Reviewer's report
Title:Online follow-up of individuals with gastroesophageal reflux disease using
a patient-reported outcomes instrument: results of an observational study
Version: 2Date:21 June 2013
Reviewer: Jan Gunnar JH Hatlebakk
Reviewer's report:
This is a study that documents to some extent the concept of defining groups of
dyspeptic patients by internet surveys, and following up by repeated symptom
questionnaires.
A main problem is selection bias, since particularly the PPI user group is likely to
consist of PPI partial or non-responders, furthermore the study is for practical
reasons open only to internet users. It can be argued that more people are
internet users than are consulters for GERD (supported by the finding that only
37-45% actually visited their PCP). It must be emphasized that symtoms
compatible with GERD is not a diagnosis, although GerdQ is designed to exclude
dyspeptic symptoms of epigastric pain and nausea to some extent by weighting
the negatively.
The two patients groups can not be compared, as all assessment variables and
endpoints are different. In non-PPI users, the definitions do not make sense,
since small or larger changes in GerdQ score crossing (or not) the cutoff of "8"
are all classified the same.
In the PPI users group, endpoints are more in line with whatr is used in clinical
studies.
All this leaves us with a pure feasibility study.
In the "Statistical analysis" section, we are presented with more variables which
should have been in the Outcomes section, or elsewhere in a separate section.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Online follow-up of individuals with gastroesophageal reflux disease using
a patient-reported outcomes instrument: results of an observational study
Version: 2Date:21 June 2013
Reviewer: Jan Gunnar JH Hatlebakk
Reviewer's report:
This is a study that documents to some extent the concept of defining groups of
dyspeptic patients by internet surveys, and following up by repeated symptom
questionnaires.
A main problem is selection bias, since particularly the PPI user group is likely to
consist of PPI partial or non-responders, furthermore the study is for practical
reasons open only to internet users. It can be argued that more people are
internet users than are consulters for GERD (supported by the finding that only
37-45% actually visited their PCP). It must be emphasized that symtoms
compatible with GERD is not a diagnosis, although GerdQ is designed to exclude
dyspeptic symptoms of epigastric pain and nausea to some extent by weighting
the negatively.
The two patients groups can not be compared, as all assessment variables and
endpoints are different. In non-PPI users, the definitions do not make sense,
since small or larger changes in GerdQ score crossing (or not) the cutoff of "8"
are all classified the same.
In the PPI users group, endpoints are more in line with whatr is used in clinical
studies.
All this leaves us with a pure feasibility study.
In the "Statistical analysis" section, we are presented with more variables which
should have been in the Outcomes section, or elsewhere in a separate section.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Online follow-up of individuals with gastroesophageal reflux disease using
a patient-reported outcomes instrument: results of an observational study
Version: 2Date:21 June 2013
Reviewer: Jan Gunnar JH Hatlebakk
Reviewer's report:
This is a study that documents to some extent the concept of defining groups of
dyspeptic patients by internet surveys, and following up by repeated symptom
questionnaires.
A main problem is selection bias, since particularly the PPI user group is likely to
consist of PPI partial or non-responders, furthermore the study is for practical
reasons open only to internet users. It can be argued that more people are
internet users than are consulters for GERD (supported by the finding that only
37-45% actually visited their PCP). It must be emphasized that symtoms
compatible with GERD is not a diagnosis, although GerdQ is designed to exclude
dyspeptic symptoms of epigastric pain and nausea to some extent by weighting
the negatively.
The two patients groups can not be compared, as all assessment variables and
endpoints are different. In non-PPI users, the definitions do not make sense,
since small or larger changes in GerdQ score crossing (or not) the cutoff of "8"
are all classified the same.
In the PPI users group, endpoints are more in line with whatr is used in clinical
studies.
All this leaves us with a pure feasibility study.
In the "Statistical analysis" section, we are presented with more variables which
should have been in the Outcomes section, or elsewhere in a separate section.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant