Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Imran Aziz
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript titled “The
changing clinical profile of celiac disease: A 15 year experience (1998-2012) in
an Italian Referral Center.”
This is an interesting paper which is in simple terms looking at the “celiac clinic”
in Bologna. This gives an overview of the different forms of presentation seen in
one clinic, which may be generalisable to other centers also looking after celiac
patients. I particularly like their table 1 and 2 highlighting some of the more
complex cases they have encountered.
However, I have a few queries:
major 1. I am not sure whether I can currently agree with the title or the
conclusion as stated in the abstract. I cannot see any evidence that the authors
have demonstrated an increasing rate of non-classical and subclinical
phenotypes over time. They have simply given a broad overview of their 15 year
experience. But have not shown the year-on-year trend of different presentations
which would answer their title and conclusion. To do this, I suggest they discuss
and also demonstrate (i.e in figure 1) each subtype % for each year 1998 to
2012. That may, for example, help show that classical was common in 1998 and
by 2012 you have classical-nonclassical-subclinical.
minor 2. Figures 4 and 5 do not add to the study, as they are simple figures
which have already and clearly been described in the written results section. I
feel they can be excluded.
minor 3. The spectrum of villous atrophy in this paper has described Marsh 3a,
mild; 3b, partial; 3c, subtotal. However, this is not as stated in for example the
American Journal of Gastroenterology guidelines on celiac disease, or the Oslo
definitions, where Marsh 3a is referred to as partial villous atrophy; 3b, subtotal
villous atrophy; 3c, total villous atrophy. This latter format is more inituitive to
follow.
Level of interest: An article whose findings are important to those with closely
related research interests
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 that I have no competing interests'
Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Imran Aziz
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript titled “The
changing clinical profile of celiac disease: A 15 year experience (1998-2012) in
an Italian Referral Center.”
This is an interesting paper which is in simple terms looking at the “celiac clinic”
in Bologna. This gives an overview of the different forms of presentation seen in
one clinic, which may be generalisable to other centers also looking after celiac
patients. I particularly like their table 1 and 2 highlighting some of the more
complex cases they have encountered.
However, I have a few queries:
major 1. I am not sure whether I can currently agree with the title or the
conclusion as stated in the abstract. I cannot see any evidence that the authors
have demonstrated an increasing rate of non-classical and subclinical
phenotypes over time. They have simply given a broad overview of their 15 year
experience. But have not shown the year-on-year trend of different presentations
which would answer their title and conclusion. To do this, I suggest they discuss
and also demonstrate (i.e in figure 1) each subtype % for each year 1998 to
2012. That may, for example, help show that classical was common in 1998 and
by 2012 you have classical-nonclassical-subclinical.
minor 2. Figures 4 and 5 do not add to the study, as they are simple figures
which have already and clearly been described in the written results section. I
feel they can be excluded.
minor 3. The spectrum of villous atrophy in this paper has described Marsh 3a,
mild; 3b, partial; 3c, subtotal. However, this is not as stated in for example the
American Journal of Gastroenterology guidelines on celiac disease, or the Oslo
definitions, where Marsh 3a is referred to as partial villous atrophy; 3b, subtotal
villous atrophy; 3c, total villous atrophy. This latter format is more inituitive to
follow.
Level of interest: An article whose findings are important to those with closely
related research interests
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 that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Imran Aziz
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript titled “The
changing clinical profile of celiac disease: A 15 year experience (1998-2012) in
an Italian Referral Center.”
This is an interesting paper which is in simple terms looking at the “celiac clinic”
in Bologna. This gives an overview of the different forms of presentation seen in
one clinic, which may be generalisable to other centers also looking after celiac
patients. I particularly like their table 1 and 2 highlighting some of the more
complex cases they have encountered.
However, I have a few queries:
major 1. I am not sure whether I can currently agree with the title or the
conclusion as stated in the abstract. I cannot see any evidence that the authors
have demonstrated an increasing rate of non-classical and subclinical
phenotypes over time. They have simply given a broad overview of their 15 year
experience. But have not shown the year-on-year trend of different presentations
which would answer their title and conclusion. To do this, I suggest they discuss
and also demonstrate (i.e in figure 1) each subtype % for each year 1998 to
2012. That may, for example, help show that classical was common in 1998 and
by 2012 you have classical-nonclassical-subclinical.
minor 2. Figures 4 and 5 do not add to the study, as they are simple figures
which have already and clearly been described in the written results section. I
feel they can be excluded.
minor 3. The spectrum of villous atrophy in this paper has described Marsh 3a,
mild; 3b, partial; 3c, subtotal. However, this is not as stated in for example the
American Journal of Gastroenterology guidelines on celiac disease, or the Oslo
definitions, where Marsh 3a is referred to as partial villous atrophy; 3b, subtotal
villous atrophy; 3c, total villous atrophy. This latter format is more inituitive to
follow.
Level of interest: An article whose findings are important to those with closely
related research interests
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 that I have no competing interests'
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