Review for 10.1186/1471-230X-14-177 (2014)

Reviewer's report
Title:Symptom profile in partial responders to a proton pump inhibitor compared
with treatment-naive patients with gastroesophageal reflux disease: a post hoc
analysis of two study populations
Version:1Date:12 May 2014
Reviewer: Alexander Dowli
Reviewer's report:
Major Compulsory Revisions
1 - The authors are encouraged to expand on how this conclusion is relevant to
clinical practice. The title did hint that this would be the focus of the paper. Would
these results help in preventing partial response to PPI.
2 - The authors are encouraged to repeat the analysis with adjusting for the
difference in women. If you have the raw data that should be feasible.
3 - Did you have the raw data of the studies? If so it should not be hard to come
up with p-values using t-test. This would add strength to the paper. It would be
better than using the 0.5 difference to look for significance.
4 - “Patients in the Diamond 92 study received esomeprazole 40 mg once daily
for 2 weeks as a treatment trial.” Did those in the PRO trail receive the same PPI
and dosage? This is not clear from the text. The legends of the figure and table
hint at this but it’s not clear.
Minor Essential Revisions
None
Discretionary Revisions
1 - The pros: Your article poses a question to a significant problem. I would like
to say that I did like the fact that this paper had a big sample size and that a
standardize questionnaire was used in the proper manner. The limitations of this
paper were also properly addressed.
2 - Please consider rephrasing this in the background:
“Persistent reflux of acidic and weakly acidic content has been described in
patients with residual reflux symptoms and delayed gastric emptying may
predispose to persistent reflux in some patients [3, 4].” Its better to put it in two
sentences as this sentence is too long.
3 - Where the two studies done in the same time of year? Reflux patterns can
vary according to season. In addition, should the study be done during a fasting
season (such as Lent) the incidence of reflux will increase. Have a look at this
article for more info: 1: Hamdan AL, Nassar J, Dowli A, Al Zaghal Z, Sabri A.
Effect of fasting on laryngopharyngeal reflux disease in male subjects. Eur Arch
Otorhinolaryngol. 2012 Nov;269(11):2361-6. doi: 10.1007/s00405-012-2038-z.
Epub 2012 May 11. PubMed PMID: 22576248.
4- How many of the patients had diabetes? This can affect your results. Please
look at this paper: Hamdan AL, Jabbour J, Barazi R, Korban Z, Azar ST.
Prevalence of laryngopharyngeal reflux disease in patients with diabetes mellitus.
J Voice. 2013 Jul;27(4):495-9. doi: 10.1016/j.jvoice.2012.07.010. Epub 2013 Apr
16. PubMed
PMID: 23602088. Please note that the two articles I sited in the paper above
were written by a PI that I worked for. I only wrote them down as I am very
knowledgeable of the subject (I worked on those publications) and would think
that inclusion of such information would be useful. These articles are only meant
for guidance. Please feel free to obtain similar articles from other authors so as
not to quote me.
Level of interest: An article of outstanding merit and interest 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 note that the two articles I
sited in the paper above were written by a PI that I worked for. I only wrote them
down as I am very knowledgeable of the subject (I worked on those publications)
and would think that inclusion of such information would be useful. These articles
are only meant for guidance. Please feel free to obtain similar articles from other
authors so as not to quote me.