Review for 10.1186/s12876-019-0985-1 (2019)

Reviewer ’s report  
 
Title: Economic burden of moderate to severe I rritable Bowel Syndrome with Constipation in 
six European countries  
 
Version: 0 Date: 07 Mar 2019  
 
Reviewer: Francesco Torresan  
 
Reviewer's report:  
 
Interesting study about direct and indirect costs rela ted to moderate and severe IBS -C. The 
manuscript is well written and stresses the large impact of this condition on healthcare systems 
and society.  
 
 
2 issues should be discussed and addressed:  
 
1. 525 patients diagnosed with IBS -C were included. During the last 6 months observation period 
many patients underwent diagnostic tests which could have modified the initial diagnosis. Did a 
subgroup of these patients have a different diagnosis after these tests or did you exclude them?  
 
2. Patients were included bot h from primary or specialist care. Do you have subgroups of 
patients managed only by primary physician and only by specialists? It could be interesting to 
study if there is a cost saving in patients followed only by specialists  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an a dditional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in  the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the co ntent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
 
 
 
 
 
 
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
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which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal