Reviewer’s report
Title: 
Intravaginal lactic acid gel versus oral metronidazole for treating women
with recurrent bacterial vaginosis: the VITA randomised controlled trial
Version: 
0 
Date: 
26 Sep 2022
Reviewer's report:
This was a nice study that attempts to answer an important question around the
treatment of bacterial vaginosis. 
My main concern is around the very high rates of lost to follow-up (21% in the
metronidazole arm 
and 20% in the lactic acid arm) in a relatively short time
interval of two weeks (the primary outcome) and 58% and 62% respectively at
six months (the secondary outcomes). This raises concerns around the robustness
of the results - did a large minority of women drop out initially due to adverse
effects of the medication or, conversely, was there selection bias and only
women who experienced recurrence remained in the study to report these
findings at six months?
The study was stopped early based on recommendations of the data monitoring
committee - however followup of enrolled participants for six months was
continued. 
The protocol states that women who did not completed the survey vis the web
were contacted by phone - was this done and, if so, what was the outcome of
this?
These high rates of lost to follow up make interpretation of the data that is
presented difficult. 
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