Reviewer’s report
Title: 
Assessment of lipoedema awareness among Polish women- online survey
study
Version: 
2 
Date: 
22 Jul 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
No - there are minor issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The authors have mostly responded appropriately to
some of the the reviewer comments and altered the paper accordingly. However,
some comments have not been addressed and the issues previously raised
remain.
REQUESTED REVISIONS: 
In the previous review, it was noted "This is a very small and focussed survey
(i.e., in women participating in online forums in Poland) and so this should be
reflected in the title, abstract, and conclusion as the generalisability of the results
beyond this select sample is doubtful." The authors have not fully addressed this
- for example, they have just added "Polish" to the title, but not that it is women
recruited from social media forums, for example. The study design (survey)
should also be in the title. 
I remain unconvinced that it is appropriate to have the secondary aim of
"increasing awareness of this condition". While this may have been a by-product
of asking women some questions, it is not a research aim as this was not a pre-
post survey design and there was no measure of awareness AFTER the survey
had been completed. Therefore, the authors cannot make any claim about
whether the study did/did not increase awareness as there are no data to answer
this aim. This aim (in the abstract and at bottom of pg 4), and associated claims
about how this aim could help (top of pg 5), should be deleted.
The additional aim on pg 4 about exploring associations is not included in the
aims in the abstract. 
Pg 16 - the reason for adding these sentences is not clear. Is it to show a
connection between diet/physical activity and the condition? If so, these are
observational studies and don't provide any evidence that altering diet or
increasing physical activity may assist.
Limitations - the 2nd sentence is not clear. Please reword. 
Limitations - not including questions about surgery is not a limitation, unless
there is evidence that surgery can help. And even so, this comment would belong
as a future research question not a limitation. 
Limitation - as per previous feedback, it's not just the small sample size that
limits the results, but the limitation to paritipcnats recruited on social media in
one country. Please acknowledge this also.
ADDITIONAL REQUESTS/SUGGESTIONS: 
There are numerous typographical errors throughout and errors in the referencing
style.
Declaration of competing interests
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interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
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Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
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Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
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Do you have any other financial competing interests?
6
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Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
This reviewer has been recruited by a partner organization, Research Square.
Reviewers with declared or apparent competing interests are not utilized for
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under a Creative Commons Attribution License attributed to Research Square
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timeframe. Honoraria for reviews such as this are paid regardless of the reviewer
recommendation.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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No