JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: The Trends of Women's Autonomy in Health Care Decision Making and Associated
Factors in Ethiopia: Evidence from 2005, 2011 & 2016 DHS
Version: 1 Date: 12 Sep 2021
Reviewer's report:
By TA
The authors raise the important issue of Women’s Autonomy trend and associated factors in
Health Care Decision Making needs further evidence especially in low-income countries where
the burden is huge. Evidence generated helps to find in the strategic plan and evidence-based
intervention in reducing maternal and child health mortality. However, the problem of this study
is a lack of consistency in addressing the objectives and making them clear in analysis. Why
was 2016 data not described? when the self-decision decreased indicates is helping women's
health care utilization?
Comment one by one
Abstract
Line three to address the gap “not yet studied in Ethiopia” may not be appropriate
Result line three what was the trend in EDHS 2016?
Introduction part: women decision making states in Ethiopia not well addressed, the gap
description was not convincing
Methodology
Selection of variables, which one is good discussing for health care decision at the household
level for married women by discussing with partners or independently, what the authors
recommend?
Which outcome variable self or other is the interest of the study objectives? So how is the data
coded?
The survey collected a detailed woman's background characteristics. However, based on their
possible impacts upon women's autonomy in health care decision-making, this study identified
the following independent variables including women’s age, education status, working status,
place of residence, household wealth index, religion, and region, how selected? Need further
description, how selected? the effect of variables not included in the study?
Result
Rearrangement first table 1 then figure two
Tables need modification required is confusing
Is the data analysis made by considering the weight one as the DHS recommends?
Multinomial analysis interpretation is not clear “which variables relative to which?”
Discussion
The discussion part needs further work, comparing the finding with the previous result need
evidence or reference, the implication of the finding should be addressed, and synthesis of the
paragraph need further development
Language edition
Title: Attributions of survival and methods of coping of long-term ovarian cancer survivors: A
qualitative study
Version: 2 Date: 22 Apr 2021
Reviewer's report:
The abstract begins with a conclusion.  The background is very weak.
There is too much jargon, that I think will not be readily understood by this journal's typical
readership.  For example: "We generated thematic codes for attributions of survival and used a
priori codes for coping from the COPE Inventory, in addition to inductively generated codes."
Some results seem are self-evident, i.e., for lack of a more scientific term, "common sense." In
other words, the authors have not given the reader any reason to expect otherwise.
An example of how the writing can be considerably improved is the conclusion of the abstract:
"This study describes attributions for survival and coping styles of long-term ovarian cancer
survivors. These findings may help underscore important coping and survival attributions for
other long-term cancer survivor populations and should be considered in cancer survivorship
plans and provider interactions. Using a patient-centered framework to understand what is
important to long-term survivors will provide guidance for interventions to address the whole
patient, including aspects of physical, psychological, social, and spiritual well-being."  These
sentences are either not related to any specific conclusion, are broad and vague, are making
predictions, or are outside of the scope of the study results.
The manuscript appears to be nearly 7,000 words, which is excessive, and much of the writing
could be improved in the way that is outlined above: much of it is broad, vague, with unclear (or
unconvincing) rationale, broad interpretation of results that push the borders of what the data
actually show.  There are too many examples to list here.
I'll try to be a little more specific:  The rationale is long and full of statements such as
this: "Understanding coping behaviors in tandem with attributions of survival may provide
insight into how these behaviors are translated into action and consequently better inform
cancer survivorship plans and interventions."  That is a conclusion that cannot replace a clear
justification of the need for this particular study.  The mention of 22 subjects comes with a caveat
up front ("sample size was limited..."); anyway, I agree with the authors that the sample size issue
may be a problem and the authors' subsequent assurances that it isn't a problem are not detailed
or convincing.  In the results section, I wonder why the average age of OC is 10 - 15 years
younger than many other study populations.  Generalizability?  In the Discussion, the authors
pat themselves on their backs regarding the uniqueness of the study, but don't really back this up.
The limitations section is too brief (the only section that may not be too long).  Although very
long, the manuscript never really gels from clear rationale, to clear (and economical) explanation
of methods and results, to clear conclusions.  I think the manuscript would benefit from being
re-written and shortened in the process.
Title: Attributions of survival and methods of coping of long-term ovarian cancer survivors: A
qualitative study
Version: 2 Date: 11 May 2021
Reviewer's report:
This is very interesting and I think it is an area of increasing need (survivorship).  It would be
interesting to look at a wider sample of patients with wider demographics.  it would also be
very interesting to include BRCA mutation status, as a high proportion of long term survivors
are BRCA mutation carriers, which brings other issues for survivorship.  I think asking about
this (as patients will know their mutation status) would be very interesting and useful for future
planning.
Title: Attributions of survival and methods of coping of long-term ovarian cancer survivors: A
qualitative study
Version: 6 Date: 05 Jun 2021
Reviewer's report:
This conclusion is obviously a critical piece of your manuscript: "Qualitative analysis shows
that long-term ovarian cancer survivors have a unique psychological profile that may be
characterized by a healthy skepticism of conventional attributions of survival such as health
behaviors, a clear-eyed pragmatism and willingness to reject cultural norms of tolerating
emotionally draining people within their network. While some reviews indicate that survivorship
care plans may have few measurable benefits, [44] [45] our results may provide avenues of
further exploration as to how well existing care plans address the hard-won insights provided
by long-term ovarian cancer survivors. Future interventions should fully incorporate the unique
perspective of long-term survivors; doing so will inform the timing of intervention strategies,
provide a context for appropriate versus ineffective messaging, and be built upon the values of
ovarian cancer patients/survivors."  The first sentence is not a complete sentence.  One can also
see that it contains some editorializing.  The second sentence suggests something of potential
value, but that is left unstated.  It's nothing more than a "teaser,"  which is a shame.  Ditto for the
following sentence; also a bit of vapid editorializing.  Big words, but little meaning.  I suggest
being more clear.
Title: Self-management of Overactive Bladder at Home using Transcutaneous Tibial Nerve
Stimulation: A Qualitative Study of Women's Experiences
Version: 1 Date: 24 Jun 2021
Reviewer:  Eren Akbaba
Reviewer's report:
Dear editor thank you for giving me the opportunity for rewieving this article.
I read this interesting article titled "Self-management of Overactive Bladder at Home using
Transcutaneous Tibial Nerve Stimulation: A Qualitative Study of Women’s Experiences".
1. The phrase “The reusability of the TENS machines and the lack of need for ongoing HCP
support and sharps-disposal are also cost-saving” is not suitable for introduction.
2. I suggest that the purpose of the study be expressed more briefly and clearly.
3. You should give the success rate of TTNS.
4. I suggest that other conservative methods be mentioned in the treatment of OAB.
5. The phrase “focussing on understanding the meaning of living with OAB while recognising
the women’s real-world experiences of these conservative treatments and underpinning
explanatory mechanisms” is not an appropriate expression for the method part.
6. Have your patients had a urodynamic test?
7. TTNS application at home is advantageous in terms of cost. In terms of cost, pelvic floor
exercises and vaginal cone applications have similar success rates with TTNS. But they are
cheaper methods, why weren't these methods preferred first? Please explain.
8. The number of patients participating in the study is small. You came to a conclusion with the
limited number of patient opinions. You did not have a statistical analysis because the number of
patients was small. The positive results of being able to treat patients at home were predictable.
Please explain.
9. Have your patients had experience with other conservative methods used in the treatment of
OAB? Do you have a report comparing TTNS with other conservative methods?
Title: Self-management of Overactive Bladder at Home using Transcutaneous Tibial Nerve
Stimulation: A Qualitative Study of Women's Experiences
Version: 1 Date: 07 Jul 2021
Reviewer's report:
The authors reported women’s experience of using self-managing Transcutaneous Tibial Nerve
Stimulation (TTNS) aiming at comparing self-managed versus HCP-led TTNS. The study
provides positive experience on using self-managing TTNS at home and also identified some
factors that may facilitate or inhibit the using of self-managing TTNS.
This qualitative research could be of potential interest for the readership. I would suggest some
improvement.
1. How were the participants selected? Were all the participants who were recruited in the
feasibility study contacted after the completion of the feasibility study? How many participants
consented to participate in the interview? How many participants refused to participate in
the interview? Could you provide a flowchart of summary of participant recruitment and
participation?
2. Where did the interview conducted?
3. Was there any other person (i.e. partners or family members) present when the participants
were doing the interview?
4. Does the interviewer have the experience in conducting qualitative research?
5. Could you please provide brief participants demographic and background information?
6. Did the participants have any further involvement following the interviews and were there
repeated interviews performed?
7. How do you assess the data saturation?
8. It is better to have a discussion on the perceived factors influencing participation and
adherence (i.e. family support, financial considerations) in the discussion part.
Title: Self-management of Overactive Bladder at Home using Transcutaneous Tibial Nerve
Stimulation: A Qualitative Study of Women's Experiences
Version: 3 Date: 03 Oct 2021
Reviewer:  Eren Akbaba
Reviewer's report:
No urodynamics was performed on the patients and very few patients
The estimate of the study is predictable.
This study, which investigated their experience with OAB and TTNS treatment, and the
perceived factors affecting participation and compliance, was interesting in terms of sharing the
results of the home self-treatment procedure during the Covid 19 pandemic period.
Title: Relugolix for oral treatment of uterine leiomyomas: a dose-finding, randomized,
controlled trial
Version: 1 Date: 06 Apr 2021
Reviewer's report:
The study is well designed. The result and discussion sections are filled with many repetitions
and do not include the idea clear. The statistical analyses can be significantly improved to present
the right or the close to right dose. statisticians re definitely aware of these methodology, which,
if included, will improve the study.
Title: Relugolix for oral treatment of uterine leiomyomas: a dose-finding, randomized,
controlled trial
Version: 1 Date: 22 Jun 2021
Reviewer's report:
This Phase II trial explored Relugolix monotherapy efficacy and safety in women with uterine
fibroids. The manuscript is well written, however, I have some comments that authors can
consider:
1- Why authors didn't add an arm of relugolix in combination with Add-Back therapy like
estradiol and NETA to overcome the resultant hypoestrogenic side effects of GnRH antagonist.
If the purpose of the current study is exploring short-term treatment to be considered pre-
surgically, the authors will need to comment on that in the discussion.
2- Title has a dose-finding trial since exploring 10, 20, and 40 mg. Considering the several
published phase 3 trials and the fact that Relugolix was approved recently by FDA as 40 mg. Is
there a rationale to find the dose especially exploring 10 mg?
3- Most of the comparisons in the results section lack statistical significance such as Hgb,
tumor size, HRQL, BMD loss, and pharmacodynamic related endpoints ...etc, same in the tables.
Authors need to add p-value, whenever applicable, in the tables and mentioned in the text of
the results section.
4-  Patients and Methods section (M&M) needs to have subtitles of design, patients, methods,
statistical analysis ...etc
5- Authors mentioned that some patients used analgesics for pain management, how that was
factored in while analysis of pain reporting?
6- Whichever secondary outcome is statistically significantly improved following treatment and
end of study should be emphasized in the abstract.
7- The details about SEs experienced sporadically by a couple of patients can be summarized
since it's unrelated to the tested drug.
8- Authors need to discuss their results more in comparison to published trials such as Liberty
1 and 2.
Title: Contribution of clinical breast exam to cancer detection in women participating in a
modern screening program.
Version: 2 Date: 16 Jun 2021
Reviewer's report:
The manuscript submitted by Tehillah S. Menes et al. describes the rare contribution of clinical
breast exam (CRE) to cancer detection in women participating in a modern screening program
from 2007 to 2016 in the Center for Screening and Preventive Medicine in the Tel Aviv Sourasky
Medical Center. The authors analyzed the date of 14,873 CBE in 8,378 women.
The data was so big, and the results was interesting.
However, I have some major and minor suggestions for improvement.
This paper can be accepted only after revision of this paper considering the comments below.
Major comments
(1)As stated in the final paragraph of “Discussion” part, the NCCN guidelines also state
that breast awareness is important. Although this retrospective cohort study only included
asymptomatic women, is it reasonable to exclude women with suspected symptoms in examining
the efficacy of CBE?
(2)The authors described that there were 14,873 CBE completed in 8,378 women and 7% were
abnormal. If there are abnormal findings in CBE, are they all undergoing mammography? What
about the rate of abnormalities in mammography and the rate of cancer for women with abnormal
findings in CBE?
(3)In Table1, the number of N is different for each parameter and it is difficult to understand.
If some of the parameters were not available for all patients, “N/A” should be included in the
table and N should be unified to 8,378 women or 14,857 CBE.
Minor comments
(a)I also fail to understand the difference between numbers and numbers in parentheses In Figure
1A.
(b)In “Result” and “Discussion” part, the numbers and % are described, but I think it is easier
to understand if the denominator and numerator are also described. For example, on the third
line of the Discussion part, is “Thirty -five (0.2%)” correct? I think the correct value is 0.42%
(35/8,378 women).
Title: Contribution of clinical breast exam to cancer detection in women participating in a
modern screening program.
Version: 2 Date: 24 Jun 2021
Reviewer:  Toshiyuki Ishiba
Reviewer's report:
It is not clear whether you arefinally affirming or denying CBE.
If you didn't recommend CBE, you should indicate what alternatives (US or MRI) are available
and what to do in the future.
Title: Contribution of clinical breast exam to cancer detection in women participating in a
modern screening program.
Version: 3 Date: 07 Jul 2021
Reviewer:  Toshiyuki Ishiba
Reviewer's report:
I’m sorry that my first comment did not get through to the author, due to a technical error on
my part. Please let me comment this time, adding some things that I couldn't say in my first
comment.
Comment1. The authors reported the clinical breast exam (CBE) in screening. The targets were
14,873 patients who underwent CBE. The authors didn't directly follow the patients who were
performed CBE, and search Israel National Cancer Registry (INCR) within 3 months of CBE
INCR for the breast cancer patients. If a patient has an abnormality on a test but does not see a
doctor within three months, that patient's abnormality will be missed. This is the major limitation
of this paper and the authors should mention that in discussion.
Comment2. If possible, the authors should collect the details of CBE abnormalities such as
tumor, redness or discharge. And they should collect the details of mammograms abnormalities
such as tumor, FAD, calcification or distortion. The frequency of these findings must be
important in screening.
Comment 3. The authors concluded that CBE couldn't contribute to the early detection of cancer.
However, it does not mention whether CBE is acceptable or not, and the authors’ argument is
ambiguous. And they added the sentence ‘ the role of CBE in specific subgroups of women will
need to be evaluated’. But it’s unclear the specific subgroups. The authors should mention the
specific group.
Minor comment 1.  In method part, how many doctors analyze each mammogram?
Minor comment 2. In figure legend 1, they should use large text such as A,B in figure 1.
Title: Factors Related to Autonomy Among Lebanese Women: A Web-Based Cross-Sectional
Study
Version: 2 Date: 01 Dec 2020
Reviewer's report:
Thank you very much for the opportunity of reading your manuscript.
The introduction was well written but it is a little long. Paragraphs 2 and 3 seems to partially
answered the aim of your study. These two paragraphs could be more synthesized and the
introduction could be more focused on introducing the studied phenomenon.
I am really interested in better understanding the reasoning behind "fertility problems" as an
exclusion criterion.
Was the sample size calculated using previously published data, a pilot study or otherwise? This
information was not clear to me.
Cronbach's alpha of both Women's Autonomy Index and Perceived stress scale short version is
really low. Are these outcomes measure reliable?
The results presented in tables should not be written fully in the text.
It would be really important to highlight and discuss the selection bias. It would be interesting to
compare the sociodemographic characteristics of the participants with data from the Lebanese
population.
Title: Factors Related to Autonomy Among Lebanese Women: A Web-Based Cross-Sectional
Study
Version: 2 Date: 24 Dec 2020
Reviewer:  Ana Carolina Pitangui
Reviewer's report:
General Comments: The article has an important theme, however, some topics concern me
and I highlight them below. My biggest concern is regarding the instruments used. Only one
was mentioned to be validated for the study language, Lebanese. I ask the authors to place the
validations of the instruments and that the acceptance of the publication is subject to this. The
autonomy instrument mentioned by the authors differs from that used in the article mentioned
and there is no mention of validating the instrument, as well as the others. The authors mention
5 instruments and only the Lebanese Anxiety Scale (LAS) is reported to be validated.
Aspects related to the article: The high level of education in the sample makes it difficult to verify
any association in this variable, however, the authors justify it in the limitations. Summary: I
suggest that the instruments used and statistical tests are placed in the methods. In results and
conclusions, the secondary objective related to psychological factors is answered.
In the body of the article:
Methods: To better describe the study sample, what location were they from?
Review exclusion criteria. What will make women excluded after entering the study? These
criteria should be better described in inclusion. What reason after being included caused the
sample to be excluded? Was not returning the form exclusion criteria?
The pilot data was inserted in the final sample, I suggest removing these data. Describe in more
detail the Sample size calculation.
The Women’s Autonomy Index (WAI): Better describe the answers and scores of the autonomy
index. How was the validation done? With which sample? What steps have been taken?
Results: if the data are already in the tables, make a brief description of the main findings, without
needing to repeat the percentage.
Figure 2 - adjustment of variables: describe the parameters that were used for each
categorization. How were the variables categorized?
Figures 1 and 2 would be better in table format.
Title: Factors Related to Autonomy Among Lebanese Women: A Web-Based Cross-Sectional
Study
Version: 4 Date: 18 Mar 2021
Reviewer's report:
It was a pleasure read your manuscript again and see how it got better.
The second phrase of your methods seams to be better suitable at the results. “The majority of
participants were from Mount Lebanon and Beirut (76.4%); the others were from North (11.9%),
South (6.5%), and Beqaa (5.1%).”
Now that I understand better the reasoning behind "fertility problems" as an exclusion criterion,
it would be important to clarify it on the text, maybe after Ethical approve, writing that this is
part of a bigger study.