Reviewer's report
Title:Socioeconomic conditions and number of pain sites in women
Version: 1Date:30 November 2011
Reviewer: Rebeca Rios
Reviewer's report:
Overall the manuscript represents an interesting contribution to the knowledge
concerning social determinants of novel pain outcome. The cross-sectional
survey design is appropriate, the manuscript overall is well-written, and the data
is appropriately analyzed. Major concerns are in relation to points of clarity in
describing the rationale of the study and in presentation of the results, and minor
concerns are related to specific grammatical and wording issues.
Major compulsory revisions:
1) I recommend further clarification of the rationale provided for investigating
number of pain sites as the pain outcome of choice in relation to socioeconomic
conditions. In the first paragraph of the first section, authors state that NPS is
established as a “better” measure of pain, but do not explain how it is better or
why this particular dimension of pain is particularly of interest in relation to
socioeconomic conditions. The authors provide relevant citations that establish
an association between socioeconomic conditions and pain prevalence, severity,
but some further expansion on the different aspects of pain as they relate to
socioeconomic conditions would strengthen the paper.
2) Comments on results. Presentation of the results is overall logical and
well-described. A) The statistical analyses section states that chi square tests
and logistic regression were inferential methods used, but it would be helpful to
make it clear in the first paragraph 2 and 3 of the results that chi square tests
were used, and how many. Could experimentwise error be an issue here? If so,
this should be commented on in the discussion. B) In the first sentence of the
fourth paragraph of the results, it would help to clarify the description of the
logistic regression models. It reads somewhat awkwardly. It states that co-factors
from table 3 as well as age, BMI and history of gyn CA were entered, but age
and CA history were included and significant variables in that table. What is
meant by co-factor, and how are the variables referred to as co-factors treated
differently from BMI, age, gyn CA history (explanatory vs. control variables)? C)
Finally, tests of co-morbidity as a moderator are mentioned in the last sentence
of the results. It would be helpful to describe here or in the statistical analysis
section why they were conducted.
3) Comments on discussion section. The discussion section thoroughly describes
the findings in the context of relevant literature, but just a few things seem
missing. Particularly due to the cross-sectional design, the authors should
consider reverse causality. A) It is possible that greater number of pain sites,
through the impact of disability on ability to work, influences her socioeconomic
standing. B) The measure of socioeconomic conditions used here includes a
measure of social support or social embeddedness, satisfaction with number of
close friends. There are well-established linkages between social support and
embeddedness with health. The measure of SCI includes social with more
economic indicators; how do the findings relate to research on social support or
embeddedness?
Minor essential revisions:
1) The first sentence in the abstract under methods uses the term “study” or
“studied” three times. Please reword to reduce repetition.
2) In the second sentence of the introduction, is “prevalence” the correct term? I
wonder if pain frequency is the intended term, since prevalence is a population
characteristic and not a self-reported characteristic.
3) In the sentence in the study population paragraph under methods beginning
“In total, 653 responses..” I believe the term “eligible” is the wrong word. This
appears to refer to the number in the final sample rather than those who were
eligible.
4) Results section, third paragraph, last sentence. This sentence reads
somewhat awkwardly and could be more clearly stated.
Discretionary Revisions
1) In the methods section, study population subheading, if data is available it
would be informative to provide a statement commenting on how similar the
study sample’s demographic characteristics were to the general population. This
then could be mentioned in the discussion as a comment on generalizability of
the findings.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.