Reviewer ’s report  
 
Title: Relationships between determinants of adjuvant endocrine therapy adherence in breast  
cancer 
 
Version: 0 Date: 31 May 2017  
 
Reviewer: Rajesh Balkrishnan  
 
Reviewer's report:  
 
This paper describes the assessment of pred ictors of adjuvant hormone therapy using an online 
survey conducted in 210 women. There are several issues that temper the enthusiasm of this 
reviewer towards the study findings.  
 
 
 
1. The purpose of this analysis is never made clear. What distinguishes it f rom other similar 
studies done in this area such as the one below (one of several dozen identified) is not clear at all. 
The basis for this paper needs more clarity.  
 
 
Endocrine therapy adherence: a cross -sectional study of factors affecting adherence and 
discontinuation of therapy.Quinn EM, Fleming C, O'Sullivan MJ.Ir J Med Sci. 2016 
May;185(2):383 -92 
 
 
 
2. There is no description of adherence levels in the sample. The reliance on a convenience and 
online sample is a major drawback. Also, in my personal research I have found very poor 
correlation between self reported and actual adjuvant hormone therapy wi th severe self 
underreport of adherence. The authors completely rely on self report.  
 
 
 
3. The whole 3 stage modeling comes across as a pure academic exercise. There is no clear 
rationale on why the most comprehensive model was not used in the first place.  
 
 
4. Finally it is very unclear what this new research adds to our knowledge about adjuvant 
hormone therapy adherence. Please review existing literature more carefully and in depth and 
comment in the discussion section.   
 
 
    
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
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 recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the sta tistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following qu estions:  
 
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  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you 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?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing i nterests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
None  
 
I agree to the ope n peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under a n Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be in cluded as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal