Review for 10.1186/s12876-025-03682-9 (2025)

Title: Health-Related Quality of Life in Pediatric Patients with Intestinal Failure without
Neurodevelopmental Delay: A Systematic Review and Meta-Analysis
Version: 2 Date: 08 Nov 2024
Reviewer's report:
This is an excellent topic that needs greater visibility, and this is a valuable study. The MS is
well written but just needs expanding in various areas.
Abstract
Some of the sentences are incomplete, please edit accordingly.
Where you have ‘(N=300)’ please add detail to highlight that this was your combined sample
size.
Please add p values to your results.
Introduction
Some sentences are long, please break up. Some language editing required.
Please spell out HRQoL before using the acronym.
The intro is rather short and would benefit from expanding on what you have there with extra
detail, and maybe some data from studies to emphasise the points you have made.
Methods
I’m unsure why you excluded conference abstracts as they can be a valuable source of data and
are commonly included in SRs and MAs. I recommend going back to check if any matched your
inclusion criteria and had sufficient data.
Please ensure you use the appropriate PRISMA headings for your methods and results sections
according to the PRISMA guideline – this will help separate our your MA results from bias
assessment etc and is encouraged by the journal [Page MJ, McKenzie JE, Bossuyt PM, Boutron
I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for
reporting systematic reviews. BMJ. 2021;372:n71. Page MJ, Moher D, Bossuyt PM, Boutron I,
Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance
and exemplars for reporting systematic reviews. BMJ. 2021;372:n160.].
Please expand on your data analysis section where you have written ‘conversions were
performed according to the methods of [15](2018) and [16](2014).’ It’s not acceptable for
readers to have to retrieve other literature to review your methods.
On the whole, your methods section also needs expanding with additional detail – adhering to
the guidelines mentioned above will help with this.
Results
Please give an overview of the studies at the individual level (a basic summary of Table 1) before
you do the combined results [PRISMA guidelines stipulate this] – this way readers will get an
overview of how many used each HRQoL tool (and which domains were used if not whole tool),
range of sample sizes etc.
You MUST add your actual p values, using ‘p <0.05’ is not acceptable as there is a huge
difference between p 0.049 and p <0.001.
There is no explanation anywhere of the HRQoL tools used – what domains/subscales are in
PedsQL etc. Also – in your results you have not mentioned how many studies contributed data
to each of the summaries/sub-domains. I think a results table of all the data used to create the
forest plots is essential.
I’m confused why your forest plot, at least the main one, isn’t in the main text?
The results for the bias tests should be p[resented as a separate paragraph from the main HRQoL
results [as in PRISMA guideline].
Discussion
There are a few points that would benefit from being expanded. For example, in the first
paragraph are there any obvious differences between the studies that showed no difference in
HRQoL and your cohorts? Did they include a broader/narrower cohort than your inclusion
criteria allowed?
Please add a  strengths and weaknesses section.
Tables
Please add a legend to Table 1 to explain what the acronyms mean
Please add a legend to Table 2 to explain what the star system represents
Supplementary files
You need to substantially reduce the amount of text you have in these and just summarise the
results – it looks like this was just copy/pasted from the stats programme and will nothing to
many readers.