Reviewer's report
Title:Clinical benefit of gluten-free diet in screen-detected older celiac disease
patients
Version: 3Date:10 November 2011
Reviewer: Geoffrey Holmes
Reviewer's report:
Coeliac disease is being increasingly diagnosed in the elderly and in this report
the authors provide useful information on 35 coeliac patients uncovered by
screening. They show that this is worthwhile,for the patients benefitted from a
gluten free diet as judged by a number of different parameters.
They also draw attention to the importnat fact that in this group there are pointers
to the presence of coeliac disease e.g. a family history, subtle symptoms,
previous low impact fractures, that are often missed and in this grop 29 of the 35
patients would have been diagnosed if these features had been taken into
account without screening. They do not advocate mass screening which would
entail huge logistical problems but do recommend rigorous case finding in the
elderly who are an at-risk group. Most gastroenterologicsts would concur with
this strategy.
I have some comments.
Minor essential revisions.
1. In the Abstract it is stated dietary complicance was good. This is supported by
statements on page 13 and on page 5 it is said the patients saw a dietician and a
gastroenterologist but there are no details given. This is a crucial aspect of the
study and I think readers would like more information on this aspect of the work.
How was compliance assessed clinically? What were the criteria for good
complicance? how many patients were judged to be strict and how many lax on
the GFD? There is still a view, widely held, that elderly patients cannot manage a
GFD or that dietary habits in the elderly are difficul to change.
2. In the Methods section - stored at 20C; should be stored at -20C.
3. In the Discussion page 13, line 11 - delete which is.
4. The Legend for Table 3 is misleading because some of the patients, as
pointed out in the text on page 10, received not only a GFD but also
supplements. I think the legend should also point this out and refer back to page
10.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no conflicting interests.
Reviewer's report
Title:Clinical benefit of gluten-free diet in screen-detected older celiac disease
patients
Version: 3Date:10 November 2011
Reviewer: Geoffrey Holmes
Reviewer's report:
Coeliac disease is being increasingly diagnosed in the elderly and in this report
the authors provide useful information on 35 coeliac patients uncovered by
screening. They show that this is worthwhile,for the patients benefitted from a
gluten free diet as judged by a number of different parameters.
They also draw attention to the importnat fact that in this group there are pointers
to the presence of coeliac disease e.g. a family history, subtle symptoms,
previous low impact fractures, that are often missed and in this grop 29 of the 35
patients would have been diagnosed if these features had been taken into
account without screening. They do not advocate mass screening which would
entail huge logistical problems but do recommend rigorous case finding in the
elderly who are an at-risk group. Most gastroenterologicsts would concur with
this strategy.
I have some comments.
Minor essential revisions.
1. In the Abstract it is stated dietary complicance was good. This is supported by
statements on page 13 and on page 5 it is said the patients saw a dietician and a
gastroenterologist but there are no details given. This is a crucial aspect of the
study and I think readers would like more information on this aspect of the work.
How was compliance assessed clinically? What were the criteria for good
complicance? how many patients were judged to be strict and how many lax on
the GFD? There is still a view, widely held, that elderly patients cannot manage a
GFD or that dietary habits in the elderly are difficul to change.
2. In the Methods section - stored at 20C; should be stored at -20C.
3. In the Discussion page 13, line 11 - delete which is.
4. The Legend for Table 3 is misleading because some of the patients, as
pointed out in the text on page 10, received not only a GFD but also
supplements. I think the legend should also point this out and refer back to page
10.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no conflicting interests.
Please review this paper.
user
Reviewer's report
Title:Clinical benefit of gluten-free diet in screen-detected older celiac disease
patients
Version: 3Date:10 November 2011
Reviewer: Geoffrey Holmes
Reviewer's report:
Coeliac disease is being increasingly diagnosed in the elderly and in this report
the authors provide useful information on 35 coeliac patients uncovered by
screening. They show that this is worthwhile,for the patients benefitted from a
gluten free diet as judged by a number of different parameters.
They also draw attention to the importnat fact that in this group there are pointers
to the presence of coeliac disease e.g. a family history, subtle symptoms,
previous low impact fractures, that are often missed and in this grop 29 of the 35
patients would have been diagnosed if these features had been taken into
account without screening. They do not advocate mass screening which would
entail huge logistical problems but do recommend rigorous case finding in the
elderly who are an at-risk group. Most gastroenterologicsts would concur with
this strategy.
I have some comments.
Minor essential revisions.
1. In the Abstract it is stated dietary complicance was good. This is supported by
statements on page 13 and on page 5 it is said the patients saw a dietician and a
gastroenterologist but there are no details given. This is a crucial aspect of the
study and I think readers would like more information on this aspect of the work.
How was compliance assessed clinically? What were the criteria for good
complicance? how many patients were judged to be strict and how many lax on
the GFD? There is still a view, widely held, that elderly patients cannot manage a
GFD or that dietary habits in the elderly are difficul to change.
2. In the Methods section - stored at 20C; should be stored at -20C.
3. In the Discussion page 13, line 11 - delete which is.
4. The Legend for Table 3 is misleading because some of the patients, as
pointed out in the text on page 10, received not only a GFD but also
supplements. I think the legend should also point this out and refer back to page
10.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no conflicting interests.
assistant