Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 3 Date: 07 Jul 2021
Reviewer's report:
To readdress the subject of diagnosis. The ESPGHAN criteria for non biopsy diagnosis of celiac
disease applies to the pediatric population only and it is not accepted world wide yet. Your study
is in adult patients so it is not applicable as a definite diagnosis for celiac disease. Serology assays
differ and are not 100% sensitive or specific and  you do  not specify what serology was used
(TTG IGA, EMA, DGP) or what values were accepted as a positive celiac diagnosis ( TTG IGA
>10 x ULN per ESPGHAN pediatric guidelines). This is a limitation of the study and should
be noted as such.  You can include the information that patients had a letter from a physician
confirming diagnosis based on either serology or serology with biopsy.  You note there is no
control group but Line 369-370 explaining why there is no control group is confusing. A control
group could be those following a gluten free diet without celiac disease but this group may be
difficult to identify though certainly exists. Please adjust the discussion.
Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 3 Date: 07 Jul 2021
Reviewer's report:
To readdress the subject of diagnosis. The ESPGHAN criteria for non biopsy diagnosis of celiac
disease applies to the pediatric population only and it is not accepted world wide yet. Your study
is in adult patients so it is not applicable as a definite diagnosis for celiac disease. Serology assays
differ and are not 100% sensitive or specific and  you do  not specify what serology was used
(TTG IGA, EMA, DGP) or what values were accepted as a positive celiac diagnosis ( TTG IGA
>10 x ULN per ESPGHAN pediatric guidelines). This is a limitation of the study and should
be noted as such.  You can include the information that patients had a letter from a physician
confirming diagnosis based on either serology or serology with biopsy.  You note there is no
control group but Line 369-370 explaining why there is no control group is confusing. A control
group could be those following a gluten free diet without celiac disease but this group may be
difficult to identify though certainly exists. Please adjust the discussion.
Please review this paper.
user
Title: The Influence of a Gluten-free Diet on Health-related Quality of Life in Individuals with
Celiac Disease
Version: 3 Date: 07 Jul 2021
Reviewer's report:
To readdress the subject of diagnosis. The ESPGHAN criteria for non biopsy diagnosis of celiac
disease applies to the pediatric population only and it is not accepted world wide yet. Your study
is in adult patients so it is not applicable as a definite diagnosis for celiac disease. Serology assays
differ and are not 100% sensitive or specific and  you do  not specify what serology was used
(TTG IGA, EMA, DGP) or what values were accepted as a positive celiac diagnosis ( TTG IGA
>10 x ULN per ESPGHAN pediatric guidelines). This is a limitation of the study and should
be noted as such.  You can include the information that patients had a letter from a physician
confirming diagnosis based on either serology or serology with biopsy.  You note there is no
control group but Line 369-370 explaining why there is no control group is confusing. A control
group could be those following a gluten free diet without celiac disease but this group may be
difficult to identify though certainly exists. Please adjust the discussion.
assistant