Review for 10.1186/1471-230X-10-1 (2010)

Reviewer's report
Title:How do patients with inflammatory bowel disease want their biological
therapy administered?
Version: 2Date:22 September 2009
Reviewer: Lesley Martine Roberts
Reviewer's report:
Major Compulsory Revisions:
1. The paper still contains some typos e.g. ‘in contrast to patients with
osteoporosis patients’ , ‘distributed and colla6ted’ and grammar is often poor
which at times impacts on the readability of the paper e.g. ‘In addition to this
patient-involved decision making in the route of administration of biologics may
improve compliance’ (there must be a comma in there somewhere – I would
have initially suggested after ‘in addition to this,’ but as the sentence starts a
paragraph this cannot be right and I really cannot understand this).
2. This paper will be of interest to those treating patients with IBD but also may
be read by those with an interest in patient preference more widely. I would
therefore suggest the abstract clarified that infliximab is IV to enable those with
no knowledge of the particular therapies to access the principles.
3. The abstract method should state the method of analysis not the stats
package used.
4. The authors reported a binomial probability test but it is unclear whether this
included patients who did not express a preference. Having run the numbers
through myself it appears that the authors have excluded those with no
preference in their analysis ie comparison of those with Pref A (36.5%) vs Pref B
(63.4%), binomial test (p=0.07) which seems appropriate but should be clearly
indicated.
5. The content of the introduction and discussion is much improved although
these sections now read a little disjointed. Paragraphs may need reordering and
better linking to ensure that the authors effectively convey both the value of this
study and the manner in which it adds to the current evidence base. At times the
relevance of points is lacking e.g. in the intro section the authors indicate that
there is considerable interest in researching patient-doctor communication, but
this point does not really fit with the surrounding text – I agree completely that
effective communication is a key factor in patient management but this paper is
not really about communication but about appreciation of factors which influence
preference. I think all that should be said about communication is that an
improved awareness of the factors influencing patient preference will facilitate
discussion and ultimately patient management. Similarly the reference to patients
with RA being ill-prepared to make decisions lacks context or relevance as again
this study is not about perceptions of preparedness but preference.
There are some issues raised in the discussion which could perhaps be raised in
the introduction to better support the value of the study.
6. The authors indicate in the discussion that the difference did not approach
statistical significance – this is a little clumsy in phrasing and the authors should
indicate that this did not reach the pre-specified level of 0.05 but should then
discuss the possibility of the study being underpowered (especially in light of the
fact that the comparison was actually on a sample size of 52 (those who actually
expressed a preference)).
Level of interest: An article whose findings are important to those with closely
related research interests
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