Clinical and Functional Characteristics of Interstitial Lung Disease in Algeria: A Single-Center Prospective Study

Round 1

Reviewer 1 Report

In this article, the authors presented their data on a real-world ILDs registry based on the experience of a single center in North Africa. The data presented are important, interesting and allow us to compare the epidemiology of ILDs in one African country with published data from other countries. The article is written quite clearly, but I have a number of major concerns:

1. Morphological methods (lung biopsy and bronchoalveolar lavage) were not used to diagnose ILDs (the authors mention only two cases of lung biopsy in the discussion). Unfortunately, this is a very big drawback of the study, since doubts immediately arise about the correct diagnosis of such conditions as idiopathic DIP, idiopathic NSIP, RB-ILD, and even sarcoidosis.

2. the large percentage of identified Raynaud's syndrome in IIP, HP, IPF (28-40%) is surprising and doubtful; is the diagnosis correct?

Minor concerns:

3. It is advisable to remove the CTD-ILD HRCT patterns section from Table 1, as this creates a false impression of other patients who were not mentioned above

4. The methods do not present criteria for “Small airways disease”

5. The discussion mentions that “Concrete evidence shows that the multidisciplinary approach…”, but the paper does not contain any data on conducting a multidisciplinary discussion of the diagnosis of ILD in this center

6. Sources 2 and 13 need correction

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

This is a valuable and quite well-written work that contains quite a lot of information, but has some limitations.

My main comments are:

I do not agree with the statement that a single-center study is the strength of the study, and I even think that the limitations of the study should include indications that the limitation is the fact that the study comes from one center in Algiers, and it cannot be written that it is a characteristic of the North African population.

Therefore, I think the title should be changed:

"Clinical and functional characteristics of interstitial lung disease, a cohort study in North Africa"

e.g. on:

"Clinical and functional characteristics of interstitial lung disease, an one center study in Algiers"

At the same time, it is difficult to write about the characterization of the functions of the respiratory system without having data on DLCO - why are these data missing? It is very important test for ILD patients.

The presentation of the results in the tables requires improvement: at least supplementing the description that the results are presented as n(%) or in the other way.

The reference to the recommendations regarding the diagnosis of IPF requires correction, as the current recommendations are from May 2022, and not from 2018 as in citation No. 5.

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Author Response

 Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The authors responded to all recommendations and concerns of the reviewers, the final version of the article has undergone significant improvement, and the paper can be recommended for publication.

Author Response