Reviewer's report
Title:Decreasing Incidence of Inflammatory Bowel Disease in Eastern Canada: A
Population database study
Version:2Date:23 May 2014
Reviewer: Govind Makharia
Reviewer's report:
Based on the population database over 2 decades, the authors have shown a
decrease in the incidence of inflammatory bowel disease, both UC and CD, in
Eastern Canada. Such information is very useful and relevant
1. If we look at the evolution of IBD over a period of time; CD followed UC. As the
diagnostic methods improved and were made easily available, the incidence of
CD started rising and equaled that of UC. That would have lead to increase in
incidence of CD. Now the authors describe a decline in the incidence of CD. Is it
a true decline in the incidence (because of change in the risk factors) or a decline
secondary to most undiagnosed patients were diagnosed during the past two
decades. That also explains no decrease in the incidence of IBD in those less
than 20 years of age.
2. The basis of classification of UC, CD and IBD-U based on the administrative
database (i.e. Discharge Abstract and Physician Billings claims databases) and
ICD diagnostic code is not very clear. Did use of these criteria have affected the
number of IBD-U.
Minor:
Discussion may be shortened
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare, No competing interest
Reviewer's report
Title:Decreasing Incidence of Inflammatory Bowel Disease in Eastern Canada: A
Population database study
Version:2Date:23 May 2014
Reviewer: Govind Makharia
Reviewer's report:
Based on the population database over 2 decades, the authors have shown a
decrease in the incidence of inflammatory bowel disease, both UC and CD, in
Eastern Canada. Such information is very useful and relevant
1. If we look at the evolution of IBD over a period of time; CD followed UC. As the
diagnostic methods improved and were made easily available, the incidence of
CD started rising and equaled that of UC. That would have lead to increase in
incidence of CD. Now the authors describe a decline in the incidence of CD. Is it
a true decline in the incidence (because of change in the risk factors) or a decline
secondary to most undiagnosed patients were diagnosed during the past two
decades. That also explains no decrease in the incidence of IBD in those less
than 20 years of age.
2. The basis of classification of UC, CD and IBD-U based on the administrative
database (i.e. Discharge Abstract and Physician Billings claims databases) and
ICD diagnostic code is not very clear. Did use of these criteria have affected the
number of IBD-U.
Minor:
Discussion may be shortened
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare, No competing interest
Please review this paper.
user
Reviewer's report
Title:Decreasing Incidence of Inflammatory Bowel Disease in Eastern Canada: A
Population database study
Version:2Date:23 May 2014
Reviewer: Govind Makharia
Reviewer's report:
Based on the population database over 2 decades, the authors have shown a
decrease in the incidence of inflammatory bowel disease, both UC and CD, in
Eastern Canada. Such information is very useful and relevant
1. If we look at the evolution of IBD over a period of time; CD followed UC. As the
diagnostic methods improved and were made easily available, the incidence of
CD started rising and equaled that of UC. That would have lead to increase in
incidence of CD. Now the authors describe a decline in the incidence of CD. Is it
a true decline in the incidence (because of change in the risk factors) or a decline
secondary to most undiagnosed patients were diagnosed during the past two
decades. That also explains no decrease in the incidence of IBD in those less
than 20 years of age.
2. The basis of classification of UC, CD and IBD-U based on the administrative
database (i.e. Discharge Abstract and Physician Billings claims databases) and
ICD diagnostic code is not very clear. Did use of these criteria have affected the
number of IBD-U.
Minor:
Discussion may be shortened
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare, No competing interest
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