Reviewer ’s report  
 
Title: Understanding what impacts on disclosing anal incontinence for women when comparing 
bowel screening tools: A phenomenological study  
 
Version: 0 Date: 19 Mar 2019  
 
Reviewer: David  Desseauve  
 
Reviewer's report:  
 
Interesting subject because we do not know the  exact prevalence of anal incontinence (IA) in 
women of childbearing age. Certainly due to poor screening tools and techniques. This study is 
interesting because it's provide a new screening tool based on a simple questionnaire and using 
common language wo rds. This Tool is developed with the help of women with AI. Completion 
of this questionnaire and two more (more known and used in routine clinical practice) by women 
suffering from AI then collection of their ease / ease or not to complete these questionna ires. The 
originality of the study is based on the second part of the methodology which is relevant in its 
choice with regard to the delicacy of the subject treated. In order to collect the experience of 
women in connection with the filling of these questi onnaires and thus to explore what facilitates 
or not the disclosure of this pathology, the methodological approach by phenomenology is 
adapted. The methodological tool used, namely semi -structured interviews with a question of 
departure, is a good choice. The size is determined by the saturation of the data and is quite 
correct for a qualitative study (n = 16). The interviews were recorded and then transcribed and 
analyzed according to a content analysis to identify 3 themes and 4 sub -themes. The duration o f 
the interviews is correct.  
 
Limits:  
Few bibliographic references related to the methodology (only 2 out of 26).  
The article format does not give access to verbatim interviews.  
 
What does it bring  
A clinical tool for screening for AI with much greater acc eptability than other screening tests 
already known and used. In addition, identification of the brakes and levers (through the 
interviews conducted) encouraging women to report their pathology. Brakes and levers that 
carers need to be aware of to improve screening and management of AI.  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
 
 
Are the conclusions drawn adequately supported by  the data shown?  
If not, please explain in your comments to the authors.  
 
 
 
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.  
 
 
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
 
 
Declaration of competing interests  
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