Title: Validation of the Menopause Representation Questionnaire (MenoSentations- Q) among
Iranian Women and Cross-Cultural Comparison with Portuguese Women
Version: 2 Date: 15 Dec 2024
Reviewer:  Héctor González-de la Torre
Reviewer's report:
Dear Authors:
Thank you for allowing me to review your manuscript. Although I am joining this review once
the process has started, I am going to make some important points that I hope will improve this
manuscript, some of which I believe are not sufficiently explained.
-This study is a multicentric-international study where a measurement instrument will be
translated and culturally adapted and where the picometric properties of the instrument will
be evaluated. Additionally, the measurement invariance of the instrument across two culturally
distinct samples (Iranian and Portuguese) will be examined. This is very interesting but I think
it is not explained clearly enough in the manuscript. For example, was only the Persian sample
or both samples used in the factor analysis? Similarly, for the reliability calculation, which
sample was used for both samples or only one? The fact that the samples were collected at a
different time is not the most relevant thing, what is important is that in reality the Portuguese
version and the Persian version cannot be considered the same instrument. It should therefore be
better explained at each stage when data from one or the other has been used. This is especially
important, as for example it is not the same to perform the factor analysis on the Persian sample
only (n=320) as with a combined sample (n=674).
- The above points are of key importance. If you have conducted the FA with the Persian sample
only, at least 400 subjects (200 for the EGFA and 200 for the CFA) were required. It is also
necessary to explain how the samples were divided into two sub-samples (e.g. if some methods
such as SOLOMON were used).
-In this type of study, information is usually provided on the profile of the experts participating
in the content validity assessment phase.
-It must be stated in which population the face validity was performed, i.e. in which target
population (number of women and characteristics). Face validity is not assessed by experts, as
it is validity from the point of view of the subjects on whom the instrument is to be used.
-Some questions about factor analysis. You should explain what kind of approximation you have
done (linear-Pearson's matrix/non-linear-polychoric matrix) and you should also justify with
references the fit values you propose, the factor analysis approach used (principal components-
varimax rotation) is nowadays highly discouraged. I am enclosing some references in this
respect. The results should clearly show how many women participated in the EFA and how
many in the CFA (it seems that 167 women participated in the CFA, please confirm this).my
experience tells me that it is normal that there are items that receive factor loadings on more
than one factor.that is why it is appropriate to present the rotated loading matrix. Personally I
always present the confidence intervals for all statistical parameters, including the FA values.
References:
Ferrando PJ, Lorenzo-Seva U, Hernández-Dorado A, Muñiz J. Decalogue for the Factor
Analysis of Test Items. Psicothema. 2022;34(1):7–17.
Lloret-Segura S, Ferreres-Traver A, Hernández-Baeza A, Tomás-Marco I. The exploratory
factor analysis of items: guided analysis based on empirical data and software. Anal Psicol.
2017;33:417–32.
Lloret-Segura S, Ferreres-Traver A, Hernandez A, Tomás I. Exploratory item factor analysis: a
practical guide revised and updated. An De Psicol. 2014;30:1151–69.
I hope that these questions will be clarified.Best regards.