Reviewer's report
Title:Validation study of villous atrophy and small intestinal inflammation in
Swedish biopsy registers
Version: 2Date:29 October 2008
Reviewer: Riccardo Troncone
Reviewer's report:
In this paper the Authors have searched all pathology Departments in Sweden
with the aim of validating the histopathological classification of small intestinal
biopsy by Swedish pathologists. They found a 90 % correct classification of
biopsies labeled as villous atrophy and only 56% of those characterized by
mucosal inflammation.
Although there was no effort to further grading villous atrophy according to the
severity of mucosal damage this is the most interesting and sound part of the
paper. The finding of high specificity for coeliac disease of villous atrophy is
useful to use those histological reports as a data source for coeliac disease.
Over the last decade the concept that CD may be characterized by minor
enteropathy has emerged. It would be important to know the specificity for the
diagnosis of CD of such minor degrees of enteropathy (here considered as
“inflammation”). It is unexpected the very low percentage of causes other than
celiac disease responsible for that (less than 2% attributed to IBD). In this
respect table 4 is unclear: should the second column read VA and not CD?
The authors wish also to look for other info (i.e. characteristics of serology,
symptoms of individuals with celiac disease, use of small biopsies for the
diagnosis of coeliac disease), but the data reported in this second part of the
paper do not allow to draw firm conclusions.
The paper, although potentially providing useful info (specificity for diagnosis of
different histological patterns) is in many sections not clearly written and difficult
to follow. It aims to answer too many questions at one time. Limitations of the
methodological approach are not satisfactorily discussed. It needs extensive
revision and clarification.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Validation study of villous atrophy and small intestinal inflammation in
Swedish biopsy registers
Version: 2Date:29 October 2008
Reviewer: Riccardo Troncone
Reviewer's report:
In this paper the Authors have searched all pathology Departments in Sweden
with the aim of validating the histopathological classification of small intestinal
biopsy by Swedish pathologists. They found a 90 % correct classification of
biopsies labeled as villous atrophy and only 56% of those characterized by
mucosal inflammation.
Although there was no effort to further grading villous atrophy according to the
severity of mucosal damage this is the most interesting and sound part of the
paper. The finding of high specificity for coeliac disease of villous atrophy is
useful to use those histological reports as a data source for coeliac disease.
Over the last decade the concept that CD may be characterized by minor
enteropathy has emerged. It would be important to know the specificity for the
diagnosis of CD of such minor degrees of enteropathy (here considered as
“inflammation”). It is unexpected the very low percentage of causes other than
celiac disease responsible for that (less than 2% attributed to IBD). In this
respect table 4 is unclear: should the second column read VA and not CD?
The authors wish also to look for other info (i.e. characteristics of serology,
symptoms of individuals with celiac disease, use of small biopsies for the
diagnosis of coeliac disease), but the data reported in this second part of the
paper do not allow to draw firm conclusions.
The paper, although potentially providing useful info (specificity for diagnosis of
different histological patterns) is in many sections not clearly written and difficult
to follow. It aims to answer too many questions at one time. Limitations of the
methodological approach are not satisfactorily discussed. It needs extensive
revision and clarification.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Validation study of villous atrophy and small intestinal inflammation in
Swedish biopsy registers
Version: 2Date:29 October 2008
Reviewer: Riccardo Troncone
Reviewer's report:
In this paper the Authors have searched all pathology Departments in Sweden
with the aim of validating the histopathological classification of small intestinal
biopsy by Swedish pathologists. They found a 90 % correct classification of
biopsies labeled as villous atrophy and only 56% of those characterized by
mucosal inflammation.
Although there was no effort to further grading villous atrophy according to the
severity of mucosal damage this is the most interesting and sound part of the
paper. The finding of high specificity for coeliac disease of villous atrophy is
useful to use those histological reports as a data source for coeliac disease.
Over the last decade the concept that CD may be characterized by minor
enteropathy has emerged. It would be important to know the specificity for the
diagnosis of CD of such minor degrees of enteropathy (here considered as
“inflammation”). It is unexpected the very low percentage of causes other than
celiac disease responsible for that (less than 2% attributed to IBD). In this
respect table 4 is unclear: should the second column read VA and not CD?
The authors wish also to look for other info (i.e. characteristics of serology,
symptoms of individuals with celiac disease, use of small biopsies for the
diagnosis of coeliac disease), but the data reported in this second part of the
paper do not allow to draw firm conclusions.
The paper, although potentially providing useful info (specificity for diagnosis of
different histological patterns) is in many sections not clearly written and difficult
to follow. It aims to answer too many questions at one time. Limitations of the
methodological approach are not satisfactorily discussed. It needs extensive
revision and clarification.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant