Review for 10.1186/s12876-018-0790-2 (2018)

Reviewer ’s report  
Title: Sustained Efficacy Following Resolution of Frequent Hea rtburn With an Over -the-
Counter Regimen of Esomeprazole 20 mg or Placebo for 14 Days: Two Randomized Trials  
 
Version: 2 Date: 14 Feb 2018  
 
Reviewer: Amy Tyberg  
 
Reviewer's report:  
This is an interesting study evaluating factors predictive of sustained heartburn relief after self -
treatment with short -term PPI use.  
 
A few comments:  
1. The objective stated at the end of the introduction is a bit confusing. I believe the authors 
intende d for the main objective to be determining factors predictive of sustained response 
after self -treatment with short -term PPI? And what is listed as the objective is more consistent 
with a secondary objective? Which could be stated a little bit more concise ly, for example: a 
secondary objective was to determine whether resolution of heartburn symptoms during the 
treatment period was associated with durability of response in the follow -up period.  
2. Please define "long -term prescription therapy" under exclus ion criteria - does this mean more 
than 2 weeks? Or 1 month? What about patients that had tried 14 days of PPI in the past? 
These patients might be less likely to respond if they had unsuccessful PPI trial previously...  
3. What kind of questionnaire did p atients use to report their symptoms? Did all patients have 
classic heartburn symptoms? Or atypical symptoms were included as well?  
4. It seems that the authors grouped placebo and PPI patients into one group when looking at 
predictors of heartburn resolu tion during follow -up period. Although more PPI patients had 
resolution of symptoms and therefore more sustained response, it would be important to 
compare the two groups.  
5. I think the conclusions stated are justified by the data, but it would be helpfu l to have a 
sentence in the conclusion as to why these findings are important. Since sustained response is 
seen with PPI use, the guidelines are justified in recommending a 14 day trial prior to seeking 
care with a physician? Or physicians can move more qu ickly to other treatment options in 
patients who have not responded to PPIs within the first 2 weeks as they are less likely to have 
a sustained response?  
 
Are the methods approp riate 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review i s recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I recommend additional statistical review  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
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