Reviewer ’s report  
 
Title: Contemporary treatment utilization among women diagnosed with symptomatic uterine  
fibroids in the United States  
 
Version: 2 Date: 09 Feb 2020  
 
Reviewer: Jeremy Jonathan Owen Herod  
 
Reviewer's report:  
 
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Dear Authors,  
 
thank you for your revised paper. I think that it is now much improved. I still do have my 
concerns about the mortality statistics that are re ported and personally I would be less able to 
dismiss this finding as simply a difference in populations. The majority of these patients will not 
be elderly as most women presenting with problems relating to fibroids are in their middle age 
(usually 30 -50). The other obvious explanation for the very high mortality reported would be the 
quality of care provided to the patients. I cannot know what the true explanation is but if I were 
any person responsible for the care of the patients I would feel duty bound  to investigate further.  
 
The mortality of over 1 in 100 patients undergoing surgery for a benign condition does of course 
affirm your point that there is a need for alternative treatments that may offer relief from 
symptoms with less risk.  
 
I will not  stand in the way of publication but I do think that as researchers you have a 
responsibility to bring your findings to the attention of Senior figures in Medicaid. If I were a 
senior member of that organisation I would want to know about such information a nd would 
investigate further rather than assuming that the mortality rate merely was the result of the 
patient population  
 
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is  required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, p lease explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require furth er 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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