Reviewer’s report
Title: 
Chronic Conditions in Women: The Development of an National Institutes
of Health Framework
Version: 
0 
Date: 
12 Dec 2022
Reviewer's report:
This manuscript provides an overview of the response to the US Congress on the
topic of chronic debilitating conditions in women, including an overview of the
public health needs, current research, and opportunities for future research to
advance our knowledge on this topic. The authors raise important topics,
including the need for a sex and gender lens on issues related to chronic
conditions, as well as a life course perspective including issues relevant to
pregnancy and menopause. This is an important summary on an emerging issue. 
I only have minor comments:
1. I wondered about the use of the term 'debilitating' throughout the manuscript.
Is this part of a technical term that is defined? (The use of this word is not
defined in the section defining chronic conditions on Pages 3-4.) The term
'debilitating' can be quite stigmatizing, so I wonder if the authors would consider
using a more neutral term such as 'chronic conditions'.
2. Definitions of chronic conditions, comorbidity, and multimorbidity are
provided, but disability (introduced on Pages 4-5) is not defined. I suggest adding
this definition.
3. Although I appreciate that DALYs are a simple means of quantifying the
effects of chronic conditions at a population level, they are not without critique
(e.g.: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646475/). Could the
authors provide a justification for the choice of this metric?
4. I appreciated the emphasis on female-specific conditions. The author might
want to add that these conditions would be important in measures of
multimorbidity, as current multimorbidity indices do not typically include
female-specific conditions.
5. The figures are largely focused on multimorbidity, which is not the sole (or
main) focus of the paper. I wondered whether the authors would consider
including figures that better address their overall focus on chronic conditions
broadly.
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