Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:23 February 2009
Reviewer: Detlef Schuppan
Reviewer's report:
Vilppula et al. studied prevalence and incidence of celiac disease in the elderly
by sequential serum screening for celiac disease antibodies. They found that the
prevalence of celiac disease in elderly people is high but the symptoms are only
minor. Furthermore, they show 5 cases that developed celiac disease within
three years after being seronegative in the first screening. Since little is known
about the development of celiac disease in elderly people these results are
interesting.
However, the major point of critique is that the first and major part of the study
was already published elsewhere (Vilppula et al; Dig Liver Dis.; 2008). Therefore
the only novel aspects the authors are presenting is the 5 newly detected cases
of celiac disease on follow up.
Minor points:
1. The study population is not well defined. The authors included all people over
55 years in their statistical analysis. It would make more sense to distinguish
groups between 55 and 65 years and over 65 years, and to calculate prevalence
and incidence separately for these groups.
2. The authors should state the number of biopsies that were taken per patient
and the histopathological appearance (MARSH criteria) of the diagnosed
patients. What does it mean when patients were only classified as celiacs based
on marginally elevated autoantibodies and a Marsh I histology?
3. Thus they should present the titers of the seropositive patients together with
the cut offs they used for diagnosis. Could the 5 newly detected celiacs be due to
some variability within the used anti-tTG assay which though showing excellent
reliability is not perfect?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
no conflicts of interest
Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:23 February 2009
Reviewer: Detlef Schuppan
Reviewer's report:
Vilppula et al. studied prevalence and incidence of celiac disease in the elderly
by sequential serum screening for celiac disease antibodies. They found that the
prevalence of celiac disease in elderly people is high but the symptoms are only
minor. Furthermore, they show 5 cases that developed celiac disease within
three years after being seronegative in the first screening. Since little is known
about the development of celiac disease in elderly people these results are
interesting.
However, the major point of critique is that the first and major part of the study
was already published elsewhere (Vilppula et al; Dig Liver Dis.; 2008). Therefore
the only novel aspects the authors are presenting is the 5 newly detected cases
of celiac disease on follow up.
Minor points:
1. The study population is not well defined. The authors included all people over
55 years in their statistical analysis. It would make more sense to distinguish
groups between 55 and 65 years and over 65 years, and to calculate prevalence
and incidence separately for these groups.
2. The authors should state the number of biopsies that were taken per patient
and the histopathological appearance (MARSH criteria) of the diagnosed
patients. What does it mean when patients were only classified as celiacs based
on marginally elevated autoantibodies and a Marsh I histology?
3. Thus they should present the titers of the seropositive patients together with
the cut offs they used for diagnosis. Could the 5 newly detected celiacs be due to
some variability within the used anti-tTG assay which though showing excellent
reliability is not perfect?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
no conflicts of interest
Please review this paper.
user
Reviewer's report
Title:Increasing prevalence and high Incidence of celiac disease in elderly
people: A population-based study
Version: 1Date:23 February 2009
Reviewer: Detlef Schuppan
Reviewer's report:
Vilppula et al. studied prevalence and incidence of celiac disease in the elderly
by sequential serum screening for celiac disease antibodies. They found that the
prevalence of celiac disease in elderly people is high but the symptoms are only
minor. Furthermore, they show 5 cases that developed celiac disease within
three years after being seronegative in the first screening. Since little is known
about the development of celiac disease in elderly people these results are
interesting.
However, the major point of critique is that the first and major part of the study
was already published elsewhere (Vilppula et al; Dig Liver Dis.; 2008). Therefore
the only novel aspects the authors are presenting is the 5 newly detected cases
of celiac disease on follow up.
Minor points:
1. The study population is not well defined. The authors included all people over
55 years in their statistical analysis. It would make more sense to distinguish
groups between 55 and 65 years and over 65 years, and to calculate prevalence
and incidence separately for these groups.
2. The authors should state the number of biopsies that were taken per patient
and the histopathological appearance (MARSH criteria) of the diagnosed
patients. What does it mean when patients were only classified as celiacs based
on marginally elevated autoantibodies and a Marsh I histology?
3. Thus they should present the titers of the seropositive patients together with
the cut offs they used for diagnosis. Could the 5 newly detected celiacs be due to
some variability within the used anti-tTG assay which though showing excellent
reliability is not perfect?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
no conflicts of interest
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