Title: Scoping review of the association between bacterial vaginosis and emotional, sexual and
social health.
Version: 1 Date: 01 Mar 2022
Reviewer's report:
This paper presents a systematic review of the literature that examines the association between
BV and the emotional, sexual, and social health. The included studies were grouped by these
three possible associations and evaluated. This information will add to the knowledge base of
the overall disease burden of BV.
The manuscript needs to be reviewed for grammar and syntax, preferably by a native English
speaker to improve clarity of your prose. Below are my comments and questions.
Abstract:
L31: Is the association b/w stress and BV fall into the emotional category? If, so please specify
as only emotional, sexual and social associations are stated in the methods section of the abstract.
L39: does "…too little evidence…" mean there weren't enough studies or were the values
measuring the associations small?
If the former, how much evidence is required to be adequate?
Introduction:
L60: is there any explanation as to why there are high recurrence rates and a lack of long-term
treatment strategy and how dies the aim of this review relate to this problem?
Methods:
The search strategy was reported adequately following PRISMA reporting guidelines, although
a statement about any limits used in the search strategy should be mentioned as well.
Alternatively, the full search strategy for each database could be presented (as a supplementary).
Was there a screening step that looked at the full manuscript after the initial screening step of
just looking at the title/abstract?
If so, was there a second reviewer that independently reviewed the full articles.
If not, please include this as a limitation and possibly edit the text as to not refer to this as a
systematic review - using only one reviewer can lead to potentially more errors and bias than a
review using multiple reviewers (see Buscemi et al.).
Buscemi, N., Hartling, L., Vandermeer, B., Tjosvold, L., & Klassen, T. P.
(2005). Single data extraction generated more errors than double data
extraction in systematic reviews. Journal of Clinical Epidemiology, 59,
697–703.
Was there any attempt to assess the study quality of the included studies?
L85: why were studies excluded after the 14th of November? Is this just the date of the most
recent literature search? If this is so, I would suggest reporting instead the range of publication
years for your included studies.
L88: How were theses/dissertations handled?
L92: exclusion reasons should also be reported in the PRISMA flowchart (flowchart can also
be referenced in text)
L93: who did the review team ask advice from?
L97: When describing how the categories were defined I suggest breaking the text up using
either paragraphs or bullet points
Results:
L13: minor suggestions, but "unique hits" could be revised to "unique records" or " unique
citations" for clarity. "Manuscript" is also used to describe the studies - I suggest being consistent
throughout and use one term.
L136-141: The number of studies and the number of references do not match in many of the
statements in this section. Do some of the citations refer to citations with the same reported
participant data?
L188-190: these two statements contradict one another and seem to be from the same reference.
Discussion:
Are there any current recommendations that exist to address the issues you pose in the
introduction?
L231: What is 'reverse causation'?
L243: Heterogeneity among your included studies should not pose any issues in assessing study
quality. Many of the study quality tools available are used on studies individually and there
are tools made for different study designs - using different quality assessments in a review that
includes different designs could report scores from different tools as long as they are noted in
the methods section.