Title: Effectiveness of a self-management mobile app on the quality of life of women with breast
cancer: a study in a developing country
Version: 2 Date: 06 Jul 2022
Reviewer's report:
Please work to improve the quality of the English throughout your manuscript. I recommend
asking a native English-speaking colleague to assist you or enlist the help of a professional
copyediting service.
Please ensure that all acronyms are defined in the first mention, including those in the Abstract.
Title
The title is inappropriate, it should be: Effectiveness of a self-management mobile app on the
quality of life of women with breast cancer: a study in a developing country.
Introduction:
Please include proper punctuation in your manuscript, such as after citation (1) and citation (3).
The logic flow of “Patients with an increased awareness of this disease can handle it better”
and “Thus, the use of self-management apps promotes patients' health and causes behavioral
changes” is not good. It seems there lack some link between these two sentences. Can self-
management apps improve awareness of patients’ diseases?
The sequence of your citation is not consecutive, such as (13) and (15).
What do you mean by “improved information” in the last paragraph of the Introduction?
What is the definition of “mobile health”?
There lacks some introduction to the prevalence of using mobile phones in Iran. If not widely
used, how the mobile app can be feasible for Iranian women with breast cancer. Please clarify.
In your introduction, you did not mention other mobile self-management apps for Iranian women
with breast cancer. Is there any similar app for breast cancer patients in Iran? If yes, what is the
innovation of your app? You need to mention this first and then say it in light of the availability
of effective mobile apps…
Methods
Please describe your study design.
First phase: What is “Balsamiq Mockups software”? What is the “Think aloud method”? Please
provide a brief introduction to these terms.
What kind of patients are in your “target community”? How do you obtain the opinions on user
experience? By interviewing? If so, how to conduct such an interview?
In the second phase, you should mainly describe how to develop the app. Such as the structure
and field of the contents in your app.
In the inclusion criteria, how does “personal satisfaction” act as inclusion criteria? How to
operate this criterion in your implementation? Scores higher or lower than a specific value for
personal satisfaction? Please be specific.
Your second phase includes implementation in Figure 1. However, the second phase in your
main document did not mention how to implement the self-management app in patients, but a
workshop to introduce the app project. Thus, I don’t think this is implementation, but something
like training. Your third phase should be implementation and evaluation.
Sample, sampling method, sample size, the validity of your measurement of quality of life and
statistical method in your third part is missed. Please provide these details.
Results
How do you obtain 5 major categories and sub-categories? What is the analytical method?
Table 1 should be a three-line table.
Arab number should not be set at the beginning of a sentence (impact rate: pre and post-
implementation).
As you have only 12 participants in pre and post-implementation, a statistical inference could
not be made due to the small sample size. Thus, we could not know the effects on quality of
life. This should be a preliminary study on the impact on the quality of life and the author must
clarify this in the abstract.
In the abstract, the author mentioned that 24 breast cancer patients were included in the study.
How do you get 24 patients? There are only 6 patients in first phase, 24 patients participated in
the project in the second phase and 12 patients in pre and post-implementation. How to know
there are 24 patients? Additionally, which phase do pre and post-implementation in?
Please provide the mean and standard deviation of your consecutive data, such as table 2 and
table 3.
Discussion
As there are only 12 patients in your pre and post-implementation study and did not provide
a p-value for comparison, you cannot make such judges like “According to our findings, the
performance and attractiveness of sexual relations in these patients have improved to a relatively
good extent due to educational materials in the mobile app entitled strategies for improving
sexuality and teaching auxiliary methods on these issues.” You should discuss with caution.
The impacts of using a mobile app should not be the central part, but the development of your
app and its feasibility, acceptability etc. You spend a lot of time and space for explaining the
impact on quality of life.
Conclusion
Without statistical inference, you cannot make such a conclusion.