Title: Development and External Validation of Clinical Predictive Model for Stress Urinary
Incontinence in Chinese women : A Multicenter Retrospective Study
Version: 1 Date: 11 Aug 2024
Reviewer:  Marco la Verde
Reviewer's report:
Esteemed Authors,
Thank you for sending us the manuscript entitled "Development and External Validation of
Clinical Predictive Model for Stress Urinary Incontinence in Chinese Women: A Multicenter
Retrospective Study." The findings are very important, probably going a long way into really
changing the clinical management of SUI in postpartum women; however, there are many places
where I have located areas in need of substantive revision to improve clarity, depth, and overall
scientific rigor in this manuscript.
Revisions
1. Intro
Provide further background information: The introduction of this study should provide more
detailed and organized background information on SUI, mainly regarding prevalence, risk
factors, and its effect on postpartum women. Introduce the physiologic mechanisms of stress
urinary incontinence in a way that explains why some risk factors are especially relevant, like
pre-pregnancy BMI, mode of delivery, and perineal condition.
2. Clearly point out the gap in the existing research that will be filled by your study. Even as
you refer to the main point, the development and validation of some predictive models, let the
audience know how senseless the existing models are and in what way the study amends these
flaws. In particular, bring out whether long-term follow-up in a multicenter approach will allow
generalization of the model.
3. State the Objectives of the Study and Hypotheses Your objectives for the study should also
be stated in detail. Again, you may state those goals as a hypothesis or simply state what might
be expected to find on which predictive factors for SUI and performance of the following
nomogram.
4. Methods
Describe how predictive modeling was done: a more elaborate commentary on developing the
predictive model. In other words, it juxtaposes describing how predictive modeling was done,
giving a point-by-point detailing of how the variables were chosen and why logistic regression
was used, and about constructing a nomogram. Lastly, it is going to describe how this external
validation was done, what modifications were done once having test results from the said
validation.
5.Discuss the potential biases: Explain such biases that can be associated with the study design;
for example, recall bias and selection bias. State how you may have modified these biases and
if you could not be avoided, state how that will offset the results.
6. Results
Elaborate on statistical analyses: While, undoubtedly, the section on results brings forth the
major findings, it can go further to elaborate more on the statistical outputs. For example,
more explication on the setting in which every AUC value was enumerated has to be furnished
independently, most especially with external validation.
7. Discussion
Further explanation: Discussion per se will highlight more on what the results mean.
Compare the results with prior studies conducted on that very SUI. Spell out consistencies
and discrepancies. One is encouraged to discuss potential physiological mechanisms behind
identified associations and why height and perineal laceration provided significant predictors of
OP-Users have never given up in attempting to learn something from the final outcome of every
function via using, technical computer-science terms, query languages.
8.Clinical Implications and Health Applications: In this section, the authors will discuss some
of the clinical implications of your predictive model. Therefore, how might this model now be
integrated into clinical practice as a part of routine care? Mention a few possible barriers to
the implementation of the intervention and how it would deal with these. Besides, discuss the
potential influence of your model on management and prevention for SUI in postpartum women.
9.Limitations and Future Research: More elaboration on the limitations of this study should be
addressed by the authors. For example, there must be biasness due to self-reported SUI, and
the study did not take multiple demographic factors like education and socioeconomic status
into consideration. This directs future steps in research to take out this limitation by prospective
studies or involvement of populations with bigger diversity.
10. Language and Clarity
Improve Grammar and Syntax: The proofreading for awkward phrasing and errors in grammar
would need to be corrected.
This is going to improve the feature of readability, as there are such sections in the manuscript
that consist of really long sentences. Keep the sentences short and concise as much as possible;
long articulated sentences are needless here. Make sure to explain all jargon medical terms for
illustration to readers who may not know the meaning.
11.Report how the sample size was estimated. The method of sample size calculation, together
with information on the anticipated effect size and power, significance level, and assumptions
underlying the sample size calculation, should be well stipulated. This shall be very important
in justifying whether or not the study was fairly powered enough to refute inconsequential
differences or associations.
Conclusion: Your manuscript is of great value to the field of postpartum care, generally in the
prevention and treatment of SUI. If the proposed revisions are addressed, then the study will
add value and have more impact on the readers. I look forward to the revised version of your
manuscript.
Warm regards,