JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Reviewer's report
Title:Abnormal vaginal bleeding in women of reproductive age: a descriptive
study of initial management by GPs
Version: 3Date:7 March 2008
Reviewer: Mark Shapley
Reviewer's report:
The re-submission is a considerable improvement both in readability and
scientific merit.
I have one major area that I feel needs clarification.
The authors have now removed data concerning the "second consultation"
and have excluded women who presented during the first 3 months of the
study period and have attempted to clarify this in the new paragraph on
page 5 "To assess initial management ...". I'm afraid I do not
understand the phrase in the paragraph "as were all other consultations
without a three months follow-up before inclusion". Does this mean women
who registered with the Practice during the study period and who
presented within 3 months of registration and/or women in whom there was
no 3 month follow-up (i.e. those that left the Practice within 3 months
of the index consultation or who first presented October 2001 to January
2002)? These women should be excluded and that they have been needs
clarification.
Once this is resolved I think it should be published.
Reviewer's report
Title:Abnormal vaginal bleeding in women of reproductive age: a descriptive
study of initial management by GPs
Version: 3Date:13 March 2008
Reviewer: A Magos
Reviewer's report:
I have read the revisions which have addressed the issues I raised initially. As
noted by the second reviewer, the language of the manuscript needs to be edited
to make it readable, but otherwise I would recommend acceptance for
publication.
Reviewer's report 
 Quality of life and symptoms of menopause in the Estonian Postmenopausal Hormone Therapy trial Title: 
[ISRCTN35338757] 
 1  30 April 2007 Version: Date: 
 Britth Marie Landgren Reviewer: 
Reviewer's report: 
The manuscript is not of a quality to publish in BMC Womens health. It involves data from a heterogen 
cohort study of postmenopausla estonian women given a mixture of HRT. The study does not give any new 
data. 
It should be rejected.
Reviewer's report 
 Quality of life and symptoms of menopause in the Estonian Postmenopausal Hormone Therapy trial Title: 
[ISRCTN35338757] 
 1  8 June 2007 Version: Date: 
 George Creatsas Reviewer: 
Reviewer's report: 
The study is evaluating Quality of Life, side effects and vasomotor sympromatology in a large sample of 
postmenopausal women. Although well designed and conducted, the study has some methodological problems: 
1. The rationale of the trial was to evaluate hormone therapy as a preventive postmenopausal regimen. 
This, however, does not apply anymore to clinical practice, at least concerning mental and cardiovascular morbidity. The results, therefore, may not have clinical relevance. 2. Mean age of participants was 58.2 years and they were 8 years postmenopausal. This is not 
representative of women who are usually prescribed hormone therapy, who are recently menopaused. 
Furthermore, women 8 years after menopause are usually devoid of vasomotor symptomatology and are less likely to benefit from hormone therapy with regard to Quality of life. On the other hand there are numerous reports holding that hormone therapy administered to recently menoapused symptomatic women 
has an effect on QoL (Genazzani A et al, Maturitas 2002, Koundi K et al Gynecol Endocrinol 2006). 
Concerning the WHI results, women were old (mean 63 years old) and asymptomatic, so it would be higly improbable that they would benefit from hormone therapy concerning QoL. These issues should be incorporated into the discussion. 
3. Results were displayed as differences between groups. Longitudinal analysis within groups with respect 
to QoL was reported only breefly in text. Women on hormone therapy had a benefit concerning troubled sleep; A figure displaying these results would be more informative. 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 Yes, but I do not feel adequately qualified to assess the statistics. Statistical review: 
Declaration of competing interests: 
I have no competing interests
Reviewer's report
Title:Quality of life and symptoms of menopause in the Estonian
Postmenopausal Hormone Therapy trial [ISRCTN35338757]
Version: 4Date:18 September 2007
Reviewer: George Creatsas
Reviewer's report:
General
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached) the data presented in the 2nd paragraph of the
discussion refers to the pre-WHI era (Ref 24-25). These figures are not
representative any more.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
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Discretionary Revisions (which the author can choose to ignore)
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:Quality of life and symptoms of menopause in the Estonian
Postmenopausal Hormone Therapy trial [ISRCTN35338757]
Version: 4Date:21 September 2007
Reviewer: Helene Ekström
Reviewer's report:
General
The manuscript is improved meaning its easier to follow and to interpret the
results and the underpinning of these.
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached)
However I still have some problems with the authors presentations of the results.
The results of the General linear mixed modelling analysis are still only
presented as statements about differences found and p-values in the text – the
numbers behind these
statements and p-values have to be presented if of significance.
The authors also state in the last paragragh of the method section that they have
used a linear regression to evaluate the influence of treatment allocation, age
and socioeconomic factors on the EQ-5D score but in table IV the results are
presented as OR. A backward elimanation is also stated to have been used but
all variables mentioned as included in the model are still there, no one has been
eliminated. Or is this the last step that is presented? Which variables where
rejected? The authors also state that QoL decreased with age (the General linear
mixed modelling analysis) but in the analysis presented in table IV age seems to
have no impact.
In Table III The minimum values are presented but the maximum values are
lacking. Also a presentation of the lowest and highest possible value of the
EQ-5D index would improve the understanding of the table.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
Table II the footnote about OR shouldn't it be "treatment versus no-treatment
arms
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Discretionary Revisions (which the author can choose to ignore)
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests' below
Reviewer's report
Title:Quality of life and symptoms of menopause in the Estonian
Postmenopausal Hormone Therapy trial [ISRCTN35338757]
Version: 4Date:25 September 2007
Reviewer: Edson Zangiacomi Martinez
Reviewer's report:
General
The revised version of the manuscript may at this point be considered accepted
for publication.
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached)
Revisions are not necessary.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
Revisions are not necessary.
-------------------------------------------------------------------------------
Discretionary Revisions (which the author can choose to ignore)
Revisions are not necessary.
What next?: Accept without revision
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
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.
Reviewer's report
Title:Quality of life and symptoms of menopause in the Estonian
Postmenopausal Hormone Therapy trial [ISRCTN35338757]
Version: 4Date:21 November 2007
Reviewer: Petra Graham
Reviewer's report:
Statistical Review of: Quality of life and symptoms of menopause in the EPHT
trial.
I concur with the completely with the reservations expressed by the reviewer,
each of those comments needs to be addressed.
Other compulsory considerations: It is not clear why logistic regression was used
(what are the outcomes of interest – there are 4 study arms not 2). Have the
blinded and non-blinded arms been combined for analysis? This seems
potentially inappropriate – for example non-treatment is different to blinded
placebo. Why use both generalised linear models and linear regression? Why not
use survival analysis-type or longitudinal models which would have better
controlled for the differing lengths of time on the study etc.? The authors should
tell readers which results (i.e. OR etc) come from which analysis as it is not
always clear from the results. In the discussion the authors mention using
longitudinal methods however this is not reported or mentioned earlier. More
should be said about the QOL score. What is the minimum and maximum
possible score – what do the scores seen here imply about the well-being of the
participants?
Some material in the methods section would be better suited to the results (eg.
Paragraph 1 page 6). What was the adherence in the blinded placebo group?
The adherence to therapy does not seem to be particularly good –what are the
possible effects of this on the results. The results for sleeping do not agree with
the Figure 4. In fact Figure 4 needs to be explained – what are the reasons for
this strange relationship. From Table 1, how is it that the final year had more
participants than the first and second years? How have these dropouts been
dealt with in the analysis? Table 2: results should show actual numbers (with
total numbers who responded to the question) and percentage since percentages
can be misleading. Also in Table 2 why not presented summaries for each year
since the analysis appears to have been done using all years (from the figures)?
What is the OR for in Table 2? Why is bleeding not presented in Table 2? Table
3 – how are 95% CI on the quartiles calculated? Are they really necessary? Were
regression diagnostics performed on all models to ensure that assumptions were
met? Given the skewed nature of the QOL score it seems unlikely that linear
regression methods would have been appropriate. Table 4 should show all of the
variables described in the results.
Conclusions and discussion do not support results for sleeping or using other
medications in depressed participants.
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Symptom reporting and quality of life in the Estonian Postmenopausal
Hormone Therapy trial
Version: 6Date:19 January 2008
Reviewer: Helene Ekström
Reviewer's report:
General
The manuscript is much improved and I have only a few comments which I think
would improve the manuscript even further.
Minor Essential Revisions
Results page 13 last paragraph - 0.027 +/- SD ? or SEM? Please clarify.
Is this correct -0.017 +/- 0.24? If so signifikant? Please clarify
The sentence in the conclusion "for women with depressive symptoms
treatments other than HT should be prescribed" (and similar sentences in p 2
page 12 and last p page 15) lack underpinning in your study even if it's probably
quite right. In your study there is no difference in the reporting of depressive
symtoms between women on HT or without HT. This is not equivalent to studying
two groups of women with depression the one randomized to HT and the other to
placebo - which is necessary to evaluate whether or not HT is effective in the
treatment of depression. Please remove these statements or rephrase them.
The differences in the reports of sleeping problems between women on HT
versus without HT seems to be of transitory nature both in the figure and in table
2. Please
modify your conclusions or include a comment if this is the case.
The lack of information about actual numbers in table 2 still is problematic as the
number of women responding the different years differs greatly - only
percentages can be misleading.
What next?: Accept after minor essential revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
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'
Reviewer's report
Title:Symptom reporting and quality of life in the Estonian Postmenopausal
Hormone Therapy trial
Version: 6Date:3 February 2008
Reviewer: Petra Graham
Reviewer's report:
I appreciate the efforts of the authors in revising their manuscript. I am now
happy that they have addressed all of my previous comments.
What next?: Accept without revision
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:How Does Social Integration Influence Breast Cancer Control Among
Urban African-American Women? Results from a Cross-Sectional Survey
Version: 1Date:24 October 2007
Reviewer: Cindy Davis
Reviewer's report:
This manuscript is well-written and addresses an important issue in the literature.
However, there is one key area that need to be addressed.
In the results and discussion section, the authors need to address the findings
regarding Table 2. They made several claims about significant relationships
between variables based on very weak associations. For example, although
statistically significant, the relationship between social roles and neighborhood
networks was r=.17, and the relationship between social roles and instrumental
help and emotional help was r=.10 and r=-.09, respectively. These and other
weak associations should be more accurately explained in the results and
discussion sections.
What next?: Accept after minor essential revisions
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
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.
Reviewer's report
Title:Human lactobacilli as adjuvant given to patients with bacterial vaginosis
reduce the recurrence rate after vaginal clindamycin therapy; a 6 month double
blind randomized placebo controlled study.
Version: 4Date:13 July 2007
Reviewer: Mark A Klebanoff
Reviewer's report:
General
My concerns have been met
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached)
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
-------------------------------------------------------------------------------
Discretionary Revisions (which the author can choose to ignore)
What next?: Accept without revision
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Hormone replacement therapy use and plasma levels of sex hormones in
The Norwegian Women and Cancer Postgenome Cohort
Version: 1Date:25 July 2007
Reviewer: Shelley Tworoger
Reviewer's report:
General
This manuscript examines hormone levels among Norwegian women based on
their self-reported menopausal status, hormone use, menstrual cycle day, and
BMI. The hormone data are used to validate menopausal status and hormone
use self report. Overall this is a well-written manuscript and an interesting study.
However, the lack of statistical adjustment for potential confounders in the
hormone analysis is concerning. For example, the authors did not observe an
association between BMI and estradiol in postmenopausal women – a
well-established positive relationship. This may be because there was no
adjustment for age, parity, age at menopause, alcohol consumption, number of
ovaries, and other potential confounders in the analysis.
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached)
1. The authors need to assess for potential confounding in the ANOVA analyses,
focusing on the confounders mentioned above. Further the analyses of various
hormone preparations should be additionally adjusted for BMI.
2. It would be very interesting to look at the BMI-sex hormone relationship among
women using hormones. In the Tworoger et al. study, they reported that sex
hormone levels were associated with BMI even among hormone users.
3. For the sensitivity and specificity analysis of self-reported menopause, it likely
will be helpful to create a dubious or unknown category in addition to pre and
postmenopausal. Specifically for women with a simple hysterectomy or irregular
menses who are between 45-53 years of age, it is extremely difficult to
accurately pinpoint their age at menopause without hormone measures. This
does not lead to misclassification but merely a reduction in power. Please
calculate the specificity and sensitivity of your questionnaires removing these
women.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
1. In figure 1, it is unclear how the 20,391 women answering the 8-page
questionnaire are 81% of the total study population of 171,977.
2. For table 4, it would be helpful to include a p-trend across BMI categories
using linear regression.
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Discretionary Revisions (which the author can choose to ignore)
What next?: Unable to decide on acceptance or rejection until the authors have
responded to the major compulsory revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Hormone replacement therapy use and plasma levels of sex hormones in
The Norwegian Women and Cancer Postgenome Cohort
Version: 1Date:30 July 2007
Reviewer: Lothar A.J. Heinemann
Reviewer's report:
Reviewer’s report
The content of the manuscript contributes nicely to open or controversially
discussed issues related with hormone levels of post- (and pre-) menopausal
women and the impact on breast cancer, for example. The manuscript is worth
to be published as it stands.
It is a methodologically straightforward and clear analysis of a sub-sample
of a large population-based, nationwide cohort study in Norway. The study
covers many self-reported questions using different questionnaires
providing information on risk factors and biomarkers, but also laboratory
data from a blood sample. All methods applied in this study are appropriate
and sufficiently described.
The main results concerning the complex issue of menopausal status and
measured hormonal plasma levels in users of HRT (specified by formulation)
compared with non-users are well presented and discussed, although the
numbers in some subgroups were small due to the design of the study. The
reviewer found the data deposition sound. Particularly interesting were the
successful attempts to confirm the validity of the self-reported menopausal
status with the measured hormone levels and the validation of the reported
currently used HRT with the national prescription data base.
The manuscript and discussion is coherent, scientifically sound and
contributes to improve our knowledge.
Reviewer's report
Title:Hormone replacement therapy use and plasma levels of sex hormones in
the Norwegian Women and Cancer Postgenome Cohort - a cross-sectional
analysis
Version: 2Date:24 October 2007
Reviewer: Shelley Tworoger
Reviewer's report:
General - The authors have addressed the comments of the reviewers and
substantially improved the manuscript.
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Major Compulsory Revisions (that the author must respond to before a decision
on publication can be reached)
It is odd that there is not a stronger relationship between estradiol and BMI in the
non-hormone users. This may be because the authors used a direct assay
(without a column extraction step) to measure estradiol. These assays can give
falsely high estradiol levels among women with very low levels. This should be
noted in the discussion as a limitation. Dr. Frank Stanczyk has an excellent
review in a recent CEBP issue of this problem.
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
There were a few grammatical mistakes in the discussion that can be fixed.
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Discretionary Revisions (which the author can choose to ignore)
What next?: Accept after minor essential revisions
Level of interest: An article of importance in its field
Quality of written English: Acceptable
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.