Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 09 Feb 2025
Reviewer's report:
Thanks for submitting this manuscript. It’s a well-executed scoping review with a solid
methodology,
• The authors focus only on diagnostic criteria in CPGs but don’t provide a rationale for
excluding treatment recommendations. Given that diagnosis and management often go hand in
hand, it would strengthen the paper to justify why treatment guidelines were excluded.
• The Rome IV criteria are subjective and symptom-based, so why prioritize this narrow focus?
A broader review considering treatment pathways in CPGs would give a more complete picture.
If this focus is intentional, the reasoning should be explicitly stated.
• Not all CPGs are created equal—some are based on systematic reviews, while others are expert
consensus-based. Without evaluating guideline rigor, the review treats all CPGs as if they hold
equal weight, which is problematic.
• There is extensive commentary on microbiome research, omics, and biomarker development,
but this feels disconnected from the manuscript’s core focus. While it’s fair to discuss
pathophysiology briefly, this review is about CPGs.
• Are the authors suggesting these biomarkers should be incorporated into current or future
guidelines? If so, that argument needs much more development. If not, this section should be
trimmed down significantly or reframed.
• Regional differences are discussed descriptively, but without any statistical tests, it’s hard to tell
whether these differences are meaningful. Even a basic chi-square test would add much-needed
rigor. If statistical analysis isn’t possible, this limitation should be explicitly acknowledged.
Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 09 Feb 2025
Reviewer's report:
Thanks for submitting this manuscript. It’s a well-executed scoping review with a solid
methodology,
• The authors focus only on diagnostic criteria in CPGs but don’t provide a rationale for
excluding treatment recommendations. Given that diagnosis and management often go hand in
hand, it would strengthen the paper to justify why treatment guidelines were excluded.
• The Rome IV criteria are subjective and symptom-based, so why prioritize this narrow focus?
A broader review considering treatment pathways in CPGs would give a more complete picture.
If this focus is intentional, the reasoning should be explicitly stated.
• Not all CPGs are created equal—some are based on systematic reviews, while others are expert
consensus-based. Without evaluating guideline rigor, the review treats all CPGs as if they hold
equal weight, which is problematic.
• There is extensive commentary on microbiome research, omics, and biomarker development,
but this feels disconnected from the manuscript’s core focus. While it’s fair to discuss
pathophysiology briefly, this review is about CPGs.
• Are the authors suggesting these biomarkers should be incorporated into current or future
guidelines? If so, that argument needs much more development. If not, this section should be
trimmed down significantly or reframed.
• Regional differences are discussed descriptively, but without any statistical tests, it’s hard to tell
whether these differences are meaningful. Even a basic chi-square test would add much-needed
rigor. If statistical analysis isn’t possible, this limitation should be explicitly acknowledged.
Please review this paper.
user
Title: Clinical Practice Guidelines for the Diagnosis of Constipation-predominant Irritable
Bowel Syndrome and Functional Constipation in Adults: A Scoping Review
Version: 1 Date: 09 Feb 2025
Reviewer's report:
Thanks for submitting this manuscript. It’s a well-executed scoping review with a solid
methodology,
• The authors focus only on diagnostic criteria in CPGs but don’t provide a rationale for
excluding treatment recommendations. Given that diagnosis and management often go hand in
hand, it would strengthen the paper to justify why treatment guidelines were excluded.
• The Rome IV criteria are subjective and symptom-based, so why prioritize this narrow focus?
A broader review considering treatment pathways in CPGs would give a more complete picture.
If this focus is intentional, the reasoning should be explicitly stated.
• Not all CPGs are created equal—some are based on systematic reviews, while others are expert
consensus-based. Without evaluating guideline rigor, the review treats all CPGs as if they hold
equal weight, which is problematic.
• There is extensive commentary on microbiome research, omics, and biomarker development,
but this feels disconnected from the manuscript’s core focus. While it’s fair to discuss
pathophysiology briefly, this review is about CPGs.
• Are the authors suggesting these biomarkers should be incorporated into current or future
guidelines? If so, that argument needs much more development. If not, this section should be
trimmed down significantly or reframed.
• Regional differences are discussed descriptively, but without any statistical tests, it’s hard to tell
whether these differences are meaningful. Even a basic chi-square test would add much-needed
rigor. If statistical analysis isn’t possible, this limitation should be explicitly acknowledged.
assistant