Title: Gluten-Free Diet Adherence Patterns and Health Outcomes in Celiac Disease: A
Retrospective Observational Study
Version: 1 Date: 27 May 2025
Reviewer's report:
Assessment:
1. Spelling mistake in background section of abstract [thier# their].
2. In methods section of article, this sentence may be rephrased to clearly understand that two
time points were asked in the same questionnaire applied once to the patient. [The questionnaire
included a broad array of clinical and demographic questions assessed at two time points:
initially, at the time of disease diagnosis, and recently during the study.]
3. What is ‘gripes’ in the figure 2? It may be considered to merge similar meaning symptoms
which the patient might had difficulty in answering, like abdominal pain and cramps; gas feeling
and bloating.
4. The response in infertility is same with all the duration category. This requires explanation
and further literature support. This is a very good finding that even short duration can cause
marked improvement in infertility. However, fallacy is the what was the cause of infertility
at the baseline? It can be mentioned that it was not assessed if not done. The same applies to
abortion also.
5. The changes in blood parameters lacks a clear explanation. Why did Ca, MCV and Hb fall
in follow up? Were these patients not on strict GFD or were relying only on GFD for nutrients?
Can this be concluded that GFD is nutritionally depleted diet and should also require drug
supplementations?
6. Were the participants taking any medications related to comorbidities, haematinics and
calcium/ vit D supplements?
7. How was the number of comorbidities and their change assessed over time? How system
related comorbidities assessed? Were these a speculation from the blood results and symptoms?
Overall, the study has assessed an important aspect of celiac disease management, that is the
change in individual parameters with GFD adherence and time duration. Further prospective
studies can be done to assess similar parameters after overcoming confounders and limitations
of this study.
Title: Gluten-Free Diet Adherence Patterns and Health Outcomes in Celiac Disease: A
Retrospective Observational Study
Version: 1 Date: 27 May 2025
Reviewer's report:
Assessment:
1. Spelling mistake in background section of abstract [thier# their].
2. In methods section of article, this sentence may be rephrased to clearly understand that two
time points were asked in the same questionnaire applied once to the patient. [The questionnaire
included a broad array of clinical and demographic questions assessed at two time points:
initially, at the time of disease diagnosis, and recently during the study.]
3. What is ‘gripes’ in the figure 2? It may be considered to merge similar meaning symptoms
which the patient might had difficulty in answering, like abdominal pain and cramps; gas feeling
and bloating.
4. The response in infertility is same with all the duration category. This requires explanation
and further literature support. This is a very good finding that even short duration can cause
marked improvement in infertility. However, fallacy is the what was the cause of infertility
at the baseline? It can be mentioned that it was not assessed if not done. The same applies to
abortion also.
5. The changes in blood parameters lacks a clear explanation. Why did Ca, MCV and Hb fall
in follow up? Were these patients not on strict GFD or were relying only on GFD for nutrients?
Can this be concluded that GFD is nutritionally depleted diet and should also require drug
supplementations?
6. Were the participants taking any medications related to comorbidities, haematinics and
calcium/ vit D supplements?
7. How was the number of comorbidities and their change assessed over time? How system
related comorbidities assessed? Were these a speculation from the blood results and symptoms?
Overall, the study has assessed an important aspect of celiac disease management, that is the
change in individual parameters with GFD adherence and time duration. Further prospective
studies can be done to assess similar parameters after overcoming confounders and limitations
of this study.
Please review this paper.
user
Title: Gluten-Free Diet Adherence Patterns and Health Outcomes in Celiac Disease: A
Retrospective Observational Study
Version: 1 Date: 27 May 2025
Reviewer's report:
Assessment:
1. Spelling mistake in background section of abstract [thier# their].
2. In methods section of article, this sentence may be rephrased to clearly understand that two
time points were asked in the same questionnaire applied once to the patient. [The questionnaire
included a broad array of clinical and demographic questions assessed at two time points:
initially, at the time of disease diagnosis, and recently during the study.]
3. What is ‘gripes’ in the figure 2? It may be considered to merge similar meaning symptoms
which the patient might had difficulty in answering, like abdominal pain and cramps; gas feeling
and bloating.
4. The response in infertility is same with all the duration category. This requires explanation
and further literature support. This is a very good finding that even short duration can cause
marked improvement in infertility. However, fallacy is the what was the cause of infertility
at the baseline? It can be mentioned that it was not assessed if not done. The same applies to
abortion also.
5. The changes in blood parameters lacks a clear explanation. Why did Ca, MCV and Hb fall
in follow up? Were these patients not on strict GFD or were relying only on GFD for nutrients?
Can this be concluded that GFD is nutritionally depleted diet and should also require drug
supplementations?
6. Were the participants taking any medications related to comorbidities, haematinics and
calcium/ vit D supplements?
7. How was the number of comorbidities and their change assessed over time? How system
related comorbidities assessed? Were these a speculation from the blood results and symptoms?
Overall, the study has assessed an important aspect of celiac disease management, that is the
change in individual parameters with GFD adherence and time duration. Further prospective
studies can be done to assess similar parameters after overcoming confounders and limitations
of this study.
assistant