Reviewer’s report
Title: 
Trends in Emotional Functioning and Psychosocial Wellbeing in Breast
Cancer Survivors: A Prospective Cohort Study Using Patient-Reported Outcome
Measures
Version: 
2 
Date: 
16 Nov 2022
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The authors have not responded adequately to each
of the issues raised. The revised manuscript requires further revisions.
REQUESTED REVISIONS: 
1. While the authors have revised the rationale for the study, they still have not
considered the large body of literature describing and predicting the pattern of
adjustment, as well as the longitudinal
trajectory of quality of life, among women diagnosed with breast cancer. 
It is
noted that in this revision, the authors have included a non-standard, study-
specific definition/operationalisation of psychosocial wellbeing, seemingly to
overcome the limitations associated with having selected the BREAST Q as a
measure of psychosocial wellbeing. 
2. The authors still have not addressed the interpretation of the results in the
discussion re: whether the scores/estimates reflect 'high' levels of functioning or
wellbeing at baseline, and whether the subsequent scores over time still place
them in the 'high' level of functioning and wellbeing? The authors were also
requested to discuss the scores/estimates in the context of reference values given
these values exist for both of the 
tools used in this study. The interpretation of
the scores/estimates is important for the utility of the findings.
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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?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes