Title: Menopause Rating Scale (MRS) in the Malay language- Translation and Validation in a
Multiethnic Population of Selangor, Malaysia
Version: 2 Date: 23 May 2022
Reviewer's report:
This is an excellent piece of research. There are a few suggestions for improvement.
Title: Bahasa Melayu can be changed into the Malay language. Thus the proposed new title is
Menopause Rating Scale (MRS) in the Malay language- Translation and Validation in a Multi-
ethnic Population of Malaysia
Abstract: It might require changes upon suggestion incoming chapter.
Introduction: According to your reference list, a few pieces of research have been published on
the same topic, namely the prevalence of menopause (references no 20, 21, and 22). In Malaysia,
one of them utilized the same questionnaire to assess menopause symptoms. The tool has also
been translated and validated by Indonesian researchers (as we know the Indonesian language
is less similar to the Malay language to a certain extent in which you just need to do some
modifications to suit Malaysian needs). As a result, one major worry is understanding why you
need to conduct this research.
Methodology: Why was a single proportion formula used to estimate the number of samples
required for sample size determination? There is no specific formula, and the most common rule
of thumb is to multiply the number of items in the questionnaire by 10. You can use this paper
as a reference: https://www.researchgate.net/deref/https%3A%2F%2Fwww.ncbi.nlm.nih.gov
%2Fpmc%2Farticles%2FPMC4275948%2F%23CR39
Change Bahasa Melayu into Malay language. Who are the experts involved in the translation
process? A detailed explanation of data collection might be required. The process might involve
a few steps which the authors did not describe well. The steps are as follows (Wild, D.; Grove,
A.; Martin, M.; Eremenco, S.; McElroy, S.; Verjee-Lorenz, A.; Erikson, P. Principles of good
practice for the translation and cultural adaptation process for patient-reported outcomes (PRO)
measures: Report of the ISPOR task force for translation and cultural adaptation. Value Health
2005, 8, 94–104):
1. Preparation
2. Forward Translation
3. Reconciliation
4. Back Translation
5. Back Translation Review
6. Harmonisation
7. Cognitive Debriefing
8. Review of Cognitive Debriefing Results and Finalisation
9. Proof-Reading
10. Final Report
Statistical analysis – the EFA should be part of the Statistical Analysis subheading. Why is EFA
required in this study given the original questionnaire version has identified the three domains
that have been demonstrated to be valid and reliable? How do you determine the fitness of the
final model? Please provide the ethical approval reference number from the institution.
Results: The explanation and accompanying document on EFA should be omitted because it
provides no further information from the original version of the questionnaire. It is suggested that
the authors compile their findings on model fitness into a table. Please take note that there is no p
= 0.000. Please double-check for real Malay grammar example “Kekenngan Vagina”, “Masalah
Pundi Kenoing”, and “Keletihan Fizikal dan Mental” – does it include mental exhaustion?
Discussion: As previously mentioned, a paper on a similar topic was published in Malaysia, and
the same tool was employed. They included responses from Malaysia's multicultural population,
including Malays. As a result, it's unclear whether the questionnaire has been validated in Malay.
Secondly, as described by the authors, Malaysia is a multiracial country. When dealing with the
elderly, not everyone is fluent in Malay; the majority prefer to talk in their native language or in
English (for those with higher education), therefore the study's objective of establishing a Malay
version of the MRS may not be applicable to all races. Furthermore, other researchers in other
countries, such as Indonesia, may not reference the findings because they already had their own.