Reviewer's report
Title:Smoking, use of moist snuff and risk of celiac disease: a prospective study
Version:2Date:2 June 2014
Reviewer: Ashwin Ananthakrishnan
Reviewer's report:
Ludvigsson et al. examine the association between smoking, moist snuff and risk
of celiac disease in a Swedish cohort. Overall, this is a well done study using a
power database and the manuscript is written well and the methods adequately
explained.
Some of my concerns which I think need to be addressed are listed below. I think
these can be quite easily addressed within the context of this manuscript and
would improve the utility.
Major Concerns:
1. Since this was a study from blue collar and white collar workers, it is possible
that there is a healthy worker effect in that patients with significant celiac disease
are excluded from these occupations? Please discuss if this is possible and if it
would influence the results.
2. The post hoc analysis showing a significant protective effect in women but not
men is quite striking. This is mentioned for the first time in the discussion but I
think should be mentioned in both the methods and results. Please discuss
potential explanations for this. I think this is the most interesting finding of this
study and merits some discussion.
3. The prior study by the authors (CGH 2005) included only women and showed
no association with smoking. This is in contrast to the findings during the present
study. Please explain the potential reasons for this discrepant result.
Minor points:
1. In their Methods (Page 6) – the authors report that the quality of smoking data
has been previously reviewed and is high. Since that is the primary predictor of
this manuscript, I would suggest provided a little more detail on that. How was
the accuracy confirmed, and please quantify the accuracy rather than merely
citing the previous publication.
2. Page 8 – the meaning of the first sentence is not clear. It says 29,146
individuals formed the basis of this study – but the numbers listed for smoking
and snuff are much higher. Please clarify.
3. For the power calculation – Page 8. I appreciate the authors providing this
information. Please clarify baseline prevalence of celiac disease used to arrive at
the power estimates.
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 have no competing interests.
Reviewer's report
Title:Smoking, use of moist snuff and risk of celiac disease: a prospective study
Version:2Date:2 June 2014
Reviewer: Ashwin Ananthakrishnan
Reviewer's report:
Ludvigsson et al. examine the association between smoking, moist snuff and risk
of celiac disease in a Swedish cohort. Overall, this is a well done study using a
power database and the manuscript is written well and the methods adequately
explained.
Some of my concerns which I think need to be addressed are listed below. I think
these can be quite easily addressed within the context of this manuscript and
would improve the utility.
Major Concerns:
1. Since this was a study from blue collar and white collar workers, it is possible
that there is a healthy worker effect in that patients with significant celiac disease
are excluded from these occupations? Please discuss if this is possible and if it
would influence the results.
2. The post hoc analysis showing a significant protective effect in women but not
men is quite striking. This is mentioned for the first time in the discussion but I
think should be mentioned in both the methods and results. Please discuss
potential explanations for this. I think this is the most interesting finding of this
study and merits some discussion.
3. The prior study by the authors (CGH 2005) included only women and showed
no association with smoking. This is in contrast to the findings during the present
study. Please explain the potential reasons for this discrepant result.
Minor points:
1. In their Methods (Page 6) – the authors report that the quality of smoking data
has been previously reviewed and is high. Since that is the primary predictor of
this manuscript, I would suggest provided a little more detail on that. How was
the accuracy confirmed, and please quantify the accuracy rather than merely
citing the previous publication.
2. Page 8 – the meaning of the first sentence is not clear. It says 29,146
individuals formed the basis of this study – but the numbers listed for smoking
and snuff are much higher. Please clarify.
3. For the power calculation – Page 8. I appreciate the authors providing this
information. Please clarify baseline prevalence of celiac disease used to arrive at
the power estimates.
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 have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Smoking, use of moist snuff and risk of celiac disease: a prospective study
Version:2Date:2 June 2014
Reviewer: Ashwin Ananthakrishnan
Reviewer's report:
Ludvigsson et al. examine the association between smoking, moist snuff and risk
of celiac disease in a Swedish cohort. Overall, this is a well done study using a
power database and the manuscript is written well and the methods adequately
explained.
Some of my concerns which I think need to be addressed are listed below. I think
these can be quite easily addressed within the context of this manuscript and
would improve the utility.
Major Concerns:
1. Since this was a study from blue collar and white collar workers, it is possible
that there is a healthy worker effect in that patients with significant celiac disease
are excluded from these occupations? Please discuss if this is possible and if it
would influence the results.
2. The post hoc analysis showing a significant protective effect in women but not
men is quite striking. This is mentioned for the first time in the discussion but I
think should be mentioned in both the methods and results. Please discuss
potential explanations for this. I think this is the most interesting finding of this
study and merits some discussion.
3. The prior study by the authors (CGH 2005) included only women and showed
no association with smoking. This is in contrast to the findings during the present
study. Please explain the potential reasons for this discrepant result.
Minor points:
1. In their Methods (Page 6) – the authors report that the quality of smoking data
has been previously reviewed and is high. Since that is the primary predictor of
this manuscript, I would suggest provided a little more detail on that. How was
the accuracy confirmed, and please quantify the accuracy rather than merely
citing the previous publication.
2. Page 8 – the meaning of the first sentence is not clear. It says 29,146
individuals formed the basis of this study – but the numbers listed for smoking
and snuff are much higher. Please clarify.
3. For the power calculation – Page 8. I appreciate the authors providing this
information. Please clarify baseline prevalence of celiac disease used to arrive at
the power estimates.
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 have no competing interests.
assistant