Analysis of sex differences could provide yet even more information regarding the phenomenon studied. The study was successful in attracting a large number of respondents with 3,090 respondents entered into the study. We are also told the respondents were predominately female (>80%), but that does not necessarily translate into how each sex would answer a particular question. The study of sex differences is an opportunity to wring even more information from the data, and to discover potential patterns regarding this disease spectrum. Is there any reason this was not done, and would the authors rework the data to look at sex differences and submit it for publication? Or, alternatively release the data to others so that sex differences can be studied? The statistics needed to ferret out sex differences for each category of question is extremely simple, just tedious to do. Lyme disease patients deserve studies that are as "cutting edge" as possible, and the analysis of sex differences has been routine in analyzing clinical studies for at least two decades now. The importance of analyzing data by sex of subject was a topic of major concern at NIH during the time Bernadine Healey, MD was NIH Director of the NIH from 1991-93, the first woman to ever direct the NIH. I would like to gently suggest that the team get up to speed, look at this data again and publish the results. Could be fascinating and enlightening.