JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Performance of Aptima-HPV in the cervical cancer screening program of Portugal: a cost-
analysis
Version: 2 Date: 18 Nov 2022
Reviewer's report:
REPORT OF THE MANUSCRIPT TITLED “PERFORMANCE OF APTIMA-HPV IN THE
CERVICAL CANCER SCREENING PROGRAM OF PORTUGAL: A COST-ANALYSIS”
Abstract
• In the methods section, I would specify the type of model, as the modeling methodology is
not clear.
• In the results section I would specify the time measurement. Is the cost saving annual? For
the two years of the analysis?
• As a keyword I would include the term “Cervical cancer”
Introduction
• More information related to screening programs should be included.
• The objective should specify the methodology used to estimate the number of diagnostic tests
and costs avoided using Aptima® HPV compared to using Hybrid Capture® 2 and Cobas®
4800.
Method
• The methodology used in the analysis is confusing, since according to the results to be obtained,
a cost analysis should be carried out; however, the text states that it is a budget impact analysis
"... the time horizon recommended for budget impact analysis, according to the Portuguese
guidelines" please clarify this aspect.
• In the methodology I miss a first paragraph specifying the type of model used and the cohort
of patients. It is true that it is detailed later, but until you get to the specific section you do not
know what the work is about.
• “The hypothetical cohort moves between health states, according to prespecified probabilities
in each decision tree node, over a period of 2 years” -> If it is a cost analysis, it is not possible to
talk about health states. Please give clear details of the type of model used and its corresponding
characteristics.
Sensitivity analysis
• In the deterministic sensitivity analyses I would include an analysis assuming a 0% discount
rate and a time horizon of 1 year.
Results
• The measure of time should be specified - is the cost saving, testing on an annual period? For
the two years of the analysis? It is not clear
Discussion
• In the discussion section it would be necessary to include as a possible limitation the assumption
made about the prices of HPV tests.
References
• Reference 1 is incomplete; it would be advisable to specify the year and if possible the link
to access the corresponding data.
Title: Need assessment for the content of educational programs about breast cancer from the
viewpoint of unaffected women
Version: 2 Date: 25 Jul 2022
Reviewer's report:
This is an interesting paper and I like the approach of asking women what their questions are.
This approach is a way for patients to give back to their community of women and is important
for patient care. I believe the results can be applied to future interventions as the authors plan
to do.
The introduction is written well, but I'd like to see more context about breast cancer in Iranian
women. This additional information would provide international readers about the scope of the
problem specific to the country and women. I would also like to see some literature in the
background reviewing what typical breast cancer education is like for Iranian women. Are there
national advertising programs? Are there national efforts to promote awareness? Is this a taboo
topic? All of this would benefit the reader in understanding why the study needed to be done on a
larger context beyond just asking patients (which is valuable, but I think there is more reasoning
behind this study that just was not revealed).
Additionally, I found it interesting that the authors chose to sample women who were healthy. I'd
like to see this reasoning explained in the background and/or methods section(s) as it's a critical
approach in the design. I also would have liked to have seen the ages of these women -- were
they of the mammography screening age? Were they younger?
I'd like to see more discussion about the healthy sample and how authors surmise what the
perspectives of a healthy sample would bring to the results.
I liked the limitations section as the authors pointed out major issues with the sample. However,
this is still useful information and gives us insight into a healthy patient population's needs
(verses an at risk population).
I enjoyed this article very much and would like the authors to add more detail about their
reasoning for sampling healthy women and also more context to breast cancer among Iranian
women. Thank you for the well-written article.
Title: Need assessment for the content of educational programs about breast cancer from the
viewpoint of unaffected women
Version: 2 Date: 01 Sep 2022
Reviewer's report:
Thank you for the opportunity to review this interesting paper. I believe the paper can be
published with some major revisions and possibly another round of review.
1. In Abstract, “For this, she must be aware of the subject; but women have many unanswered
questions about this cancer.” In Introduction, “In Iran, many women are aware of the risk of
breast cancer and have many unanswered questions.” –How do you define awareness? Please
give more information about “unanswered questions” in Abstract, it’s confusing.
2. Please add information about the data analysis strategy in your Abstract.
3. In Background: clarify this sentence: the rate of response to treatment. How can “timely
diagnosis can assist in breast cancer prevention?”
4. Please polish your language and avoid using informal expressions like “For that to happen.”
This phrase is especially problematic when it’s the first sentence in this paragraph—what is
“that”?
5. Overall, more information needs to be added for Background to provide a clear summary of
previous research on this topic and the significance of this paper. For example, are you describing
previous research here: “This state of confusion causes unreasonable worry and fear of the
disease and leads to not taking action at the proper time.” You are describing a series of causal
relationships. Please expand on it and cite references to support your statement.
6. Methods: please expand details about your data analysis: The written questions were reviewed
and categorized after every fifteen consecutive filled forms by a breast surgeon and two breast
care nurses.
7. Was there any quality control for data analysis?
8. Discussion: please be consistent with wording, e.g. “non-answered”, “unanswered”
9. Add citations to “These studies confirm that despite some educational programs being carried
out”
10.  After reading your discussion, the significance of understanding information needs in
unaffected women is still unclear to me.
Title: Need assessment for the content of educational programs about breast cancer from the
viewpoint of unaffected women
Version: 3 Date: 25 Oct 2022
Reviewer's report:
Thank you so much for your additional information that you added about Iranian women and
the culture. I believe this is particularly helpful context to the reader and also provides a great
service to Iranian women.
The additional information in the methods section and discussion section reads much better. I
have greatly enjoyed reviewing this manuscript and looking forward to seeing it published.
Title: A structural equation model linking health literacy, self-efficacy, and quality of life in
patients with polycystic ovary syndrome
Version: 1 Date: 17 Dec 2022
Reviewer:  Jan Roar Mellembakken
Reviewer's report:
Review
The paper has an interesting topic on linking health literacy, self-efficacy and quality of life
(QoL) in patients with PCOS.
The method to search knowledge about the study questions is good. The results are interesting
and the interpretation well balanced.
I would like to hear a little more about two topics:
1. Health literacy (HL) is well explained in the paper.  Self-efficacy (SE) is an essential mediator
which influence QoL. I would like to have a similar good explanation for what SE is, as the one
the authors present for HL.
2. The conclusion of the paper is that HL is low among patients with PCOS. That is ok. Even
if it is not the topic of the paper, I would like a small discussion about the level of knowledge
among doctors (GP, gynecologists and endocrinologists) on PCOS.
Is that knowledge (HL) good enough?
Patients in America and Europe do not find that doctors have sufficient knowledge on PCOS.
This has been studied in China as well.
Will doctors HL on PCOS also influence significantly on patients QoL?
See:
Anja Dokras et al: Fertil Steril 2017 Jun. PMID 28483503
Terhi Piltonen et al. PLOS ONE. 2019 Dec. PMID 31877155
Rulin Ma et al. BMC Endocri Disord 2021. PMID 34488736
Deng Yan et al. J. Ovarian Res. 2021. PMID 33536040
Title: A structural equation model linking health literacy, self-efficacy, and quality of life in
patients with polycystic ovary syndrome
Version: 1 Date: 01 Jan 2023
Reviewer's report:
Dear Editor
The presented manuscript is devoted to the study of health literacy in patients with PCOS, as
well as factors affecting health literacy.
The problem studied by the authors is very relevant as compliance with treatment and the course
of the disease significantly depend on health literacy. The authors conducted a survey of 300
patients with PCOS and revealed the relationship of education, disease duration, marital status
with health literacy, quality of life and self-efficacy. Interesting results of stepwise multiple
linear regression analysis in determining the contribution of the above factors to health literacy.
The manuscript is well structured and interesting to read.
However, there are some minor remarks
1. Please, check the spelling and punctuation in the text (there are typos), check the Results
section.
2. In the Results section, the description of the results in Table 3 is not entirely clear "As shown
in table 3, marital status, education, duration of PCOS, QOL, and SE were significantly higher
HL scores (p<0.01). Education and duration of PCOS were significantly higher QOL and SE
scores (p<0.01)", please rephrase the sentences, describe the results in more detail
Dear Editor, the manuscript can be accepted but after minor revision
Title: A structural equation model linking health literacy, self-efficacy, and quality of life in
patients with polycystic ovary syndrome
Version: 3 Date: 29 Jan 2023
Reviewer's report:
Dear authors, You have done a great job correcting the manuscript according to our comments.
but minimal changes are still required
Page 6 line 164.......  The majority of women had been educated beyond middle school (n=300,
77.70%),  77% from 300 (it s you sample size) is 233, why again you keep (n=300, 77%)?   I
believe it should be (n=233, 77%)  (you have the same comment from another reviewer but did
not change it)
Title: Changes in maternal heart rate in delayed post-partum preeclampsia
Version: 0 Date: 29 Dec 2022
Reviewer's report:
Abstract:
-Write a few lines for Background and then mention the aim.
Key words:
-Some of them are not special .Find more related keywords in mesh  such as maternal heart rate,
maternal bradycardia.
Introduction:
- it is good
Methods:
The method is not clear, you write more complete and mention these things carefully, please:
- what day is the routine screening hearing test performed? It continues to 6 weeks after delivery?
Because it has defined in your paper  "Delayed-onset postpartum preeclampsia was defined as
a new diagnosis of preeclampsia that occurred 48 hours to 6 weeks postpartum"
-How do you obtain hemoglobin level on the day of labor in the control group?
-when do you measure the heart rate in control group?
- Chronic diseases such as kidney disease, liver diseases,heart diseases should be in Excluded
criteria.
- Review type of study again.
References:
The format of 7and 8 references is different from others.
Please,references before 2012 have been deleted and replaced with newer references unless they
are necessary.
It was an interesting topic.I think  to read this article is useful .
Angsubhakorn N, Benditt D (February 10, 2021) Relative Sinus Bradycardia: An Unexpected
Finding in Preeclampsia With Acute Pulmonary Edema. Cureus 13(2): e13262. doi:10.7759/
cureus.13262
Title: Changes in maternal heart rate in delayed post-partum preeclampsia
Version: 0 Date: 31 Dec 2022
Reviewer:  Murallitharan Munisamy
Reviewer's report:
Dear colleagues, thank you very much for the effort to highlight an issue which is highly
significant for health professionals, but may have received little attention.
Please allow me to provide some comments which will help to further improve the quality of
this well-thought out and formulated piece.
1. In terms of study design,  there is probably better value in utilising a case-control design
which would be more appropriate. From the methods and the analysis which seems to be of a
retrospective secondary analysis, there would be great value in utilising a case control design
rather than describing it as a cohort- it may well be this, with a nested case-control design?
2. The use of the comparison variable of maternal HR between case and control groups on same
postpartum day is concerning in terms of heterogeneity. Were all these samples from results on
Day 1 Post-partum? Or Day 2? A similar comparison should be exhibited, and the authors may
have utilised this strategy without quite highlighting it to us, the reader. This then needs to be
clarified better in the text.
3. Description of the  test in Table 1 needs more elaboration. For example, Chest X Ray = 5
(11%)  needs some explanation on whether only 5 individuals got a chest x ray, or only 5 had
an abnormal finding on the chest X ray and so on.  In terms of overall flow, Table 1 has little
to add to the discussion, so it is also worth rethinking on whether there is a need for Table 1 in
terms of space. It may be added as a supplementary table rather.
4. There is some confusion from the text on the recruitment of the control group. It seems that
the participants were recruited in a f2f intervention long after the control group. Is Was this so?
for homogeneity, recruitment should have been carried out in a similar mannner. Again, this
may have been addressed by authors but is unclear in the text.
5. In terms of statistical analysis, there are no tables presented with multivariable logistic
regression- despite this being alluded to in the methods. In case control studies, the proper
variables need to be presented, and this may be in the form of median rather than as means; as
well the understanding of the proper multivariate tests to be utilised. These too may have been
utilised in the actual analysis but are not visible in the text.
6.  There is a need to show the severity of the problem- i.e a likelihood of how many post-partum
eclampsia mothers may exhibit low maternal HR for it to be a likely added prognosticator = data
on this will prove to be extremely valuable for us all as HCPs.
Title: Changes in maternal heart rate in delayed post-partum preeclampsia
Version: 3 Date: 30 Jan 2023
Reviewer's report:
Thank you for amendments.
In Discussion ,You wrote most but point to one article. Please correct it.
"Most studies on delayed- onset postpartum preeclampsia concentrated mainly on clinical
features. In a small series of pregnant women, it has been shown that maternal heart rate is lower
in women with antenatal preeclampsia as compared to healthy controls, (71±14 vs 85±10 bpm),
respectively (6)"
Title: Chronic cough in postmenopausal women and its associations to climacteric symptoms
Version: 2 Date: 09 Apr 2022
Reviewer's report:
The study has evaluated the relation of chronic cough and postmenopausal symptoms in 200
healthy postmenopausal women. The results showed that the prevalence of chronic cough
was 33% in healthy postmenopausal women, with higher menopausal symptoms, especially
urogenital and somato-vegetative domains in patients with cough. Climacteric symptoms
correlated strongly with parameters of cough. Based on the findings, the prediction for
respiratory complaints could be shown. The authors concluded chronic cough was significantly
associated with menopausal symptoms, but chronic cough as a possible climacteric symptom
and its underlying mechanisms should be further explored. The study was clinically relevant
and added some new knowledge to the field. However, some issues need to be addressed.
Major comments
1. LCQ was wrongly scored and calculated. It is true that LCQ covers a physical (8 items),
mental (7 items), and social (4 items) domains. However, each domains was scored by the total
points divided by items in the domain, with total score ranging from 3 to 21(Ref 28 in the text).
Based on the mistake, the authors should recalculate the data again and be sure the findings
were consistent.
2. Chronic cough was not separately evaluated by a tool such as VAS score. LCQ mainly assesses
the quality of life related to cough, which is not completely consistent with the severity of cough.
3. The data in the manuscript came only from the questionnaire-based survey, not from the
objective detection, for example cough sensitivity test to inhaled capsaicin and levels of serum
estrogen and progesterone, which weakens the power of conclusion of the study.
Minor comments
1. How to define the mild and heavier cough symptoms in the study? There is no corresponding
description in the method section of manuscript.
Title: Chronic cough in postmenopausal women and its associations to climacteric symptoms
Version: 7 Date: 16 Sep 2022
Reviewer's report:
This remains a novel study with some interesting findings. The manuscript has been improved
from an earlier version I reviewed. However there are further changes that should be made.
1. There are some typographical and grammatical errors. E.g. "The cough receptor’s
hypersensitivity " (first paragraph of Purpose suction) suggests there is only one cough receptor.
2. Second paragraph of Results: the phrase "mild to severe symptoms of chronic cough " is
confusing. How are mild and severe defined? Could you not just say  66 patients reported chronic
cough (if that is the meaning intended)?
3. MRS Results: "In 2 of the 3 MRS domains (mental (p = 0.036), urogenital (p < 0.001), and
somato-vegetative (p < 0.001)), there is a highly significant difference between the subjects with
versus without cough". Would sound more convincing to say "in all three domains of the MRS
there were statistically significant differences in MRS scores between the subjects with versus
without cough". The current wording is confusing, and the absolute magnitude of the p-value is
not as important as whether it reaches the threshold for statistical significance.
4. Table 5,  Figure 2, Table 6. I am not at all sure what this data adds here. All you are saying is
that subjects who have chronic cough have worse cough-related quality of life than those who do
not cough. This is not surprising, it relates to how the (very well-validated) LCQ was designed,
and it is not relevant to the question of the study.
5. The discussion needs another revision. The points currently made could be done so more
concisely. The hypothesis (as I understand it) essentially is that chronic cough may be part of
the menopause, possibly explained by  hormonally-driven mucosal and neuronal changes in the
airway. Any supportive evidence for this from the literature should be made more explicit; if
there is no evidence then this should be more clearly stated.  The review with reference Front.
Physiol., 07 May 2021 | https://doi.org/10.3389/fphys.2021.654797 is very relevant here but has
not been cited.
7. Rather than supporting a specific aetiological role of menopause in causing chronic cough,
could the data more simply not be interpreted as menopause symptoms are worse in those who
also happen to have chronic cough (of whatever cause)?  Chronic cough is certainly associated
with sleep problems, exhaustion, muscular discomfort, etc, even in those who have not gone
through the menopause (Table 3).
Title: Chronic cough in postmenopausal women and its associations to climacteric symptoms
Version: 8 Date: 12 Jan 2023
Reviewer's report:
The manuscript is not yet ready for publication in my view.  Please see specific points here.
Methods
How were patients with cough identified? Was every subject asked “do you suffer with cough?”
or some other question? This is not clear in the methods.
Results
Para 2:
I am still unclear how the categories ‘mild’ and ‘severe’ cough are defined. This should either
be made explicit, or as I suggested previously just say ‘66 patients reported chronic cough’ (if
that is the meaning intended). The abstract should be changed similarly.
Table 1:
‘number of diseases’ – how was this defined and what is the hypothesis? Unless every subject has
gone through the same screening and diagnostic protocol I am not sure what this measure adds.
‘number of medications’ – please clarify what you mean, how this is determined, and how it
is relevant (e.g. currently prescribed for daily use at the time of the study, or taken at any time
around the menopause, including herbal remedies, etc)
Please specifically state here the numbers of patients in whom cough predated the menopause
symptoms (if any). Also, the data of Table 2 should also be displayed graphically so we can see
individual patient data - the time onset of cough in relation to the menopause is of key interest
in this study.
LCQ results
It is difficult to make sense of LCQ scores in patients who do not cough. It would be better to
say, however, ‘subjects who did not report chronic cough’ rather than ‘subjects without cough’.
These phrases have different meanings – everyone coughs a bit.
The data should be summarised to one decimal place – an accuracy of 2 d.p. is not justified.
As before, Table 5, Figure 2, Table 6  - at least 2 of these should be removed. All you are saying
is that subjects who have chronic cough have worse cough-related quality of life than those
who do not cough. This is not surprising, it relates to how the (very well-validated) LCQ was
designed, and it is not relevant to the question of the study.
Table 8:
The heading needs to be made clearer and include the word ‘cough’ to explain what the data
are about
Discussion
Please change the sentence “To define chronic cough solely on duration falls probably too short
in clinical practice”. Chronic is from the Greek khronikos (of time) – so by definition a cough
is chronic if it exceeds a particular duration.
The following statement that novel treatments require a cough to be present for > one year is
not justified, unless it can be backed up with citations that argue otherwise. I then do not follow
the further discussion about using 8 weeks as a cut-off to define chronic cough, and how this
is relevant.
‘MRS symptoms of 10 + 40% pre and post hormonal treatment were described’ – I am not sure
what this is referring to – at no point was the effect of hormonal treatment mentioned earlier
in the study. In fact patients taking menopause hormone therapy seem to have been explicitly
excluded.
The discussion about cough hypersensitivity could be made much more concise.
Title: The psycho-social impact of obstetric fistula and available support for women residing
in Nigeria: a systematic review
Version: 3 Date: 12 Jan 2022
Reviewer's report:
Introduction
Report the other review studies and mention to difference between your study and the other study
Inclusion and Exclusion Criteria
Letter to the Editor, Case Report exclude or include  ######
Search Strategy
Other data base ????
Gray literature?
Data Extraction and risk of bias :
Performed by one  author or two?
What would have happened if the two had not reached an agreement?