Reviewer’s report
Title: 
The impact of symptoms on quality of life before and after diagnosis of
coeliac disease: the results from a Polish population survey and comparison with
the results from the United Kingdom
Version: 
1 
Date: 
28 May 2020
Reviewer's report:
In this study Majsiak et al. aim to analyse the diagnostic process of coeliac
disease in Poland and to describe the quality of life of coeliac patients before
and after the diagnosis of coeliac disease. The Authors also provide a
comparison between data about Poland and data from a previous study
conducted in the UK. They found that diagnosis of coeliac disease in Poland is
still burdened by a significant diagnostic delay, albeit being shorter than in the
UK.
Overall the topic is interesting, the paper is well built and the results are
discussed in an organic way.
I only have a few concerns about how diagnoses of coeliac disease were made in
the patients enrolled in the study. The patients were all members of the Polish
Coeliac Society and they were recruited by means of a postal questionnaire. If
we consider that the patients enrolled in the study received a diagnosis of coeliac
disease at different times and at different ages (pediatric vs. adult CD), it would
be interesting to have more details about methods of diagnosis (type of
antibodies tested? Duodenal biopsy? Diagnoses in accordance with ESPGHAN
guidelines in children?). If feasible, I would suggest the Authors to add a few
lines on this in the methods and to briefly comment on this in the discussion.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Reviewer’s report
Title: 
The impact of symptoms on quality of life before and after diagnosis of
coeliac disease: the results from a Polish population survey and comparison with
the results from the United Kingdom
Version: 
1 
Date: 
28 May 2020
Reviewer's report:
In this study Majsiak et al. aim to analyse the diagnostic process of coeliac
disease in Poland and to describe the quality of life of coeliac patients before
and after the diagnosis of coeliac disease. The Authors also provide a
comparison between data about Poland and data from a previous study
conducted in the UK. They found that diagnosis of coeliac disease in Poland is
still burdened by a significant diagnostic delay, albeit being shorter than in the
UK.
Overall the topic is interesting, the paper is well built and the results are
discussed in an organic way.
I only have a few concerns about how diagnoses of coeliac disease were made in
the patients enrolled in the study. The patients were all members of the Polish
Coeliac Society and they were recruited by means of a postal questionnaire. If
we consider that the patients enrolled in the study received a diagnosis of coeliac
disease at different times and at different ages (pediatric vs. adult CD), it would
be interesting to have more details about methods of diagnosis (type of
antibodies tested? Duodenal biopsy? Diagnoses in accordance with ESPGHAN
guidelines in children?). If feasible, I would suggest the Authors to add a few
lines on this in the methods and to briefly comment on this in the discussion.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Please review this paper.
user
Reviewer’s report
Title: 
The impact of symptoms on quality of life before and after diagnosis of
coeliac disease: the results from a Polish population survey and comparison with
the results from the United Kingdom
Version: 
1 
Date: 
28 May 2020
Reviewer's report:
In this study Majsiak et al. aim to analyse the diagnostic process of coeliac
disease in Poland and to describe the quality of life of coeliac patients before
and after the diagnosis of coeliac disease. The Authors also provide a
comparison between data about Poland and data from a previous study
conducted in the UK. They found that diagnosis of coeliac disease in Poland is
still burdened by a significant diagnostic delay, albeit being shorter than in the
UK.
Overall the topic is interesting, the paper is well built and the results are
discussed in an organic way.
I only have a few concerns about how diagnoses of coeliac disease were made in
the patients enrolled in the study. The patients were all members of the Polish
Coeliac Society and they were recruited by means of a postal questionnaire. If
we consider that the patients enrolled in the study received a diagnosis of coeliac
disease at different times and at different ages (pediatric vs. adult CD), it would
be interesting to have more details about methods of diagnosis (type of
antibodies tested? Duodenal biopsy? Diagnoses in accordance with ESPGHAN
guidelines in children?). If feasible, I would suggest the Authors to add a few
lines on this in the methods and to briefly comment on this in the discussion.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
assistant