Reviewer's report
Title:Patients' perspectives of living with a percutaneous endoscopic
gastrostomy (PEG)
Version: 1Date:27 May 2012
Reviewer: Simon N Rogers
Reviewer's report:
There is a paucity of patient reported outcomes of gastrostomy feeding so this is
a potentially exciting addition to the literature.
The authors elude to an earlier paper – it is assumed that the patient reported
outcome data in this report was collected as part of the RCT but not presented in
the earlier paper, assumingly because the PROM was a secondary endpoint.
Blomberg J, Lagergren P, Martin L, Mattsson F, Lagergren J: Novel approach to
antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG):
randomised controlled trial. BMJ 2010, 341:c3115. doi: 3110.1136/bmj.c3115.
The patients completed a questionnaire at 2 months. It is not clear why this time
point was chosen. There was follow up to 6 months and perhaps both time points
could have been used.
A non-validated study specific PROM was used in this study. This is fine as there
are only a few questionnaires available e.g reference 12 but this was published in
2007 and this study started in 2005. The disappointment is that there is no other
anchors for this measure e.g swallowing questionnaires as part of HRQOL
outcomes used in H&N, also it would have been useful to include a general
HRQOL measure such as EQ-5d to describe the cohort and perhaps look for
difference in PEG responses by the items.
The PEG questions used in this study are very simple and are suitable for postal
survey, telephone survey, not necessary clinic review. With clinic review extra
data on nutrition and frequency of use would add to the interpretation of the
study.
Was there baseline PROM and if so what was this?
The details on the insertion of the PEG is not really relevant to this paper.
Interesting to combine the 4 point Likert scale to yes / no dichotomized response
for statistical analysis. Not sure about this. A table giving the data is often quite
useful to the reader and could be achieved as only 10 questions are used. It is
not clear why all 16 questions are not reported.
The reason for PEG needs thought as 51 patients died within 2 months seems
high, whilst 12 patients had already had it removed. It is not clear why 55 patients
were excluded.
The paper highlights the patient reported impact of PEG feeding but there seems
to be no balance with trade off if the PEG was not placed. The patients were not
asked about how necessary they felt the PEG was, or if they regretted having the
PEG.
As a prospective study it is a pity that there is not data on how much the PEG
was needed for feeding and nutritional aspects of the PEG – how much feed by
PEG and how much orally.
Level of interest: An article of importance in its field
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:Patients' perspectives of living with a percutaneous endoscopic
gastrostomy (PEG)
Version: 1Date:27 May 2012
Reviewer: Simon N Rogers
Reviewer's report:
There is a paucity of patient reported outcomes of gastrostomy feeding so this is
a potentially exciting addition to the literature.
The authors elude to an earlier paper – it is assumed that the patient reported
outcome data in this report was collected as part of the RCT but not presented in
the earlier paper, assumingly because the PROM was a secondary endpoint.
Blomberg J, Lagergren P, Martin L, Mattsson F, Lagergren J: Novel approach to
antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG):
randomised controlled trial. BMJ 2010, 341:c3115. doi: 3110.1136/bmj.c3115.
The patients completed a questionnaire at 2 months. It is not clear why this time
point was chosen. There was follow up to 6 months and perhaps both time points
could have been used.
A non-validated study specific PROM was used in this study. This is fine as there
are only a few questionnaires available e.g reference 12 but this was published in
2007 and this study started in 2005. The disappointment is that there is no other
anchors for this measure e.g swallowing questionnaires as part of HRQOL
outcomes used in H&N, also it would have been useful to include a general
HRQOL measure such as EQ-5d to describe the cohort and perhaps look for
difference in PEG responses by the items.
The PEG questions used in this study are very simple and are suitable for postal
survey, telephone survey, not necessary clinic review. With clinic review extra
data on nutrition and frequency of use would add to the interpretation of the
study.
Was there baseline PROM and if so what was this?
The details on the insertion of the PEG is not really relevant to this paper.
Interesting to combine the 4 point Likert scale to yes / no dichotomized response
for statistical analysis. Not sure about this. A table giving the data is often quite
useful to the reader and could be achieved as only 10 questions are used. It is
not clear why all 16 questions are not reported.
The reason for PEG needs thought as 51 patients died within 2 months seems
high, whilst 12 patients had already had it removed. It is not clear why 55 patients
were excluded.
The paper highlights the patient reported impact of PEG feeding but there seems
to be no balance with trade off if the PEG was not placed. The patients were not
asked about how necessary they felt the PEG was, or if they regretted having the
PEG.
As a prospective study it is a pity that there is not data on how much the PEG
was needed for feeding and nutritional aspects of the PEG – how much feed by
PEG and how much orally.
Level of interest: An article of importance in its field
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:Patients' perspectives of living with a percutaneous endoscopic
gastrostomy (PEG)
Version: 1Date:27 May 2012
Reviewer: Simon N Rogers
Reviewer's report:
There is a paucity of patient reported outcomes of gastrostomy feeding so this is
a potentially exciting addition to the literature.
The authors elude to an earlier paper – it is assumed that the patient reported
outcome data in this report was collected as part of the RCT but not presented in
the earlier paper, assumingly because the PROM was a secondary endpoint.
Blomberg J, Lagergren P, Martin L, Mattsson F, Lagergren J: Novel approach to
antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG):
randomised controlled trial. BMJ 2010, 341:c3115. doi: 3110.1136/bmj.c3115.
The patients completed a questionnaire at 2 months. It is not clear why this time
point was chosen. There was follow up to 6 months and perhaps both time points
could have been used.
A non-validated study specific PROM was used in this study. This is fine as there
are only a few questionnaires available e.g reference 12 but this was published in
2007 and this study started in 2005. The disappointment is that there is no other
anchors for this measure e.g swallowing questionnaires as part of HRQOL
outcomes used in H&N, also it would have been useful to include a general
HRQOL measure such as EQ-5d to describe the cohort and perhaps look for
difference in PEG responses by the items.
The PEG questions used in this study are very simple and are suitable for postal
survey, telephone survey, not necessary clinic review. With clinic review extra
data on nutrition and frequency of use would add to the interpretation of the
study.
Was there baseline PROM and if so what was this?
The details on the insertion of the PEG is not really relevant to this paper.
Interesting to combine the 4 point Likert scale to yes / no dichotomized response
for statistical analysis. Not sure about this. A table giving the data is often quite
useful to the reader and could be achieved as only 10 questions are used. It is
not clear why all 16 questions are not reported.
The reason for PEG needs thought as 51 patients died within 2 months seems
high, whilst 12 patients had already had it removed. It is not clear why 55 patients
were excluded.
The paper highlights the patient reported impact of PEG feeding but there seems
to be no balance with trade off if the PEG was not placed. The patients were not
asked about how necessary they felt the PEG was, or if they regretted having the
PEG.
As a prospective study it is a pity that there is not data on how much the PEG
was needed for feeding and nutritional aspects of the PEG – how much feed by
PEG and how much orally.
Level of interest: An article of importance in its field
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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