Reviewer's report
Title:A gluten-free diet effectively reduces symptoms and health care
consumption in a Swedish celiac disease population
Version: 2Date:18 February 2012
Reviewer: Donald Duerksen
Reviewer's report:
Major Points
1.The AIM of the study is to determine the effect of a gluten free diet on various
factors including symptoms, associated autoimmune diseases and health care
consumption. In this paper, there is no data on the degree of adherence with a
gluten free diet. There is an assumption that all of the patients completing the
questionnaire are adhering to a gluten free diet. In order to answer the aim of the
study, data should be included on the self-reported adherence as this is likely the
only data that is available. A table should be included that stratifies patients
based on degree of adherence to a gluten free diet to determine if there is any
treatment association with the different variables considered in this study. If this
data is not available, at the very least, a portion of the discussion should be
devoted to this as a limitation.
2. What was the mean and median duration of time on a GFD for the
respondents? This would have some influence on the magnitude of the recall
bias of the study. Factors such as recalling health care utilization would be
particularly affected by time since diagnosis. A table listing the demographics of
this study group should be included.
Minor Points
1. Background
In the first sentence celiac disease is defined as “intolerance”. This is confusing
given recent literature on ‘gluten intolerance’, and its distinction from celiac
disease. Would avoid this terminology and define celiac disease in other ways.
2. Methods
‘rheumatic disease’ was asked about in the questionnaire. This implies a
multitude of possible syndromes including RA, SLE, scleroderma etc. Do the
individuals in the questionnaire know what rheumatic diseases are? Were they
asked about all of these individually? Which diseases were asked about?
3. Results Page 6 – Health case consumption 2nd last line - no should be not
4. Discussion. Worth commenting in the discussion on the finding that although
‘all symptoms’ except joint symptoms improved post diagnosis compared with
pre diagnosis, in some cases, a significant minority (20% for fatigue and
flatulence) still had symptoms of major severity. How does this compare to other
studies in the literature?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:A gluten-free diet effectively reduces symptoms and health care
consumption in a Swedish celiac disease population
Version: 2Date:18 February 2012
Reviewer: Donald Duerksen
Reviewer's report:
Major Points
1.The AIM of the study is to determine the effect of a gluten free diet on various
factors including symptoms, associated autoimmune diseases and health care
consumption. In this paper, there is no data on the degree of adherence with a
gluten free diet. There is an assumption that all of the patients completing the
questionnaire are adhering to a gluten free diet. In order to answer the aim of the
study, data should be included on the self-reported adherence as this is likely the
only data that is available. A table should be included that stratifies patients
based on degree of adherence to a gluten free diet to determine if there is any
treatment association with the different variables considered in this study. If this
data is not available, at the very least, a portion of the discussion should be
devoted to this as a limitation.
2. What was the mean and median duration of time on a GFD for the
respondents? This would have some influence on the magnitude of the recall
bias of the study. Factors such as recalling health care utilization would be
particularly affected by time since diagnosis. A table listing the demographics of
this study group should be included.
Minor Points
1. Background
In the first sentence celiac disease is defined as “intolerance”. This is confusing
given recent literature on ‘gluten intolerance’, and its distinction from celiac
disease. Would avoid this terminology and define celiac disease in other ways.
2. Methods
‘rheumatic disease’ was asked about in the questionnaire. This implies a
multitude of possible syndromes including RA, SLE, scleroderma etc. Do the
individuals in the questionnaire know what rheumatic diseases are? Were they
asked about all of these individually? Which diseases were asked about?
3. Results Page 6 – Health case consumption 2nd last line - no should be not
4. Discussion. Worth commenting in the discussion on the finding that although
‘all symptoms’ except joint symptoms improved post diagnosis compared with
pre diagnosis, in some cases, a significant minority (20% for fatigue and
flatulence) still had symptoms of major severity. How does this compare to other
studies in the literature?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:A gluten-free diet effectively reduces symptoms and health care
consumption in a Swedish celiac disease population
Version: 2Date:18 February 2012
Reviewer: Donald Duerksen
Reviewer's report:
Major Points
1.The AIM of the study is to determine the effect of a gluten free diet on various
factors including symptoms, associated autoimmune diseases and health care
consumption. In this paper, there is no data on the degree of adherence with a
gluten free diet. There is an assumption that all of the patients completing the
questionnaire are adhering to a gluten free diet. In order to answer the aim of the
study, data should be included on the self-reported adherence as this is likely the
only data that is available. A table should be included that stratifies patients
based on degree of adherence to a gluten free diet to determine if there is any
treatment association with the different variables considered in this study. If this
data is not available, at the very least, a portion of the discussion should be
devoted to this as a limitation.
2. What was the mean and median duration of time on a GFD for the
respondents? This would have some influence on the magnitude of the recall
bias of the study. Factors such as recalling health care utilization would be
particularly affected by time since diagnosis. A table listing the demographics of
this study group should be included.
Minor Points
1. Background
In the first sentence celiac disease is defined as “intolerance”. This is confusing
given recent literature on ‘gluten intolerance’, and its distinction from celiac
disease. Would avoid this terminology and define celiac disease in other ways.
2. Methods
‘rheumatic disease’ was asked about in the questionnaire. This implies a
multitude of possible syndromes including RA, SLE, scleroderma etc. Do the
individuals in the questionnaire know what rheumatic diseases are? Were they
asked about all of these individually? Which diseases were asked about?
3. Results Page 6 – Health case consumption 2nd last line - no should be not
4. Discussion. Worth commenting in the discussion on the finding that although
‘all symptoms’ except joint symptoms improved post diagnosis compared with
pre diagnosis, in some cases, a significant minority (20% for fatigue and
flatulence) still had symptoms of major severity. How does this compare to other
studies in the literature?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
assistant