Reviewer's report
Title:Investigation of Potential Early Histologic Markers of Pediatric Inflammatory
Bowel Disease
Version:2Date:17 August 2014
Reviewer: Mark Riddle
Reviewer's report:
This restrospective case control study, which as designed has important
limitations that make generalization difficult. However, the study does identify a
current clinical practice conundrum and provides some evidence that additional
clinical investigation is needed to better distinguish early IBD from other causes.
An equaly important question is how such earlier diagnosis and appropriate
treatment might change the course of disease. In general, the manuscript is well
written. The following recommendations are made for consideration by the
authors:
Major Compulsory Revisions:
1. Methods - With respect to they way stained sections were evaluated for the
presence of TNF-alpha activity, further detailed information on the qualification of
"immunoreactivity". For others to repeat such a study based on histological
examination, very specific definitions are needed. Currently such detailed
methodology is lacking. Further objective description is needed.
2. Statistical Analysis - Authors need to justify the use of an idependent T-test for
comparison of continuous variables. It would appear that the Central Limit
Theorem would not apply given the small group sizes. Please justify the
appropriateness of this test or select a more appropriate non-parametric test.
Minor Essential Revisions
Discussion. p.11,ln 8 and line 12 - These are two statements that need to be
appropriately referenced.
Drop Figure 1, it is redundant with table 4
Discretionary revisions
Consider analyzing or providing description which evaluates whether clinical
features might correlate with crypt distortion or eosinophilia among those who
develop IBD in your data set. Such clinical features might be considered useful
for an eventual diagnostic algorithm which includes both histological and clinical
features.
Include discussion on the consideration of what proportion of individuals with
"high" criteria of crypt distortion and rectosigmoid eosinophilia might not go onto
develop IBD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Investigation of Potential Early Histologic Markers of Pediatric Inflammatory
Bowel Disease
Version:2Date:17 August 2014
Reviewer: Mark Riddle
Reviewer's report:
This restrospective case control study, which as designed has important
limitations that make generalization difficult. However, the study does identify a
current clinical practice conundrum and provides some evidence that additional
clinical investigation is needed to better distinguish early IBD from other causes.
An equaly important question is how such earlier diagnosis and appropriate
treatment might change the course of disease. In general, the manuscript is well
written. The following recommendations are made for consideration by the
authors:
Major Compulsory Revisions:
1. Methods - With respect to they way stained sections were evaluated for the
presence of TNF-alpha activity, further detailed information on the qualification of
"immunoreactivity". For others to repeat such a study based on histological
examination, very specific definitions are needed. Currently such detailed
methodology is lacking. Further objective description is needed.
2. Statistical Analysis - Authors need to justify the use of an idependent T-test for
comparison of continuous variables. It would appear that the Central Limit
Theorem would not apply given the small group sizes. Please justify the
appropriateness of this test or select a more appropriate non-parametric test.
Minor Essential Revisions
Discussion. p.11,ln 8 and line 12 - These are two statements that need to be
appropriately referenced.
Drop Figure 1, it is redundant with table 4
Discretionary revisions
Consider analyzing or providing description which evaluates whether clinical
features might correlate with crypt distortion or eosinophilia among those who
develop IBD in your data set. Such clinical features might be considered useful
for an eventual diagnostic algorithm which includes both histological and clinical
features.
Include discussion on the consideration of what proportion of individuals with
"high" criteria of crypt distortion and rectosigmoid eosinophilia might not go onto
develop IBD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Investigation of Potential Early Histologic Markers of Pediatric Inflammatory
Bowel Disease
Version:2Date:17 August 2014
Reviewer: Mark Riddle
Reviewer's report:
This restrospective case control study, which as designed has important
limitations that make generalization difficult. However, the study does identify a
current clinical practice conundrum and provides some evidence that additional
clinical investigation is needed to better distinguish early IBD from other causes.
An equaly important question is how such earlier diagnosis and appropriate
treatment might change the course of disease. In general, the manuscript is well
written. The following recommendations are made for consideration by the
authors:
Major Compulsory Revisions:
1. Methods - With respect to they way stained sections were evaluated for the
presence of TNF-alpha activity, further detailed information on the qualification of
"immunoreactivity". For others to repeat such a study based on histological
examination, very specific definitions are needed. Currently such detailed
methodology is lacking. Further objective description is needed.
2. Statistical Analysis - Authors need to justify the use of an idependent T-test for
comparison of continuous variables. It would appear that the Central Limit
Theorem would not apply given the small group sizes. Please justify the
appropriateness of this test or select a more appropriate non-parametric test.
Minor Essential Revisions
Discussion. p.11,ln 8 and line 12 - These are two statements that need to be
appropriately referenced.
Drop Figure 1, it is redundant with table 4
Discretionary revisions
Consider analyzing or providing description which evaluates whether clinical
features might correlate with crypt distortion or eosinophilia among those who
develop IBD in your data set. Such clinical features might be considered useful
for an eventual diagnostic algorithm which includes both histological and clinical
features.
Include discussion on the consideration of what proportion of individuals with
"high" criteria of crypt distortion and rectosigmoid eosinophilia might not go onto
develop IBD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests.
assistant