Title: Comparison of Quality of Life in Patients with Endometriosis Undergoing Treatment with
Progestins, Oral Contraceptives Pills (OCP), and GnRH Agonists
Version: 2 Date: 13 Jun 2025
Reviewer's report:
I would like to thank you for the opportunity to review the manuscript entitled "Comparison
of Quality of Life in Patients with Endometriosis Undergoing Treatment with Progestins,
Combined Oral Contraceptives (OCP), and GnRH Agonists." I congratulate the authors on their
hard work and dedication to researching such a relevant topic in women's health.. However, I
have a few considerations that can improve the quality of this study.
1) Suggestion of the previous reviewer:
The attached response letter does not include the previous reviewers’ comments, and the current
version of the manuscript does not highlight the changes made between submissions. This lack
of information significantly hinders the ability to conduct a proper evaluation, as it is unclear
which modifications were implemented in response to earlier feedback. For a thorough and
fair assessment, it is essential that the authors provide a detailed point-by-point reply to the
reviewers’ comments and clearly indicate the revisions made in the manuscript.
2)Methods: The Methods section needs to be rewritten for greater clarity, scientific precision,
and internal coherence. Several aspects require attention:
- Grammar correction: The section inconsistently shifts between past and present tense (e.g.,
“A gynecologist confirms” vs. “This study included”). For consistency and clarity, the entire
Methods section should be written in the past tense, as it describes procedures already performed.
For non-native English speakers, this can be challenging, but it can be effectively addressed
using artificial intelligence tools for grammar correction.
- Diagnostic process: The description of how endometriosis was diagnosed is vague. It should
be clarified whether all patients underwent the same imaging modality, or if different tools were
used based on clinical judgment. The criteria used to confirm the diagnosis based on imaging
findings should be described in more detail.
- Study design clarity: The phrase “descriptive-analytical study” is vague. The authors should
explicitly state whether the study is prospective or retrospective, observational or interventional,
and whether it has a comparative or longitudinal design.
- Sampling method and size: There is no information about how patients were selected (e.g.,
consecutive sampling, random sampling), nor how many patients were included. It would also
be helpful to include whether a sample size calculation was performed.
- Data collection: The section on data collection lacks structure and flow. It would benefit from
a clearer description of when and how data were collected (e.g., baseline, follow-up points),
and who administered the questionnaires. In particular, the authors should explain whether the
EHP-30 was self-administered or interviewer-administered, and at what time points.
- Ethical approval: While informed consent is mentioned, the section does not state whether
the study was approved by an ethics committee or institutional review board, which is essential
information for any human research.
3) Results: The Results section requires substantial revision to improve clarity, organization,
and scientific rigor. I suggest the following improvements:
- Structure and Flow: The text is currently fragmented and highly dependent on raw tables.
A results section should provide a narrative synthesis of the findings, highlighting the key
comparisons and statistically significant results, while referencing tables for detailed data.
- Clarity in Descriptions: The description of groups (e.g., “OCs,” “Progesterone,” “GnRH”)
should be standardized throughout the text. Avoid switching between names (e.g., OCP vs. OCs
vs. oral contraceptives).
- Tables vs. Text: Avoid simply repeating what is in the tables. Instead, focus on summarizing
trends and emphasizing relevant findings, especially significant differences.
- Tables: Please ensure that all tables include clear and informative captions. Each table
should have a concise legend that describes its contents and highlights the main variables or
comparisons being presented. The captions should be placed above the tables and should allow
the reader to understand the data without needing to refer back to the main text. Additionally,
please ensure that abbreviations used in the tables are defined either in the table footnotes or
within the legend itself.
- Statistical Language: Use appropriate scientific language when describing statistical findings
(e.g., "There were no statistically significant differences in age among the groups [p=0.822]").
- Grouping by Domain: Present results in logical sections: (1) Baseline characteristics, (2)
Demographic and behavioral factors, (3) Health status, and (4) Quality of life.
- Interpretation of Findings: Whenever significant differences are found (e.g., for nutritional
status, dyschezia, psychological disease), briefly comment on the direction or pattern, even if
interpretation is reserved for the Discussion.