not performed.
As the authors state among study execution limitation a low percentage of male SLE and SCC
took part in the study, making sex comparisons not accurate.
Please review this paper.
user
Title: Eosinophilic Esophagitis Patients Report Substantial Disease Burden Comparable to
More Systemic Immune-Mediated Diseases
Version: 3 Date: 06 Apr 2025
Reviewer's report:
The paper describes the disease-burden in a Swiss cohort of eosinophilic esophagitis as assessed
by patient-developed web-based questionnaire evaluating various domains of the quality of life
(leisure, social, travel) by comparison with a cohorts of patients with systemic immune-mediated
diseases, such inflammatory bowel disease (IBD), as systemic lupus erythematosus, systemic
scleroderma.
The main study finding was that perceived impairment in everyday life, particularly within
subdomains such as leisure, is substantial and comparable to that experienced by patients with
other immune-mediated disease states, including IBD.
The topic if of interest and the manuscript is generally well written.
There are some major methodological concerns
The web-based questionnaire distributed by national organisations may constitute a selection
bias favouring the enrolment of highly motivated patients with internet access.
Regarding response bias, given that the study is patient-generated, disease burden estimates may
be inflated.
There are, as the authors acknowledge, concerns about the validity of the questionnaire. A formal
validation is lacking and the definition of subdomains (such as leisure, social, travel) is not
accuracy.
Regarding study design an interesting comparison group would be the subgroup of patients with
scleroderma and oesophageal involvement.
From the statistical perspective, response rate within the cohorts is not thoroughly assessed. The
sample may not be representative of the whole cohort.
Moreover, when evaluating impairment scores across diseases adjustments for disease severity,
sex and age are not performed.
As the authors state among study execution limitation a low percentage of male SLE and SCC
took part in the study, making sex comparisons not accurate.
assistant