Reviewer's report
Title:Importance of Duodenal Bulb Biopsies in the Diagnosis of Celiac Disease
in Clinical Practice
Version: 1Date:15 June 2009
Reviewer: David Sanders
Reviewer's report:
Minor Essential
1. The authors do not clarify if the study has been performed solely by a single
endoscopist? I suspect this is the case but it needs to be more explicitly stated in
the methods.
2. Was the endoscopist aware of the positive TTG result? Again I would imagine
yes but needs to be stated.
3. With regards to the pathologists – the authors are right to say this is real
clinical practice with multiple pathologists reporting. However, was there any
internal validation check? For example, did the pathologists as a group re-assess
any of the cases to ensure that the initial reports were accurate? If so did they do
this for the whole cohort?
4. Table 1 is not particularly valuable. I would recommend deleting it and instead
providing a table with all 35 patients. This allows the readers to see all cases.
This is important because although the authors comment on discordant cases
between bulb and distal duodenum – they do not comment on concordance for
severity. In other words for the 29 concordant cases was the degree of villous
atrophy the same?
5. Within this table they should also give a TTG level that is quantitative (along
with a normal range). Symptoms allow the reader ascertain whether there may
be a relationship between severity of symptoms and likelihood of having only D1
involved or any other pattern which may immerge.
6. The authors should provide statistics – this should be between concordant and
discordant results. This is likely to be a chi-square and likely to be negative but
that is ok – the information should still be presented.
Level of interest: An article of importance in its field
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:Importance of Duodenal Bulb Biopsies in the Diagnosis of Celiac Disease
in Clinical Practice
Version: 1Date:15 June 2009
Reviewer: David Sanders
Reviewer's report:
Minor Essential
1. The authors do not clarify if the study has been performed solely by a single
endoscopist? I suspect this is the case but it needs to be more explicitly stated in
the methods.
2. Was the endoscopist aware of the positive TTG result? Again I would imagine
yes but needs to be stated.
3. With regards to the pathologists – the authors are right to say this is real
clinical practice with multiple pathologists reporting. However, was there any
internal validation check? For example, did the pathologists as a group re-assess
any of the cases to ensure that the initial reports were accurate? If so did they do
this for the whole cohort?
4. Table 1 is not particularly valuable. I would recommend deleting it and instead
providing a table with all 35 patients. This allows the readers to see all cases.
This is important because although the authors comment on discordant cases
between bulb and distal duodenum – they do not comment on concordance for
severity. In other words for the 29 concordant cases was the degree of villous
atrophy the same?
5. Within this table they should also give a TTG level that is quantitative (along
with a normal range). Symptoms allow the reader ascertain whether there may
be a relationship between severity of symptoms and likelihood of having only D1
involved or any other pattern which may immerge.
6. The authors should provide statistics – this should be between concordant and
discordant results. This is likely to be a chi-square and likely to be negative but
that is ok – the information should still be presented.
Level of interest: An article of importance in its field
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:Importance of Duodenal Bulb Biopsies in the Diagnosis of Celiac Disease
in Clinical Practice
Version: 1Date:15 June 2009
Reviewer: David Sanders
Reviewer's report:
Minor Essential
1. The authors do not clarify if the study has been performed solely by a single
endoscopist? I suspect this is the case but it needs to be more explicitly stated in
the methods.
2. Was the endoscopist aware of the positive TTG result? Again I would imagine
yes but needs to be stated.
3. With regards to the pathologists – the authors are right to say this is real
clinical practice with multiple pathologists reporting. However, was there any
internal validation check? For example, did the pathologists as a group re-assess
any of the cases to ensure that the initial reports were accurate? If so did they do
this for the whole cohort?
4. Table 1 is not particularly valuable. I would recommend deleting it and instead
providing a table with all 35 patients. This allows the readers to see all cases.
This is important because although the authors comment on discordant cases
between bulb and distal duodenum – they do not comment on concordance for
severity. In other words for the 29 concordant cases was the degree of villous
atrophy the same?
5. Within this table they should also give a TTG level that is quantitative (along
with a normal range). Symptoms allow the reader ascertain whether there may
be a relationship between severity of symptoms and likelihood of having only D1
involved or any other pattern which may immerge.
6. The authors should provide statistics – this should be between concordant and
discordant results. This is likely to be a chi-square and likely to be negative but
that is ok – the information should still be presented.
Level of interest: An article of importance in its field
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'
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