Title: Association between grip strength and stress urinary incontinence of NHANES 2011–
2014
Version: 0 Date: 09 Aug 2023
Reviewer:  Tarek Tawfik Amin
Reviewer's report:
BMC Women's Health
Title:  "Association between grip strength and stress urinary incontinence of NHANES 2011–
2014".
Comments to the authors
General comment:
- There is a discrepancy between the abstract and the main text, authors should be consistent in
the methodology and stating the statistical methods.
Abstract:
- Line 23: Chi-square was adopted?  Correct the verb
- Line 24: what type of generalized linear regression was used?
- How the prevalence was calculated (generally)?
- Your study is a secondary analysis of already existing databases and there in no need to mention
participants (your population included was 4263 women out of database used for analysis).
- The methods section in the abstract in not complete, line 30, describing the monthly, weekly
or none but in the main text the response was non-moderate or severe?
- Again the comparison of quartiles was not clear and should be mentioned in the methods
section not in the results.
- Line 29: what do you mean by (2.06, 0.57)?
Introduction:
- Line 49-line 51: relevance of this paragraph is confusing?
- Again, line 52: relevance of sacrpenia to the current context of the paper?
- Line 58- line 59: more elaboration about the controversial results of the previous studies should
be mentioned.
- The rationale for conducting this study is not clear, please provide more literature about the
importance, size, and consequences of the research question at least on global level.
Methods:
- It is a secondary analysis of an existing database and not cross-sectional in nature.
- Description of the data base used should be mentioned in greater details
- How the degree of SUI was assessed by questionnaire (and severity as well)?
- There is fleeting of ideas (grip strength was mentioned in this section and then followed in
detailed section afterward as grip S. measurement.
- Mention the statistical analysis in separate section
- More detailed GS assessment is mentioned (did the authors measured this or it is inbuilt for
in the database?
- How participants were selected form the database (open source) and the link to this database
should be mentioned.
- The study variable section mentioning the composition of the database
- Line 102: the mean GS and rGS were computed for each participant?
Statistical analysis:
- This section should be carefully written
- Why categorization of rGS was conducted? Was it for the sake of conducting logistic regression
analysis?
- Linear for which variables (type) and logistic for which variables (type), explain
- You did not assess the risk of SUI how was it used for GS and rGS?
- Instead of using five regression models, you mean stepwise regression analysis to control for
possible confounders or Hierarchical regression model??
- No details about why and how PSM was used in this section?
- The R was used for what? This should be mentioned in this section.
Results:
- Table 1: contrary to the results outlined in abstract the no. pf patients without SUI was 3085?
- Table 2: is so confusing, quartile should be mentioned at the table footnote.
- Table 3: ambiguous and not sure how the prevalence was calculated?
- Same comments for table 4.
- The same comments for the included graphs
- In the graphs what was the relative risk?
- Graphs of PSM should be explained properly in the text.
Discussion section:
- This is not a population-based study.
- Line 206: the present study, which included 92 women revealed a positive correlation ---??
Conclusion:
- The ultimate question, in this study what was the prevalence of SUI?
- The consistency of your results was not explained properly and need more elaboration.