Reviewer’s report
Title: 
Interplay between Traumatic Brain Injury and Intimate Partner Violence:
Data Driven Analysis Utilizing Electronic Health Records
Version: 
0 
Date: 
24 May 2020
Reviewer's report:
BMC Women's Health TBI Review
Thank you for the opportunity to review this article. I have been interested in the
overlap of these two issues for some times, especially related to the increased
Danger a victim experiences when strangulation occurs. I think this article will
be well received in the field and have a few recommendations to hopefully
enhance its usability. 
Title: The title is clearly stated as to the purpose of the paper. 
Abstract: The abstract is well written but would be enhanced by including the
time of the data collection in months and years, the number of patient records
reviewed, and the type of team: interdisciplinary, intradisciplinary,
transdisciplinary? That would help orient the reader for their expectations upon
reading the article.
Keywords: I suggest you include key words that are not in the title. For instance,
domestic violence, cohort study, and blunt force or something to that effect.
Such an approach will increase the searchability for your article. 
Introduction: There is new data out from the CDC released 2017. I suggest you
update the first paragraph. Reports are available on the CDC website. It is the
same survey name, but the more recent data and citation. Acronyms are not
typically used in the beginning of a sentence: page 1 line 48; pg 3 line35 & 38 &
43 & 49; Please explain page 3 line 28 "environmental accidents" in greater
detail. You might consider defining IPV - depending on what you decide to do
regarding replacing that with the term domestic violence, per your methods
below. I suggest you add a few references from the strangulation/IPV literature
to discuss the connection in a bit more depth about IPV/strangulation and TBI.
Methods: You indicated you included the term Domestic Violence for IPV,
however that is a much broader term than IPV and includes child abuse and
neglect, elder abuse, sibling abuse, etc. As you already accounted for the elder
abuse overlap, did you explore child abuse parent and child terms? If child abuse
is in fact considered in your sample, might you consider using the term domestic
violence in your title if that in fact was the search term? If child abuse is not an
issue - please explain that. Also of some concern is page 5 line 20. You indicate
that your control group is unlikely to have IPV. As you know - from your
introduction - the rates if IPV - within year is approximately 6% nationally - for
men and women. The lifetime rate is significantly higher. There is a high
likelihood that many in your control group does have comorbid IPV as well.
Your second control group included Car accidents etc. - accidents are often
reported by IPV survivors as their partners will utilize automobiles as weapons.
You note the possibility of 
"falling off stairs" as IPV-related potentially - as
many victims report slip and falls at the ED in lieu of reporting IPV. Lastly,
might you explain why you limited your sample to women only?
I am not a medical provider - but could you address the science in your field of
TBI a bit? To a lay person, it seems there might be a big difference in the
identification of TBI (both screening, assessment and treatment) from 1999 to
now. That would be helpful in understanding how the timeframe may or may not
place limits on your data and findings. Also - please add the cohort size for each
of the 16 cohorts in the paper. While it is noted in the figures/tables - it would be
helpful their too. 
Findings: Given the finding that IPV and falling down the stairs have more
shared factors than IPV and TBI, I wonder if it is an artifact of methodology for
identifying TBI. If you could stratify your sample with a time variable, perhaps
when TBI diagnostic screening/measures changed, might the findings be
different? 
Regarding the pregnancy finding, there are some studies that suggest among
pregnant women who experience IPV, pre-IPV is the risk factor - not pregnancy.
Please add a reference for your stated belief. There are articles that suggest that,
however, they may not include pre-IPV as a variable.
Discussion: Please enter the acronyms again - you begin to spell out IPV and
TBI. Can you suggest next steps to creating a screening measure - or perhaps
training to help ED providers understand the comorbidities of IPV and these
other terms? You might consider noting in the limitations that this was a female
sample only, you don't have any way of knowing that the control samples don't
have IPV due to under-screening and disclosures.
Tables and Figures: I thought the tables and figures are amazing. Very nicely
done - color scheme - clarity etc. I would suggest editing only the arrows on
figure 6. Should they be renumbered? 5b appears before 5a in the text and there
is no reference to figure 5 overall. 
References -Often if refworks or some other program is used, words are not
carried over correctly -: i.e. reference 20 needs US capitalized.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
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