11 November 2017 0 10K Report

Dear ....

we have to accept your decision. However, let me say, that this processing was felt to be below scientific standards. First, one of the reviewers obviously wanted to include some remarks about macrobiotic diet (by the way - how is that in any way linked to the study subject, namely "nutrition in cancer patients"?). The other reviewer obviously never submitted a paper to an ethics committee. It should be known, that already at this stage, you must calculate the required sample size. And for this, it is necessary to know the effect size. As this was not known, there was no other way than to classify the study as a pilot study. And changing that to a regular study, as the reviewer suggested, is like recommending, to make another study than the one approved by the ethics committee.

Thirdly, to say that the study "may have many other concerns" is not fair and scientific! Where and what are these concerns? Why haven’t they be put forward in the reviewers comment?

All together, we had the feeling, the our arguments have not been read and answered sufficiently but only by monotonic unbased phrases just sounding somewhat scientific. We think, that this all is below scientific standard.

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