Review for 10.1186/s12876-020-1157-z (2020)

Reviewer ’s report  
 
Title: Group cognitive behavioural therapy (GCBT) versus treatm ent as usual (TAU) in the 
treatment of irritable bowel syndrome (IBS): a study protocol for a randomized controlled trial  
 
Version: 1 Date: 05 Dec 2019  
 
Reviewer: Sarah Ballou  
 
Reviewer's report:  
 
The authors have provided a thorough response to the original review. However, there are still 
several points that require clarification and/or mention in the limitations section.  
 
1) The authors have added two use ful paragraphs to the introduction to describe CBT -IE. 
However, they have not indicated how their study will "clarify the relationship between 
IBS and psychological stress and will help to elucidate the underlying mechanisms of 
IBS". I don't see how a trea tment study can accomplish these goals. I recommend 
removing this line from the abstract.  
 
2) The exclusion criteria of "past or current psychotherapy" is still unclear. Are the authors 
saying that patients with past or current psychotherapy specifically fo r IBS is 
exclusionary? If so, this seems appropriate. However, if patients who report past or 
current psychotherapy for something else (i.e. depression, anxiety, etc) were excluded, 
then this is a major limitation of the study and the rationale for this de cision should be 
addressed. Given the high comorbidity between IBS and anxiety/depression, eliminating 
patients who are being treated for anxiety/depression is problematic.  
 
3) The fact that patients with Rome III or Rome IV are included should probably be 
mentioned as a limitation.  
 
4) Will gastroenterologists be administering CBT alone, or will a psychologist always be 
there with them? CBT requires advanced training in clinical psychology. If the 
gastroenterologists were always with a psychologist, then thi s is a strength. If the 
gastroenterologists were administering CBT independently, however, this must be 
addressed as a limitation.  
 
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 co mments 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 statistica l review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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that holds or has applied for patents relating to the content of the manuscript?  
 
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