Review for 10.1186/s12876-021-01739-z (2021)

Reviewer’s report
Title: 
Patient experiences with the role of physical activity in inflammatory bowel disease: results from a
survey and interviews
Version: 
0 
Date: 
15 Feb 2021
Reviewer's report:
This is a well written study. I have some comments:
- The authors may want to consider entering information of what institution/ hospital the patients have
been followed up.
- Please spell out SQUASH at the page 7, line 117, instead of at page 8, line 141.
- The interviews being conducted by the same researcher of the project and using open-ended questions
raise concerns about Pygmalion's bias.
- How were medication and previous surgical procedures assessed? 
- The correlation between physical activity and disease activity scores was not adjusted by medication and
previous surgery, which can lead to bias.
- The strength of this manuscript is the real-world data, however there is no control on how compliant the
patients are to the exercises. All the information were gathered according to the patients' reports.
- As acknowledged by the authors, it is probable that patients with more severe disease are less likely to be
physically active, which was supported by the interviewees; therefore it is not possible to conclude that
lack of physical activity leads to higher disease activity.
- In the conclusion, I would not say "we found an association between physical activity and disease activity
in Crohn's" since patients presenting less severe disease performed more physical activities than patients
not in remission. Furthermore, the lack of objective assessment given the open-ended questions on the
interviews prevents a robust conclusion.
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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?
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