Reviewer ’s report  
 
Title:  Validation of the Pelvic Organ Prolapse Simple Screening Inventory (POPSSI) in a 
populatio n of Ethiopian women.  
 
Version: 1 Date: 14 Dec 2018 
 
Reviewer:  Douglas  Tincello  
 
Reviewer’s report:  
 
Thank you for the revised manuscript. you have addressed my major concerns and the paper is 
now much more clear. I do have a few remaining comments:  
 
1) it is still not clear to me why you excluded women presenting  with prolapse as their main 
concern. Was this because you wanted to use the tool to screen for women who may not present 
with prolapse, as a way of screening communities for women with disease? Please provide more 
explanation  
 
2) data on parity should be p resented as median/range not as mean/SD, and compared by Mann 
Whitney test. Parity is a non -continous variable and so parametric tests are incorrect.  
 
3) you should use the terms "anterior compartment prolapse" and "posterior compartment 
prolapse" rather th an "cystocele" and "rectocele"  
 
4) I think your conclusions and discussion is very non -critical of the data you present. My 
interpretation is that the single question about vaginal bulge has a higher sensitivity and 
specificity than the whole questionnaire (particularly as the other three questions have very poor 
test performance characteristics). Surely, a more appropriate conclusion is that there is no need 
for a questionnaire, but a single screening question about vaginal bulge will serve the function as 
a screening too well, and indeed better than this questionnaire? I think you should revise your 
discussion and conclusion.  
 
Are the methods appropriate and we ll 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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is re commended, please specify what aspects require further 
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  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
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3. Do yo u hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript ? 
 
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below. If your reply is yes to any, please give details below.  
 
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