Title: Celiac Disease Symptom Profiles and their Relationship to Gluten-free Diet Adherence,
Mental Health, and Quality of Life
Version: 2 Date: 29 Aug 2023
Reviewer's report:
This manuscript addresses a very relevant and  current topic: quality of life and celiac disease still
needs of a great amount of research. Even though the paper is very well written and structured,
I would like to make some comments:
1. I am not sure if we should talk about quality of life (QoL) or Health Related Quality of
Life. Quality of life is probably a wider term which includes incomes, social support, work
conditions... I leave it to authors´consideration.
2. I would include a brief description of iCureCeliac research network for those unfamiliar with
that registry (year of creation, number of records, requirements for registration,  information
held...)
3. Despite figure 1,  I miss a table describing each profile or additional information in figure 1
note. It is hard to keep in mind the differences among the profiles.
4. Were participants asked for time in GFD? Should we assume that time since diagnosis is the
same that time in GFD?
5. Were voluntary and unnoticed transgressions explored/controlled somehow?
6. The study gathers a lot of information I miss a deeper analysis regarding CDQoL (even though
no differences among profiles were found) and its relation with the cut-off point (If I'm not
mistaken a score of 63.07 is below the cut-off point that indicates good quality of life and that
should be addressed.
7. I also miss a deeper analysis for CDAT results. Have you found differences among low/
moderate/good adherence groups in Quality of life or any other variable. I am aware that this
information may fall beyond the objectives of this study but I encourage the authors to include
this analysis (and the one in comment 7)  either here o in another paper in the future.
8. As it is commented in the limitations section, CDAT may be insufficient to address adherence.
An interview with an expert dietitian or the use of GIP's would help to control transgressions
and assure adherence.  I understand this is not possible due to methodology selected but it could
be taken into consideration in future research to confirm the profiles found.
To sum up,  I consider this manuscript relevant and suitable for publication although I would like
to see a deeper analysis on the issues commented to enable comparison with previous research.
Title: Celiac Disease Symptom Profiles and their Relationship to Gluten-free Diet Adherence,
Mental Health, and Quality of Life
Version: 2 Date: 29 Aug 2023
Reviewer's report:
This manuscript addresses a very relevant and  current topic: quality of life and celiac disease still
needs of a great amount of research. Even though the paper is very well written and structured,
I would like to make some comments:
1. I am not sure if we should talk about quality of life (QoL) or Health Related Quality of
Life. Quality of life is probably a wider term which includes incomes, social support, work
conditions... I leave it to authors´consideration.
2. I would include a brief description of iCureCeliac research network for those unfamiliar with
that registry (year of creation, number of records, requirements for registration,  information
held...)
3. Despite figure 1,  I miss a table describing each profile or additional information in figure 1
note. It is hard to keep in mind the differences among the profiles.
4. Were participants asked for time in GFD? Should we assume that time since diagnosis is the
same that time in GFD?
5. Were voluntary and unnoticed transgressions explored/controlled somehow?
6. The study gathers a lot of information I miss a deeper analysis regarding CDQoL (even though
no differences among profiles were found) and its relation with the cut-off point (If I'm not
mistaken a score of 63.07 is below the cut-off point that indicates good quality of life and that
should be addressed.
7. I also miss a deeper analysis for CDAT results. Have you found differences among low/
moderate/good adherence groups in Quality of life or any other variable. I am aware that this
information may fall beyond the objectives of this study but I encourage the authors to include
this analysis (and the one in comment 7)  either here o in another paper in the future.
8. As it is commented in the limitations section, CDAT may be insufficient to address adherence.
An interview with an expert dietitian or the use of GIP's would help to control transgressions
and assure adherence.  I understand this is not possible due to methodology selected but it could
be taken into consideration in future research to confirm the profiles found.
To sum up,  I consider this manuscript relevant and suitable for publication although I would like
to see a deeper analysis on the issues commented to enable comparison with previous research.
Please review this paper.
user
Title: Celiac Disease Symptom Profiles and their Relationship to Gluten-free Diet Adherence,
Mental Health, and Quality of Life
Version: 2 Date: 29 Aug 2023
Reviewer's report:
This manuscript addresses a very relevant and  current topic: quality of life and celiac disease still
needs of a great amount of research. Even though the paper is very well written and structured,
I would like to make some comments:
1. I am not sure if we should talk about quality of life (QoL) or Health Related Quality of
Life. Quality of life is probably a wider term which includes incomes, social support, work
conditions... I leave it to authors´consideration.
2. I would include a brief description of iCureCeliac research network for those unfamiliar with
that registry (year of creation, number of records, requirements for registration,  information
held...)
3. Despite figure 1,  I miss a table describing each profile or additional information in figure 1
note. It is hard to keep in mind the differences among the profiles.
4. Were participants asked for time in GFD? Should we assume that time since diagnosis is the
same that time in GFD?
5. Were voluntary and unnoticed transgressions explored/controlled somehow?
6. The study gathers a lot of information I miss a deeper analysis regarding CDQoL (even though
no differences among profiles were found) and its relation with the cut-off point (If I'm not
mistaken a score of 63.07 is below the cut-off point that indicates good quality of life and that
should be addressed.
7. I also miss a deeper analysis for CDAT results. Have you found differences among low/
moderate/good adherence groups in Quality of life or any other variable. I am aware that this
information may fall beyond the objectives of this study but I encourage the authors to include
this analysis (and the one in comment 7)  either here o in another paper in the future.
8. As it is commented in the limitations section, CDAT may be insufficient to address adherence.
An interview with an expert dietitian or the use of GIP's would help to control transgressions
and assure adherence.  I understand this is not possible due to methodology selected but it could
be taken into consideration in future research to confirm the profiles found.
To sum up,  I consider this manuscript relevant and suitable for publication although I would like
to see a deeper analysis on the issues commented to enable comparison with previous research.
assistant