Reviewer ’s report  
 
Title: Transvaginal Son ography: Perception and attitude of Nigerian women  
 
Version: 0 Date: 01 Jan 2017  
 
Reviewer: Imran Morhason -Bello  
 
Reviewer's report:  
 
Department of Obstetrics & Gynaecology,  
Faculty of Clinical Sciences,  
College of Medicine,  
University of Ibadan,  
Ibadan,  
Nigeria  
30th December 2016  
 
The Editor in Chief,  
BMC Women's Health  
 
 
 
 
Dear Sir,  
 
Report of my review of the manuscript [BMWH -D-16-00254]  
 
I thank you for asking me to review this manuscript entitled "Assessment of Women's Attitude to 
and Perception of Transvaginal Sonography (TVS) in Nigeria". Authors of this manuscript made 
attempt to  present results of their research findings on TVS, a radiological procedure that is fast 
gaining ground in obstetrics and gynaecological clinical practice in Nigeria and other developing 
countries. According to their main objective, they wanted to investi gate attitude and perception 
of women of "mixed educational status" toward TVS use which they hope could potentially 
increase the existing body of evidence available in Nigeria. Other secondary objectives were; 
factors that may prevent or discourage women from accepting TVS, and also to assess women's 
experience of pain during TVS.  
 
 
 
These are my comments following my review:  
 
1. General comments: The manuscript was poorly written with many grammatical and 
punctuation errors. It was very difficult to apprec iate the rationale for this study as 
authors failed to clearly present justifications for the study. I am at a loss as to what 
information they want to present based on educational status.  
2. Specific comments: My specific comments are as follows;  
 
 
i. Title of the manuscript: Since the study was conducted only in one of the 6 geo -
political zones in Nigeria, I suggest they include their study location into the title.  
 
 
ii. Abstract: This is confusing to me and the current state fails to summarise the expecte d 
key findings. Results on association between educational status and attitude and 
perception towards TVS were not presented (This was the main objective of the 
paper), yet authors concluded that "majority of our respondents had positive 
attitude……."! I am  at a loss on what constitute positive attitude here! I suggest that 
this section should be rewritten to match the core objective of the study. It may be 
important to include sampling of study settings (how were the hospitals selected?) 
and study populatio ns (Please provide details of sample size by facility).  
 
 
iii. Background: There are several statements that need to be edited. For example….Line 
7 -"it is ideal for the assessment of ovulation???? " Is there any reference for this 
statement??? Authors need  to improve on the literature review by including other 
studies conducted in Nigeria. The assertion on line 24 & 25 that most studies 
conducted in Nigeria were mostly on literate might not be entirely correct! May be 
you meant most studies had more literat e than illiterate.  
 
 
iv. Methods: This section did not provide details on how health facilities and sub -
population were selected. It is also unclear as to whether authors used convenience or 
random sampling. How was the sample size determined for the entire  study and by 
study sites??? What sort of consent (verbal or written) was obtained? It is confusing 
to me as to how selected experts validated the tools. It would also be nice to have a 
template of the data collection form. There were no information on how  data was 
analysed to address each of the key objectives. For instance, what is the primary 
outcome here and what is or are secondary outcome(s)? I suggest that authors should 
seek help of a statistician to be able to justifiably analyse their data and 
comprehensibly address each of the study objectives.  
 
 
v. Results: This section needs to be rewritten! There are were so many tables that could 
be merge. I suggest you have a detailed descriptive table - sociodemographics. 
Another should be on test of associat ion. I don't think the figure is necessary. It is 
better used for scientific presentation.  
 
 
vi. Discussion - This has to be rewritten as current arguments did not align with 
objectives of the study. Clear limitations of the study should also be discussed 
including possible sources of bias.  
Conclusion: I cannot recommend this manuscript for publication as it require MAJOR 
CORRECTIONS  
 
 
 
Thank you.  
 
Sincerely,  
 
 
Imran Morhason -Bello, MSc, MPH, FICS, FMCOG, FWACS  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments t o the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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 am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manus cript:  
 
Not suitable for publication unless extensively edited  
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, fu nding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to al l of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
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