Title: Women’s use of online health and social media resources to make sense of their polycystic
ovary syndrome (PCOS) diagnosis: a qualitative study
Version: 4 Date: 19 Dec 2023
Reviewer's report:
Dear authors,
Many thanks for the comprehensive response to feedback from the reviewers. This has greatly
improved the clarity of the paper. However, I still have some concerns.
Overall, whilst the paper does offer novel and interesting contributions, the paper still feels
unclear in its purpose. Is it to report on information seeking, sense making or finding normal?
Attempting to address all three makes the messages and key findings unclear. I would
still suggest that the authors considering re-writing the paper(s) so that the knowledge and
information shared is clear, this would allow in-depth literature reviews to take place and
position the findings. At a minimum, a greater literature review of the PCOS literature is still
needed, as this is limited and somewhat dated.
Abstract: The results do not detail themes, and the conclusion does not discuss conclusions, but
states what the paper discusses. Could this be amended to include clear results and conclusions
from the paper.
Line 30 – information seeking in PCOS has been discussed in previous literature which has not
been included here, this literature search and review needs expanding.
Line 45 – includes ‘suffering’ the authors suggest they have amended this in their reviewer
feedback (SOC #6). Please ensure the changes have been addressed throughout the paper.
Line 50 – refers to ‘chronic conditions’ this is out of sync with the SOC #40 where the authors
state these have been changed. Please ensure the changes have been addressed throughout the
paper, as you have stated.
Line 51 – this argument does not consider the literature on the experience of PCOS which
discusses information seeking. This argument needs rewording to be clearer. I believe you are
suggesting that no research has, to date, focused specifically on experiences of information
seeking online for women with PCOS. Rather than suggesting that there is no literature on
information seeking online for women with PCOS which has been published and does exist. As
if the wider literature had been considered the authors would know that women with PCOS do
engage with information seeking online, and do engage in ‘finding normal’.
Line 145 – Whilst it is good that the epistemology is now detailed, it needs discussing in more
depth. An additional sentence or two would suffice and appropriate references.
Line 166 – the subthemes have been discussed but need further clarity.
Line 351 – please reference ‘Normal PCOS’ - this is not a label known to me. Moreover, whilst I
suggested that “Lean PCOS is a common label that has been attached to a specific phenotype of
PCOS” in my reviewer comments I did not expect this to be copied word for word and written
into the paper. The authors need to conduct a literature review and use appropriate evidence
for their paper.
Line 382-402– this is discussed in wider PCOS literature which could be drawn upon here.
Line 404 – please reference.
Line 511 – this shares a lot of similarities with the common-sense model of self-regulation
(Leventhal et al.). Some discussion here would be useful since the Common-sense model is
widely known in long-term conditions literature. This would align with line 526 – in the common
sense model, individuals make sense of the information based on pre-existing paradigms they
hold – before information seeking.