JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Evaluation of the diagnostic value of the Risk of Ovarian Malignancy Algorithm (ROMA)
index in the detection of ovarian cancer in postmenopausal women: a meta-analysis.
Version: 1 Date: 11 Mar 2025
Reviewer's report:
Review Comments:
The manuscript provides a comprehensive summary and evaluation of the diagnostic value of the
ROMA index in the detection of ovarian cancer. It is organized according to the standards of a
diagnostic meta-analysis. However, several aspects need further clarification and improvement:
1. Introduction and Title:
- The ROMA index has specific formulas for premenopausal and postmenopausal women. If the
study focuses on the applicability of the ROMA index in postmenopausal women, it should be
clearly stated to avoid confusion. The title and introduction should explicitly reflect this focus.
2. Methods:
- If there are specific criteria for interpreting the numerical values, these should be clearly
stated in the methods section. In addition, the authors should explain how studies that included
premenopausal women were handled. If such studies were included, the criteria for excluding
or stratifying premenopausal data should be detailed to ensure the validity of the results.
3. Results:
- The sample size and other relevant details should be more thoroughly presented in Table 2.
- The “The main characteristics of the included studies in the meta-analysis” section should
include a summary of the overall study characteristics. Data that are not directly displayed in
the tables can be presented using frequencies and percentages to provide a more comprehensive
overview.
- In Table 3, terms such as “menopausal” and “postmenopausal” should be used consistently.
- Please check “Fig. 3” in this statement “The SROC diagram and Forest plot presented in (Fig.
3) illustrate…”.
4. Discussion:
- The authors attempt to explain differences in diagnostic specificity using incidence rates.
However, this approach may not be sufficient. The discussion should consider other potential
sources of heterogeneity, such as differences in epidemiology, disease subtypes, staging, and
genetic variations across different continents. These factors could significantly influence the
diagnostic accuracy of the ROMA index and should be thoroughly considered to provide a more
robust explanation for the observed differences.
Overall, the manuscript has the potential to provide valuable insights into the diagnostic accuracy
of the ROMA index in postmenopausal women. However, the above-mentioned issues need to
be addressed to enhance the clarity, consistency, and validity of the study.
Title: Evaluation of the diagnostic value of the Risk of Ovarian Malignancy Algorithm (ROMA)
index in the detection of ovarian cancer in postmenopausal women: a meta-analysis.
Version: 2 Date: 04 Apr 2025
Reviewer's report:
The author has undertaken a more detailed revision, but I must emphasize the importance of
GRADE, which is not a bias assessment tool and does not conflict with the current QUADAS-2.
I am confident that with the author's ability to learn this method of grading, which they did not
have difficulty with, I will recommend acceptance for publication after the next supplemental
GARDE rating of the results.
Title: Evaluation of the diagnostic value of the Risk of Ovarian Malignancy Algorithm (ROMA)
index in the detection of ovarian cancer in postmenopausal women: a meta-analysis.
Version: 2 Date: 17 Apr 2025
Reviewer's report:
Thank the author for the revisions. It is suggested to include the number of studies in the
subgroup analyses. Additionally, consideration should be given to the potential limitations
arising from this aspect in the 'Limitations' and 'Conclusions' sections.
Title: Evaluation of the diagnostic value of the Risk of Ovarian Malignancy Algorithm (ROMA)
index in the detection of ovarian cancer in postmenopausal women: a meta-analysis.
Version: 3 Date: 22 Apr 2025
Reviewer's report:
I have seen the changes made by the authors and it is a vast improvement on the first version of
the article, so I would recommend that this manuscript be published in this form.
However, I need to point out a small error in GRADE, where cross-sectional studies should be
rated from Low, not High as is the case for RCTs, so your results should be Very Low, but this
doesn't affect anything, it's the quality of the research in the field that determines it, it doesn't
affect the significance of your study, and it's precisely the fact that you have pointed out the
low-quality research that will push the field towards the development of high-quality research.
development of high quality research. So correct it before publishing.
Title: The influence of primary dysmenorrhea on chronotypes, social jetlag, and night eating
habits: A cross-sectional study of anxiety and depression
Version: 0 Date: 25 Apr 2025
Reviewer's report:
Overall, I think this could be an interesting article for a wider readership because it contextualizes
the PD with some unexplored relationships.
This article is generally easy to read. I would only suggest the authors to rewrite the Conclusion
section and revise some important details:
Keywords - I suggest that you replace most keywords with synonyms or other words. It is not
common to have the same words in the title and as keywords.
Line 100 – The aim of the research should be emphasized separately, i.e. rewritten (e.g. “This
study aimed to compare” instead of “This study was designed to compare”) and placed on a new
line as a separate paragraph concluding the introduction.
In the last paragraph of the Discussion, I suggest the authors explain the limitations of the study
(and future recommendations). No research is without limitations, so these should also be listed.
Line 308 – “Although the small number of participants is a limitation” is unnecessary. Firstly,
it makes no sense to start the Conclusion chapter like this, and furthermore, the number of
participants is not a limitation considering the results of the power analysis you performed prior
to the research.
Lines 314-316 – Again, the number of participants in this study is not a limitation, and the rest
of the sentence belongs more in the last paragraph of the Discussion (future recommendations).
In the Conclusion, you should give a brief summary of your findings and the relevance of the
study with potential implications (already mentioned in lines 313-314).
You should rewrite the Conclusion section!
Title: The influence of primary dysmenorrhea on chronotypes, social jetlag, and night eating
habits: A cross-sectional study of anxiety and depression
Version: 0 Date: 27 Apr 2025
Reviewer:  Sri Lestariningsih
Reviewer's report:
Dear Author,
Thank you for submitting your manuscript. The study addresses an important topic by exploring
the influence of primary dysmenorrhea on chronotypes, social jet lag, night eating habits,
anxiety, and depression among university students. The manuscript is generally well-structured
and presents relevant findings.
However, several areas require clarification and improvement to enhance the scientific rigor
and clarity of your work. These include more detailed reporting of statistical analyses, clearer
presentation of results with complete statistical values, consistent terminology usage, and a more
comprehensive discussion contextualizing your findings within existing literature.
I encourage you to carefully consider the specific comments provided in this review to strengthen
your manuscript for publication in a reputable journal.
Best regards.
Title: The impact of diabetes on postoperative outcomes following hysterectomy: A systematic
review and meta-analysis.
Version: 1 Date: 15 Jun 2024
Reviewer:  Martina Arcieri
Reviewer's report:
I read and evaluated the meta-analysis 'The impact of diabetes on post-operative outcomes
following hysterectomy: A systematic review and meta-analysis'. It is a very interesting
manuscript, but I found some criticisms.
Methods:
- selection criteria What does "blood glucose level" mean? What is the cut-off?
- Is there a minimum number of participants in the study selection?
- Is there any information on the type of hysterectomy: laparoscopic, laparotomic or vaginal?
-In the inclusion criteria, do the authors include only hysterectomies performed for benign
indications?
Results
Maybe some forest plot could help to understand the results.
If the authors considered both malignant and benign indications for hysterectomy, this could
create an important bias in the analysis of the results.
Could a sub-analysis be done based on the surgical route of hysterectomy?
Discussion
The limits and the strength of the manuscript should be better discussed.
Title: The impact of diabetes on postoperative outcomes following hysterectomy: A systematic
review and meta-analysis.
Version: 1 Date: 10 Jul 2024
Reviewer's report:
I read with great interest the Manuscript titled “The impact of diabetes on postoperative
outcomes following hysterectomy: A systematic review and meta-analysis.”  which falls within
the aim of BMC Women's Health
In my honest opinion, the topic is interesting enough to attract the readers’ attention.
Methodology is accurate and conclusions are supported by the data analysis. Nevertheless,
authors should clarify some point and improve the discussion citing relevant and novel key
articles about the topic.
Authors should consider the following recommendations:
- Manuscript should be further revised by a native English speaker
- Inclusion/exclusion criteria should be better clarified
- What are the actual clinical implications of this study? it is important to report the results
obtained by the authors in the context of clinical practice and to adequately highlight what
contribution this study adds to the literature already existing on the topic and to future study
perspectives
- Discussion is lacking of comparison with existing literature and previous works on the topic.
Discuss regarding the potential presence of diabetes and worsened hospitalization outcomes sucs
as same-day discharging, postoperative complications etc. See PMID: 38264751; 37604136;
35725683; 33530258.
Title: The impact of diabetes on postoperative outcomes following hysterectomy: A systematic
review and meta-analysis.
Version: 4 Date: 08 Aug 2024
Reviewer:  Martina Arcieri
Reviewer's report:
I read and evaluate this manuscript.
I have some questions:
Methods: Did all included studies include a control group of non-diabetic patients?
Were the indications for hysterectomies for both benign and malignant pathology?
is it possible to perform a sub-analysis according to the surgical approach? I expect fewer
complications in the minimally invasive surgery group
The discussion should be improved.
Diabetes is often linked to the metabolic syndrome and is therefore a risk factor for the
development of endometrial cancer. Therefore, the increased number of hysterectomies may
be due to this. I would add a comment on this.  Line 306-307 Also in high risk endometrial
cancer mini invasive surgery could be used (PMID: 32880752) and now it is of choice in benign
conditions.
Also often diabetic patients are obese, could this be a bias in the increased complications?
Are there any studies evaluating the risk of postoperative complications in diabetic patients
differentiating between diabetes with controlled and uncontrolled glycaemias?
Title: HPV Vaccination, Screening Disparities, and the Shifting Landscape of Cervical Cancer
Burden: A Global Analysis of Trends, Inequalities, and Policy Implications
Version: 1 Date: 30 Mar 2025
Reviewer's report:
The data source used for incidence rates and DALYs is not explicitly mentioned. If they come
from the Global Burden of Disease (GBD), it is essential to recognize their limitations, such
as the reliance on models for countries with insufficient data. Regarding the comparability
of screening and vaccination data: Screening data (from 33 countries) and vaccination data
(from 106 countries) may not be globally representative. Furthermore, differences in operational
definitions of coverage may affect comparability.
Including a more in-depth analysis to explore causal associations would be useful, considering
other variables such as access to treatment or health inequalities.
Regarding geographic coverage, HPV vaccination data come from the WHO, suggesting broader
coverage but not whether countries were excluded. Screening data are obtained only for OECD
member countries, leaving out many low- and middle-income regions, where access to screening
is more variable and relevant to the overall burden of disease.
It is not mentioned whether differences in definitions of vaccination or screening coverage
between countries were adjusted for. For example, screening programs may use different criteria
for age, methods (cytology vs. HPV testing), and frequency. WHO and OECD data may have
been collected using various techniques (self-reporting, national registries, surveys), which
could introduce measurement biases.
SII and CI require reliable data on cervical cancer incidence in all analyzed countries. However,
in countries with poor record-keeping, values may be underestimated or overestimated.
It is not mentioned whether adjustments were made to minimize biases related to data quality
and availability in countries with surveillance systems.
Title: HPV Vaccination, Screening Disparities, and the Shifting Landscape of Cervical Cancer
Burden: A Global Analysis of Trends, Inequalities, and Policy Implications
Version: 1 Date: 27 Apr 2025
Reviewer's report:
General comments
This is an interesting and well-written manuscript that analyzes cervical cancer trends across
different socio-demographic Index levels.
Specific comments
The authors should include a list of abbreviations used in the manuscript.
Line 60: “Correlation analysis showed negative associations between screening rates and
DALYs (r = -0.56, p < 0.01) and between vaccination coverage and incidence (r = -0.35, p
< 0.01).”  Line 288 of the manuscript should be included in the abstract: “While the global
ASIR and DALYs rates of cervical cancer have shown an overall downward trend, significant
differences exist in specific patterns of change across SDI regions. In middle-high SDI regions,
the incidence rate has generally increased.”
Line 71: “Cervical cancer is both preventable and treatable….”
This should be modified to read that cervical cancer is both preventable and curable.
Line 106: OECD should be defined and added to the list of abbreviations
Line 116: “Additionally, we calculated the estimated annual percentage change (EAPC) for the
five SDI regions.”
The authors should include either data tables or clear references so that readers can learn which
countries comprise the five socio-demographic regions.
Line 221: “For age-standardized incidence rate, low SDI and high SDI areas experienced a
significant decline, while changes in low-middle SDI, middle SDI, and high-middle SDI areas
were less pronounced (Fig.1.Part1).”
The term “were less pronounced” is a bit ambiguous. As noted later in the text, ASIR increased
in high-middle SDI regions. Because an increase is different than a less-pronounced decline, the
increase in ASIR in high-middle regions should be made clearer here.
Line 288: “While the global ASIR and DALYs rates of cervical cancer have shown an overall
downward trend, significant differences exist in specific patterns of change across SDI regions.
In middle-high SDI regions, the incidence rate has generally increased.”
As previously noted, this line is one of the most interesting findings from the analysis and should
be included in the abstract.
Line 292: “This finding is consistent with the unexpectedly low coverage in middle-high SDI
regions observed in this study.”
By “low coverage” do the authors mean low vaccination coverage, low screening coverage, or
both?
Line 297: “The growth rates in middle-high SDI regions varied significantly across periods.
From 1998 to 2018, the age-standardized incidence rate showed an upward trend. Notably,
the growth rate was particularly high between 2002 and 2005, which may be attributed to the
introduction of high-risk human papillomavirus (HR-HPV) testing as a cervical cancer screening
method around 2000. Although advances in detection technology improved sensitivity, they also
brought challenges associated with the detection paradox.”
The authors should consider whether unit costs for HPV tests relative to Pap smears may also
have played a role.
Title: Causal Association Between Gut Microbiota and Endometrial Cancer in European and
East Asian Populations: a two-sample Mendelian Randomization Study
Version: 0 Date: 10 Oct 2024
Reviewer's report:
1.  The manuscript appears to cover a topic already well-reported in recent literature (doi:
10.1097/MD.0000000000037628; doi: 10.3389/fmicb.2024.1417904). This overlap largely
reduces the novelty of the present findings, although the authors added the GWAS data from
East Asian populations . It would be important to clarify what new insights this study provides
that distinguish it from existing publications on the same topic.
2. The results section should include more visual representations such as scatter plots, forest
plots, and funnel plots to provide multi-dimensional data interpretation and visual evidence.
Title: Causal Association Between Gut Microbiota and Endometrial Cancer in European and
East Asian Populations: a two-sample Mendelian Randomization Study
Version: 0 Date: 16 Oct 2024
Reviewer's report:
The manuscript titled "Causal Association Between Gut Microbiota and Endometrial Cancer in
European and East Asian Populations: a two-sample Mendelian Randomization Study" is based
on the investigation of the speculated causal influence of microbiota dysbiosis in the gut on the
occurrence of endometrial cancer (EC) risk. This framework uses MR to determine the causal
relationships between the two traits of concern by employing a data multiplier from MiBioGen
and the IEU OpenGWAS databases.
Suggested Revisions:
1. While MR is a reliable tool for this analysis, the manuscript should provide a clearer
explanation of the assumptions underlying the MR approach (i.e., independence, exclusion
restriction, and relevance). A clear description of how instrumental variable assumptions apply
to both exposure (gut microbiota) and outcome (endometrial cancer) should be added to improve
the rigidity of results.
2. The manuscript examines two distinct populations (European and East Asia), but it is unclear
how population stratification was accounted for.  It would be helpful to specify whether the
MR analyses were done for each population separately or if a meta-analysis of the different
populations was conducted. Furthermore, underline whether there was a difference in the causal
effects on these two areas as it could be necessary for precision medicine programs.
3. The discussion section would benefit from expanding on the biological mechanisms that
could underlie the causal links identified between gut microbiota and endometrial cancer. The
discussion should focus on the ecological roles of the specific microbiota taxa and how they
might influence the genetic/cellular pathways involved in cancer progression to put the findings
into a much broader context.
4. The limitation section might be improved by exploring some drawbacks of the MR approach
in this context. For instance, you could point out whether the study is not going to be sufficiently
powered to detect rare microbial taxa's causal effects and if there is a possible misclassification
bias embedded in the microbiome data.
5. The clarity of figures and tables could be improved. Make sure all figure legends can be read
and contain ample information to make them independently understandable.
Title: Causal Association Between Gut Microbiota and Endometrial Cancer in European and
East Asian Populations: a two-sample Mendelian Randomization Study
Version: 3 Date: 17 Mar 2025
Reviewer's report:
Overall, your response letter and the revised manuscript address most concerns raised. Most of
the content is grammatically correct and the spelling is accurate, but there are minor errors in
some parts. For example, "his imbalance" should be "this imbalance" and "atients" should be
"patients." It is recommended to perform a thorough proofreading to eliminate such errors.
Title: Causal Association Between Gut Microbiota and Endometrial Cancer in European and
East Asian Populations: a two-sample Mendelian Randomization Study
Version: 3 Date: 22 Mar 2025
Reviewer:  Bingdong Liu
Reviewer's report:
The authors have addressed my concerns raised in the review. I appreciate the authors' efforts
in improving the clarity, accuracy, and overall quality of the manuscript.
Title: The Safety and Efficacy of Liraglutide Combined with Metformin in Clinical Treatment
of Polycystic Ovary Syndrome Patients: A Meta-Analysis
Version: 0 Date: 09 Nov 2024
Reviewer:  Yigit Cakiroglu
Reviewer's report:
General Comments
This meta-analysis gives a brief information about the safety and efficacy of liraglutide in
combination with metformin for the treatment of PCOS. The authors have investigated a total
of 12 trials (1096 patients) and have compared the parameters in between the groups with
combination. Tehnically, PRISMA guidelines have been followed and the results have been
demonstrated in regards of the findings and the included trials.
Abstract:
The abstract accurately describes the short-summarized content of the article.
Key words are adequate in quality and number.
Introduction:
The rationale of polycystic ovary syndrome, pathogenesis, clinical treatment, mechanisms of
liraglutide have been well defined in the introduction section.
Materials and Methods
The materials and method section contains briefly and comprehensively the search strategy,
inclusion-exclusion criteria, data extraction, quality assessment, and statistical methods
employed. Prospera registration and the detailed literature research have been performed.
Results
The result section contains important and significant findings and observations in regards of the
included studies.
Discussion
The discussion section states the importance and significance of the findings in a very detailed
way. The authors have discussed the effects on the metabolic, laboratory, and clinical parameters
including ovulation and conception in detail. They have also mentioned about limitations of the
study.
Conclusion:
Conclusion part reflects the main idea of the MS.
References:
The references section contains appropriate and reasonable number of references
Figures:
The figures are so demonstrative and clear
Tables:
The tables are well designed.
Title: The Safety and Efficacy of Liraglutide Combined with Metformin in Clinical Treatment
of Polycystic Ovary Syndrome Patients: A Meta-Analysis
Version: 0 Date: 19 Nov 2024
Reviewer's report:
-The subject is original.
-The paper is well-planned, organized and written.
-Registered to PROSPERO.
However,
-There are some grammatical mistakes. Needs edit.  Please see the highlighted  words for some.
- I could not find some of the references.
-Specifically, reference number 15, Sun 2021. It was referred for AMH figure, line 325. The
given AMH level  does not look like realistic. It is too high. The unit might not be the same
as others.
Finally,
The paper should be reviewed by a reviewer who has an expertise in statistics.