Reviewer’s report
Title: 
Assessment of lipoedema awareness among Polish women- online survey
study
Version: 
1 
Date: 
20 Jun 2023
Reviewer's report:
"PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
No - there are major issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The authors have responded appropriately to most of
the previous reviewers' comments, however concerns still remain with the article
and there are corrections needed before it can be considered suitable for
publication.
REQUESTED REVISIONS: 
* This is a very small and focussed survey (i.e., in women participating in online
forums in Poland) and so this should be reflected in the title, abstract, and
conclusion as the generalisability of the results beyond this select sample is
doubtful. 
* There is conflict between the primary aim and secondary aim of the study with
them reversed in the abstract to the main paper. I think there should only be one
aim (to understand current knowledge, etc.…) and the aim of increasing
awareness can't be achieved by a simple survey about knowledge - that would
need some education provided, etc. 
* Pg 5- I presume BMI data was from self-report? Please clarify this (and add as
a limitation)
* Pg 5 - please detail how the social media groups and forums were identified
* Table 2 - it's not clear what the third column is - is that the % correct or the %
who nominated that feature?
* Please detail how the answers to the questions about treatment were decided
(e.g. from evidence-based guidelines or systematic reviews or…?) Is there
adequate quality scientific evidence for EACH of these treatments? While some
of this information has been added to the discussion, it's not the appropriate place
to fully present the supporting evidence for the treatments. Consider adding a
table in the appendix that presents the evidence, level of evidence, and sources/s
for each of the treatments. 
* Table 5 - I have concerns about the validity of these exploratory analyses for
three main reasons: 1) I'm assuming they are post-hoc (and that there's no
available protocol with them listed and justified as a priori analyses) and 2) in
such a small sample size, the results are likely to be meaningful; and 3) it is not a
stated objective to explore such association. 
* Pg 13, line 9 - this sentence is very confusing - please reword. Is it that the 250
women self-reported lipoedema?
* Please add limitations in addition to those added above - ie very small, very
selected sample (ie online forums in Poland), likely low generalisability,
volunteer bias, non-validated survey.
ADDITIONAL REQUESTS/SUGGESTIONS: 
The entire article needs a careful edit by someone who is a native English
speaker as there are many grammatical errors and difficult to read sentences."
Declaration of competing interests
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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