Title: Polycystic Ovary Syndrome (PCOS) Management using a Nutrition Recommender
Mobile Application: Identifying Key Requirements
Version: 5 Date: 19 May 2025
Reviewer:  Hamid Sharif-Nia
Reviewer's report:
Dear Editor,
Strengths:
Relevance and Importance: The study addresses a significant and timely issue—the management
of Polycystic Ovary Syndrome (PCOS) through a nutrition-focused mobile application. PCOS is
a prevalent endocrine disorder, and the use of mobile health (mHealth) solutions is a promising
approach to improving patient outcomes.
Methodology: The study employs a structured, three-stage methodology (systematic review,
questionnaire design, and expert validation), which is appropriate for identifying key
requirements for the proposed mobile application. The inclusion of expert opinions adds
credibility to the findings.
Comprehensive Analysis: The article provides a detailed analysis of existing PCOS-related
mobile applications, highlighting gaps and opportunities for improvement. The categorization of
requirements into educational needs, demographic information, data elements, and app features
is well-organized and logical.
Practical Implications: The identified requirements for the mobile application have clear
practical implications for developers, nutritionists, and healthcare providers, potentially
enhancing self-care and lifestyle management for PCOS patients.
Weaknesses and Areas for Improvement:
Clarity and Flow:
The manuscript would benefit from improved clarity in some sections, particularly in the
methodology and results. For example, the transition between stages could be smoother, and the
presentation of results (e.g., tables and figures) could be more reader-friendly.
The abstract and introduction could better highlight the novelty of the study compared to existing
literature.
Sample Size and Demographics:
The study relies on a relatively small sample of experts (15 participants), which may limit the
generalizability of the findings. A larger and more diverse panel of experts could strengthen the
validity of the results.
The demographic characteristics of the respondents (e.g., faculty members vs. PhD candidates)
are mentioned but not thoroughly discussed in terms of potential biases or perspectives.
Limitations:
The absence of real user (patient) feedback is a notable limitation, as highlighted by the authors.
Future studies should include patient perspectives to ensure the application meets their needs.
The cross-sectional nature of the study and reliance on expert opinions instead of patient data
may affect the applicability of the findings in real-world settings.
Technical Details:
The manuscript mentions the use of Kotlin and Visual Studio Code for app development but
lacks technical depth regarding the proposed recommender system's algorithms or architecture.
Including these details would enhance the reproducibility and feasibility of the study.
The Content Validity Ratio (CVR) calculations are explained, but a brief discussion on why
certain items were deemed low-necessity (e.g., "news of Iran's PCOS society") would add value.
References and Citations:
Some sections, such as the discussion, could benefit from more citations to support claims and
comparisons with similar studies. For example, the discussion on AI-based diagnostic systems
(e.g., SVM model) could be expanded with additional references.
Language and Grammar:
While the authors used Grammarly for grammar checks, some sentences are still awkwardly
phrased or repetitive (e.g., the discussion of educational needs). A thorough proofreading by a
native English speaker or professional editor is recommended.
Suggestions for Revision:
Major Revisions:
Expand the methodology section to clarify the selection criteria for experts and the rationale
behind the questionnaire design.
Include a more detailed discussion of the limitations and how they might impact the study's
conclusions.
Add technical details about the proposed mobile application's architecture or algorithms.
Improve the flow and clarity of the manuscript, particularly in the results and discussion sections.
Minor Revisions:
Proofread the manuscript to correct grammatical errors and improve readability.
Ensure all tables and figures are clearly labeled and referenced in the text.
Add more citations to the discussion to strengthen comparisons with existing literature.
Final Recommendation:
The article is well-structured and addresses an important gap in PCOS management. However, it
requires major revisions to address the limitations, improve clarity, and provide more technical
and methodological details. With these revisions, the manuscript has the potential to make a
significant contribution to the field of mHealth for PCOS.
Recommendation: Major Revision