Review for 10.1186/s12876-022-02130-2 (2022)

Reviewer’s report
Title: 
The global, regional and national burden of peptic ulcer disease from 1990
to 2019: a population-based study
Version: 
0 
Date: 
27 Oct 2021
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
No - there are major issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
The main objective of the study is to understand the trends and patterns of peptic
ulcer disease (PUD) burden across 204 countries. The data were drawn from the
Global Burden of Disease, Injuries and Risk factors study and the estimates
covering the period from 1990-2019. Though this is an important study, the
analysis is descriptive and has little analytical rigor. 
The authors have simply describing the numbers without going into explaining
the reasons for the trends, and patterns and variations across regions/countries.
The discussions were only drawn from different studies as speculations and did
not come from the analysis of the data.
The authors could have done a modelling to identify the factors (Socioeconomic,
demographic, biological, environmental, 
behavioral including diet and smoking
etc. ) contributing for morbidity, mortality and DALY of PUD. In addition, how
the changes in these factors contributed to the changes in the morbidity,
mortality including on DALY over the period between 1990-2019 could have
enhanced the value of the paper.
The paper used the data from GBD study and did not make any significant
contribution to the analysis to bring any unravel findings on the PUD problem.
Further, the paper is lacking scientific rigor in terms of interpretation and
discussion.
REQUESTED REVISIONS: 
The objective is very simple. There is no analytical research question or
hypothesis for the study. 
The design is descriptive. However, scientific approach of analyzing and
interpreting the trends and patterns are lacking.
The paper used generalized linear model for estimating the annual percentage
change. Though this is ok but the study did not discuss about how the
improvement in data quality over time would affect the annual percentage
change. Similarly differences in the quality of data on PUD across the countries
would also affect the understanding on trends and patterns of PUD. 
The interpretation and discussion of the results needs analytical rigor. For
example, Figure 5 reveals that there is high heterogeneity in the age standardized
prevalence of PUD among the countries of high SDI whereas the variation is low
among the countries of low SDI. Why this type of patterns presents and what
factors contributing to it? This type of analysis could be interesting and
appealing.
ADDITIONAL REQUESTS/SUGGESTIONS: 
NO
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes