Reviewer’s report
Title: 
Factors associated with health-related quality of life in women using path
analyses: Mediation effect of the adiposity traits
Version: 
1 
Date: 
24 Mar 2021
Reviewer's report:
"STATISTICAL REVIEWER ASSESSMENT: 
Is the study design appropriate for the research question (considering whether the
analyzed population accurately reflects the design and whether you see any
problems with control/comparison groups, e.g., likely confounders)?
No - there are minor issues
Are methodologies adequate and well implemented (considering whether
assumptions are addressed and whether analyses are robust)?
No - there are minor issues
Are the analyses adequately communicated (considering whether reporting
details are adequate and whether figures and tables are well labeled and
described)?
No - there are minor issues
Does the interpretation accurately reflect the analyses without overstatement
(considering whether limitations/bias are acknowledged and whether accurate
descriptors, e.g., 'significant', are used)?
No - there are minor issues
Could an appropriately REVISED version of this work represent a statistically
sound contribution? 
Probably - with minor revisions
STATISTICAL REVIEWER COMMENTS:
Generally speaking, the authors have been responsive to all comments of the
prior statistical reviewer comments in a point-by-point fashion, and their
responses are largely satisfactory. 
Still, I have the following comments and
concerns for the authors to consider.
1. To have confidence in the results of Structural Equation Modeling (SEM), the
first important issue is related to statistical assumptions (such as normality) and
needed sample sizes, as the prior statistical reviewer had pointed out. 
The other
crucial concern is the issue of causal interpretation. 
After reading the feedback
and recommendations of the prior statistical reviewer, the authors of the present
study adopted the recommendation and carried out path analysis instead,
appropriately. 
Nevertheless, the authors still interpreted their research findings in
a cause-and-effect manner occasionally. 
For instance, "On the other hand, there
were significant direct effects of obesity (B=0.608; P = 0.018) and PSQI score
(B=-0.240; P= 0.034) on MCS." (p. 9, lines 189-190).
2. Page 9, lines 185-187, "Among socio-demographic parameters, age was found
to be indirectly and negatively associated with MCS (B=-0.040; P= 0.050)". 
It
should be statistically insignificant. 
By the same token, within Table 4 "Age →
MCS" is also statistically insignificant, even though in the footnotes the authors
declared "All standardized path coefficients shown were significant (P<0.05)".
Plus, Table 4 is missing a horizontal line at the bottom.
3. The survey of the study was done by performing face-to-face interviews.
However, authors did not provide evidence of the inter-rater reliability (i.e., the
kappa statistics).
4. Table 1: The sample size is 278. 
Nonetheless, some data do not add up;
specifically, the variables of marital status and education (both are 279).
5. Table 2: For the variable of TEF emotional score, the maximum is 12.00, but
the mean value is 20.03, which is illogical. 
6. The statement above Table 3 is patently unreasonable -- "Table 2. Fit
measures for the structural equation models".
7. Table 3 only consists of a row of statistics. 
Accordingly, it is not necessary to
present the results by using a table.
8. Page 11, lines 247-248, "Additionally, applying reliable and validated
questionnaires to obtain information was an important strength of this study." 
A
valid and reliable questionnaire is a must, not a strength, indeed.
9. Finally, although the authors responded to previous review comments by
declaring "We have carefully re-checked the manuscript for grammatical/syntax
errors and it has been edited for proper English", there are quite a few editorial
attentions needed. 
For example, p. 11, line 274, "the generalization of our
findings is limited by these limitations"; plus, in the references section, ref #13,
the journal title -- "World health forum"; ref #25, the journal title -- ": Elsevier".
REQUESTED REVISIONS: 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes