Reviewer ’s report  
Title: The Women's Heart Health Programme: A Pilot Trial  Of Sex -Specific Cardiovascular 
Management  
 
Version: 0 Date: 16 Oct 2017  
 
Reviewer: Tracy Madsen  
 
Reviewer's report:  
OVERALL: Very impor tant topic and intervention. Appreciate your work on this important 
topic.  Paper needs a lot of work in terms of re -focus on intro, more detail in methods, re -
organization of discussion. Has great potential.  
 
Abstract  
1)- not sure what 90% significance le vel means - reword - do you mean alpha level .1?  
- methods: what outcomes were measured  
2) RESULTS: need confidence intervals around difference between groups. Would be nice to 
have p -values as well. Need basic demographics: race/ethnicity, age in abstract.  
 
INTRODUCTION:  
- Needs some work - 1st paragraph is too vague —I think we are past knowing that CVD is also 
a woman's disease. I would write a short paragraph describing known pertinent sex 
differences in CV disease (pathophysiology, symptoms) in more detail  with references. Also, 
are you talking about CHD? Or all CVD?  
- Then can lead into 2nd paragraph and talk about disparities in care and differences in 
outcomes  
- Don't need paragraph about bikini medicine - too broad for this paper. Would take out lines re: 
breast/ gynecologic health.  
- Have you seen VIRGO study? Would reference that  
 
 
METHODS  
- Keep in past or present tense, don't switch back and forth  
- Did you c onsider that some patients under the care of cardiology for a longer period of time 
might have different outcomes?  
- Need to cite data supporting your decision to use all women on the treatment team  
- This should probably be in your introduction.  
- Need mo re information/ detail on the development of the program; or if you have written 
other papers about its development you should site them. This info would be key to 
reproducing the study. What do you mean by culture centered approach? Need much more 
detail here.  
- Were participants followed every 4 months? Wording here is confusing.  
- Specify change in CV risk factors from baseline?  
- How were data on CVD events/ admissions collected/ confirmed/ adjudicated?  
- Did you conduct a power analysis?  
- Why 10% alp ha level rather than 5%  
 
RESULTS  
- Need to describe basic demographics of your sample in the first sentence - race/ethnicity, age, 
etc 
- Is difference in HbgA1c adjusted for baseline values?  
- Are differences in BMI and HbA1c clinically significant?  
- Last paragraph of results - what was the model adjusted for  
- Consider adding subgroup analysis by diagnosis  
 
DISCUSSION:  
- First three paragraphs sound like they belong in the introduction. Also you note many 
cardiology clinics for women - is there literature co mparing the effectiveness of these clinics 
in parts of world other than Asia?  
- Grammar issues throughout - for example don't start sentence with numbers, look for run on 
sentences  
- The discussion is hard to follow - needs to be regorganized. Start with sum mary of your 
important results, then compare to previous literature, then talk about implications for care, 
then future directions.  
- Participation and followup rates should be in results section  
- How is the study both open and blinded??  
 
TABLES  
Need to define acronyms in text and tables when first used.  
 
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 comme nts to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any st atistics 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 manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
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