Reviewer’s report
Title: 
Psychometric Performance of the Arabic Versions of the Functional
Assessment of Cancer Therapy-Breast plus Arm Morbidity (FACT-B+4) in
Patients with Breast Cancer Related Lymphedema
Version: 
3 
Date: 
26 Mar 2022
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
Overall this was a thorough study, albeit with limitations in sample size and
generalizability, that is worthy of publication, with some tweaking and
substantial English language editing help. There is one methods decision that I
question, and I'd like to see an addition in the discussion. I'll discuss these points
next.
REQUESTED REVISIONS: 
On page 7, the researchers set what seem to be arbitrary boundaries for
percentages of hypotheses that need to be confirmed to equate to very good,
good, and moderate construct validity. I took a look at the article cited for that
sentence and found that those authors gave no rationale or citation for where
they set the bounds. The rationale for the researchers' choices here needs to be
made more clear and defensible. With respect to interpretation, I agree that
overall the measure performed adequately. However, its performance did leave
some to be desired, and the discussion should include more guidance on what
work could be done to improve the measure (the single, very generic sentence
just before the conclusion is not satisfactory).
ADDITIONAL REQUESTS/SUGGESTIONS: 
This manuscript needs substantial English language editing help.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes