Reviewer’s report
Title: 
Trend Changes and Factor Analysis of Endometrial Hyperplasia in
Patients with Polycystic Ovarian Syndrome Based on the Korean National
Health Insurance Database
Version: 
1 
Date: 
19 Jul 2022
Reviewer's report:
"PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: I think the authors had significantly improved the
quality of the paper by adequately address the queries and feedbacks from the
previous reviewers. There is much more clarity to the goals of the research and
the outcomes. This is a strong paper that provides a population based accurate
data on the prevalence and incidence of PCOS and endometrial hyperplasia over
time using a large nationally collected dataset. A few more minor revision are
needed as suggested below that will further improve the quality and readability
of the paper
REQUESTED REVISIONS: 
-Line 53-54 : Please clarify what is means by ""care is needed when choosing
OCP and progestin"" ? In what sense ? need to use more potent progestin ? less
estrogen- please be more specific
-Line 103-104 : please expand on the matching process of case vs control in term
of age and follow up duration ? Please clarify the follow up duration meaning . Is
it from diagnosis until treated or resolution of disease ?
-Line 111: Why are ""regional health care delivery system"" and ""type of health
care provider"" being included as risk factor for acquiring EH after PCOS ? Is it
because one is more likely to be diagnosed with EH by more aggressive
investigations in one setting than the other ? This should be reworded to make it
less confusing
-Line 131 : As this is a matched dataset, please confirmed that conditional
logistic regression model analysis was done
-Line 176 : please clarify ""follow up duration"" .. follow up for what condition
?? How is this defined ?
-Line 182-205 : Suggest the authors state the reference category to each odds
ratio provided to improve readability and clarity of the paper. I realize that this is
provided in the tables but best to include in the text as well
ADDITIONAL REQUESTS/SUGGESTIONS: 
See my comments above"
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No
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from apparent manipulation?
Yes