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title stringlengths 32 37	abstract stringclasses 1 value	full_text stringlengths 117 61.6k	review stringlengths 117 61.6k	source stringclasses 1 value	review_src stringlengths 37 41	criteria_count dict	dimension_scores dict	overall_score float64 0 5	conversations listlengths 2 2	year int64 2k 2.03k
Review for 10.1186/s12916-025-03956-9	Reviewed - bmc_medicine	Title: Impact of Coronary Artery Calcium on Progression of Diastolic Dysfunction: A Cohort Study Version: 2 Date: 29 Jan 2025 Reviewer's report: Below is my response and feedback. Please incorporate in your submission website. I appreciate your help. I am traveling and would not be able to do this in the format your office would have preferred. I apologize for any inconvenience. Response: Reviewer 3 I would like to congratulate the authors for the evident hard work in revising the manuscript. All my concerns were addressed with a very much improved revision. Thank you very much for the authors’ openness for critic. Most importantly for the patience and fortitude in accomplishing a meaningful cardiovascular population health study. Congratulations! I have no further comments and I look forward seeing this manuscript published Thank you very much for the opportunity to review this meaningful study.	Title: Impact of Coronary Artery Calcium on Progression of Diastolic Dysfunction: A Cohort Study Version: 2 Date: 29 Jan 2025 Reviewer's report: Below is my response and feedback. Please incorporate in your submission website. I appreciate your help. I am traveling and would not be able to do this in the format your office would have preferred. I apologize for any inconvenience. Response: Reviewer 3 I would like to congratulate the authors for the evident hard work in revising the manuscript. All my concerns were addressed with a very much improved revision. Thank you very much for the authors’ openness for critic. Most importantly for the patience and fortitude in accomplishing a meaningful cardiovascular population health study. Congratulations! I have no further comments and I look forward seeing this manuscript published Thank you very much for the opportunity to review this meaningful study.	BMC	12916_2025_3956_ReviewerReport_V2_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 2, "materials_and_methods": 0, "praise": 6, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 2, "total": 11 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.18181818181818182, "materials_and_methods": 0, "praise": 0.5454545454545454, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0.18181818181818182 }	0.909091	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Impact of Coronary Artery Calcium on Progression of Diastolic Dysfunction: A Cohort\nStudy\nVersion: 2 Date: 29 Jan 2025\nReviewer's report:\nBelow is my response and feedback. Please incorporate in your submission website. I appreciate\nyour help. I am traveling and would not be able to do this in the format your office would have\npreferred. I apologize for any inconvenience.\nResponse: Reviewer 3\nI would like to congratulate the authors for the evident hard work in revising the manuscript.\nAll my concerns were addressed with a very much improved revision.\nThank you very much for the authors’ openness for critic. Most importantly for the\npatience and fortitude in accomplishing a meaningful cardiovascular population health study.\nCongratulations! I have no further comments and I look forward seeing this manuscript\npublished\nThank you very much for the opportunity to review this meaningful study.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03962-x	Reviewed - bmc_medicine	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 0 Date: 03 Oct 2024 Reviewer: Muhammad Owais Reviewer's report: Overall Impression This manuscript presents a well-structured and innovative study leveraging multimodal data and deep learning for the early detection of biliary atresia (BA). The technical approach is sound, and the results demonstrate promising performance. The study addresses a significant clinical challenge and highlights the potential of artificial intelligence (AI) in improving diagnostic accuracy. Major Comments 1. Literature Review: While comprehensive, some references are outdated. Include recent studies on BA diagnosis and AI applications in medical imaging. 2. Dataset Description: Provide more details on data quality control, patient demographics, and lesion characteristics. 3. Model Interpretability: Discuss the limitations of using Grad-CAM for visualization and consider alternative methods for explaining model decisions. 4. Clinical Relevance: Expand on the potential clinical impact, including integration into existing diagnostic workflows and potential cost savings. 5. Comparison with Existing Studies: Clarify how the proposed model differs from existing BA diagnosis models and provide direct performance comparisons. Suggestions for Future Work 1. Investigate transfer learning and domain adaptation techniques to improve model generalizability. 2. Explore the use of other AI architectures for BA diagnosis. 3. Conduct a cost-effectiveness analysis of the proposed AI system. Recommendation With revisions addressing the above comments, this manuscript has the potential to make a valuable contribution to the field of medical imaging and AI. Specific Questions 1. How did you ensure data quality and consistency across different modalities? 2. Were any data augmentation strategies employed to increase dataset size? 3. Can you provide more details on the computational resources used for training and testing? 4. How do you plan to address potential overfitting issues in future studies? Rating - Originality: 9/10 - Technical Quality: 9/10 - Significance: 9/10 - Presentation: 8.5/10 - Overall: 9/10	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 0 Date: 03 Oct 2024 Reviewer: Muhammad Owais Reviewer's report: Overall Impression This manuscript presents a well-structured and innovative study leveraging multimodal data and deep learning for the early detection of biliary atresia (BA). The technical approach is sound, and the results demonstrate promising performance. The study addresses a significant clinical challenge and highlights the potential of artificial intelligence (AI) in improving diagnostic accuracy. Major Comments 1. Literature Review: While comprehensive, some references are outdated. Include recent studies on BA diagnosis and AI applications in medical imaging. 2. Dataset Description: Provide more details on data quality control, patient demographics, and lesion characteristics. 3. Model Interpretability: Discuss the limitations of using Grad-CAM for visualization and consider alternative methods for explaining model decisions. 4. Clinical Relevance: Expand on the potential clinical impact, including integration into existing diagnostic workflows and potential cost savings. 5. Comparison with Existing Studies: Clarify how the proposed model differs from existing BA diagnosis models and provide direct performance comparisons. Suggestions for Future Work 1. Investigate transfer learning and domain adaptation techniques to improve model generalizability. 2. Explore the use of other AI architectures for BA diagnosis. 3. Conduct a cost-effectiveness analysis of the proposed AI system. Recommendation With revisions addressing the above comments, this manuscript has the potential to make a valuable contribution to the field of medical imaging and AI. Specific Questions 1. How did you ensure data quality and consistency across different modalities? 2. Were any data augmentation strategies employed to increase dataset size? 3. Can you provide more details on the computational resources used for training and testing? 4. How do you plan to address potential overfitting issues in future studies? Rating - Originality: 9/10 - Technical Quality: 9/10 - Significance: 9/10 - Presentation: 8.5/10 - Overall: 9/10	BMC	12916_2025_3962_ReviewerReport_V0_R1.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 4, "materials_and_methods": 12, "praise": 4, "presentation_and_reporting": 3, "results_and_discussion": 2, "suggestion_and_solution": 6, "total": 30 }	{ "criticism": 0.03333333333333333, "example": 0, "importance_and_relevance": 0.13333333333333333, "materials_and_methods": 0.4, "praise": 0.13333333333333333, "presentation_and_reporting": 0.1, "results_and_discussion": 0.06666666666666667, "suggestion_and_solution": 0.2 }	1.066667	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early\nDetection of Biliary Atresia\nVersion: 0 Date: 03 Oct 2024\nReviewer: Muhammad Owais\nReviewer's report:\nOverall Impression\nThis manuscript presents a well-structured and innovative study leveraging multimodal data and\ndeep learning for the early detection of biliary atresia (BA). The technical approach is sound,\nand the results demonstrate promising performance. The study addresses a significant clinical\nchallenge and highlights the potential of artificial intelligence (AI) in improving diagnostic\naccuracy.\nMajor Comments\n1. Literature Review: While comprehensive, some references are outdated. Include recent\nstudies on BA diagnosis and AI applications in medical imaging.\n2. Dataset Description: Provide more details on data quality control, patient demographics,\nand lesion characteristics.\n3. Model Interpretability: Discuss the limitations of using Grad-CAM for visualization and\nconsider alternative methods for explaining model decisions.\n4. Clinical Relevance: Expand on the potential clinical impact, including integration into\nexisting diagnostic workflows and potential cost savings.\n5. Comparison with Existing Studies: Clarify how the proposed model differs from existing\nBA diagnosis models and provide direct performance comparisons.\nSuggestions for Future Work\n1. Investigate transfer learning and domain adaptation techniques to improve model\ngeneralizability.\n2. Explore the use of other AI architectures for BA diagnosis.\n3. Conduct a cost-effectiveness analysis of the proposed AI system.\nRecommendation\nWith revisions addressing the above comments, this manuscript has the potential to make a\nvaluable contribution to the field of medical imaging and AI.\nSpecific Questions\n1. How did you ensure data quality and consistency across different modalities?\n2. Were any data augmentation strategies employed to increase dataset size?\n3. Can you provide more details on the computational resources used for training and testing?\n4. How do you plan to address potential overfitting issues in future studies?\nRating\n- Originality: 9/10\n- Technical Quality: 9/10\n- Significance: 9/10\n- Presentation: 8.5/10\n- Overall: 9/10", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03962-x	Reviewed - bmc_medicine	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 0 Date: 30 Oct 2024 Reviewer's report: This manuscript presents a comprehensive study on developing and validating an artificial intelligence-based multimodal diagnostic system for early detection of biliary atresia (BA). The authors constructed a large multimodal BA dataset, comprising ultrasound images, clinical data, and laboratory results, and developed both comprehensive and simplified deep learning models. The study demonstrated that their AI system achieved high diagnostic accuracy (AUC 0.9870 on internal test set and 0.9740 on external validation), outperforming or matching experienced radiologists. Furthermore, the system showed significant potential in improving the diagnostic accuracy of less experienced radiologists. Positive aspects: The study addresses a critical clinical need with a novel approach, utilizing a relatively large multimodal BA dataset. The comprehensive inclusion of various data types (ultrasound images, clinical information, and laboratory data) provides a more complete diagnostic picture than previous single-modality approaches. The methodology is robust and well-designed, including both retrospective and prospective validation, and the development of simplified models for practical clinical implementation. The comparison with radiologists of varying experience levels adds significant clinical relevance to the findings. The technical innovation of the self-masked attention mechanism for handling multimodal data fusion and missing data is noteworthy. The model's architecture allows for flexible component switching to accommodate different clinical scenarios and requirements. The manuscript also has some weaknesses: The study shows a notable gap in the comprehensive analysis of misdiagnosed cases. While the overall performance metrics are impressive, there is insufficient investigation into false positive and false negative cases, particularly regarding how different modalities contribute to these misdiagnoses. The study would benefit from a detailed examination of cases where the model failed, including analysis of specific clinical characteristics (such as age, gender, bilirubin levels) that might be associated with incorrect predictions. Understanding these patterns could provide valuable insights for model improvement and help clinicians better understand the system's limitations in specific clinical scenarios. Although the study includes prospective external validation, its generalizability remains questionable due to single-institution validation. Multi-center validation across different healthcare settings, geographical locations, and resource levels would provide more robust evidence of the model's real-world applicability. This is particularly important given the varying prevalence and presentation of biliary atresia across different populations and healthcare systems. The study would be strengthened by validation data from institutions with different levels of expertise and technical capabilities. They also inadequately addresses several critical implementation aspects. The computational requirements for deploying the system in clinical practice, including hardware specifications, processing time, and integration with existing healthcare IT infrastructure, are not thoroughly discussed. The manuscript does not sufficiently explore the impact of technical variations on model performance. This is particularly relevant for ultrasound-based diagnostics, where image quality can vary significantly based on operator experience, equipment quality, and patient factors. The robustness of the model against variations in image acquisition parameters, ultrasound machine specifications, and operator technique needs more thorough evaluation. The demographic considerations deserve more attention. The study does not adequately address how ethnic differences in BA incidence might affect the model's performance, nor does it explore potential variations in disease presentation across different populations. A more comprehensive analysis of these demographic factors would enhance the model's applicability across diverse patient populations and healthcare settings. Even if such work cannot be completed, the author should explain it in the discussion section. The author also does not thoroughly investigate the model's interpretability from a clinical perspective. While the visualization of attention maps provides some insight into the model's decision-making process, there is limited analysis of whether these highlighted features align with clinically recognized diagnostic markers. The study would benefit from a more detailed comparison between the features identified as significant by the AI system and those traditionally used by experienced clinicians. This gap in interpretability could affect clinicians' trust and acceptance of the system in real-world practice. The study lacks comprehensive evaluation of the model's performance in challenging clinical scenarios, including special patient populations and edge cases. The study also does not address the model's reliability in cases where some input data are missing or of poor quality, which is a common scenario in clinical practice. Understanding the model's limitations in these challenging cases is crucial for safe clinical implementation and appropriate use by healthcare providers.	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 0 Date: 30 Oct 2024 Reviewer's report: This manuscript presents a comprehensive study on developing and validating an artificial intelligence-based multimodal diagnostic system for early detection of biliary atresia (BA). The authors constructed a large multimodal BA dataset, comprising ultrasound images, clinical data, and laboratory results, and developed both comprehensive and simplified deep learning models. The study demonstrated that their AI system achieved high diagnostic accuracy (AUC 0.9870 on internal test set and 0.9740 on external validation), outperforming or matching experienced radiologists. Furthermore, the system showed significant potential in improving the diagnostic accuracy of less experienced radiologists. Positive aspects: The study addresses a critical clinical need with a novel approach, utilizing a relatively large multimodal BA dataset. The comprehensive inclusion of various data types (ultrasound images, clinical information, and laboratory data) provides a more complete diagnostic picture than previous single-modality approaches. The methodology is robust and well-designed, including both retrospective and prospective validation, and the development of simplified models for practical clinical implementation. The comparison with radiologists of varying experience levels adds significant clinical relevance to the findings. The technical innovation of the self-masked attention mechanism for handling multimodal data fusion and missing data is noteworthy. The model's architecture allows for flexible component switching to accommodate different clinical scenarios and requirements. The manuscript also has some weaknesses: The study shows a notable gap in the comprehensive analysis of misdiagnosed cases. While the overall performance metrics are impressive, there is insufficient investigation into false positive and false negative cases, particularly regarding how different modalities contribute to these misdiagnoses. The study would benefit from a detailed examination of cases where the model failed, including analysis of specific clinical characteristics (such as age, gender, bilirubin levels) that might be associated with incorrect predictions. Understanding these patterns could provide valuable insights for model improvement and help clinicians better understand the system's limitations in specific clinical scenarios. Although the study includes prospective external validation, its generalizability remains questionable due to single-institution validation. Multi-center validation across different healthcare settings, geographical locations, and resource levels would provide more robust evidence of the model's real-world applicability. This is particularly important given the varying prevalence and presentation of biliary atresia across different populations and healthcare systems. The study would be strengthened by validation data from institutions with different levels of expertise and technical capabilities. They also inadequately addresses several critical implementation aspects. The computational requirements for deploying the system in clinical practice, including hardware specifications, processing time, and integration with existing healthcare IT infrastructure, are not thoroughly discussed. The manuscript does not sufficiently explore the impact of technical variations on model performance. This is particularly relevant for ultrasound-based diagnostics, where image quality can vary significantly based on operator experience, equipment quality, and patient factors. The robustness of the model against variations in image acquisition parameters, ultrasound machine specifications, and operator technique needs more thorough evaluation. The demographic considerations deserve more attention. The study does not adequately address how ethnic differences in BA incidence might affect the model's performance, nor does it explore potential variations in disease presentation across different populations. A more comprehensive analysis of these demographic factors would enhance the model's applicability across diverse patient populations and healthcare settings. Even if such work cannot be completed, the author should explain it in the discussion section. The author also does not thoroughly investigate the model's interpretability from a clinical perspective. While the visualization of attention maps provides some insight into the model's decision-making process, there is limited analysis of whether these highlighted features align with clinically recognized diagnostic markers. The study would benefit from a more detailed comparison between the features identified as significant by the AI system and those traditionally used by experienced clinicians. This gap in interpretability could affect clinicians' trust and acceptance of the system in real-world practice. The study lacks comprehensive evaluation of the model's performance in challenging clinical scenarios, including special patient populations and edge cases. The study also does not address the model's reliability in cases where some input data are missing or of poor quality, which is a common scenario in clinical practice. Understanding the model's limitations in these challenging cases is crucial for safe clinical implementation and appropriate use by healthcare providers.	BMC	12916_2025_3962_ReviewerReport_V0_R2.pdf	{ "criticism": 10, "example": 0, "importance_and_relevance": 11, "materials_and_methods": 29, "praise": 10, "presentation_and_reporting": 1, "results_and_discussion": 3, "suggestion_and_solution": 10, "total": 34 }	{ "criticism": 0.29411764705882354, "example": 0, "importance_and_relevance": 0.3235294117647059, "materials_and_methods": 0.8529411764705882, "praise": 0.29411764705882354, "presentation_and_reporting": 0.029411764705882353, "results_and_discussion": 0.08823529411764706, "suggestion_and_solution": 0.29411764705882354 }	2.176471	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early\nDetection of Biliary Atresia\nVersion: 0 Date: 30 Oct 2024\nReviewer's report:\nThis manuscript presents a comprehensive study on developing and validating an artificial\nintelligence-based multimodal diagnostic system for early detection of biliary atresia (BA). The\nauthors constructed a large multimodal BA dataset, comprising ultrasound images, clinical data,\nand laboratory results, and developed both comprehensive and simplified deep learning models.\nThe study demonstrated that their AI system achieved high diagnostic accuracy (AUC 0.9870\non internal test set and 0.9740 on external validation), outperforming or matching experienced\nradiologists. Furthermore, the system showed significant potential in improving the diagnostic\naccuracy of less experienced radiologists.\nPositive aspects:\nThe study addresses a critical clinical need with a novel approach, utilizing a relatively large\nmultimodal BA dataset. The comprehensive inclusion of various data types (ultrasound images,\nclinical information, and laboratory data) provides a more complete diagnostic picture than\nprevious single-modality approaches. The methodology is robust and well-designed, including\nboth retrospective and prospective validation, and the development of simplified models for\npractical clinical implementation. The comparison with radiologists of varying experience levels\nadds significant clinical relevance to the findings. The technical innovation of the self-masked\nattention mechanism for handling multimodal data fusion and missing data is noteworthy. The\nmodel's architecture allows for flexible component switching to accommodate different clinical\nscenarios and requirements.\nThe manuscript also has some weaknesses:\nThe study shows a notable gap in the comprehensive analysis of misdiagnosed cases. While the\noverall performance metrics are impressive, there is insufficient investigation into false positive\nand false negative cases, particularly regarding how different modalities contribute to these\nmisdiagnoses. The study would benefit from a detailed examination of cases where the model\nfailed, including analysis of specific clinical characteristics (such as age, gender, bilirubin levels)\nthat might be associated with incorrect predictions. Understanding these patterns could provide\nvaluable insights for model improvement and help clinicians better understand the system's\nlimitations in specific clinical scenarios.\nAlthough the study includes prospective external validation, its generalizability remains\nquestionable due to single-institution validation. Multi-center validation across different\nhealthcare settings, geographical locations, and resource levels would provide more robust\nevidence of the model's real-world applicability. This is particularly important given the\nvarying prevalence and presentation of biliary atresia across different populations and healthcare\nsystems. The study would be strengthened by validation data from institutions with different\nlevels of expertise and technical capabilities. They also inadequately addresses several critical\nimplementation aspects. The computational requirements for deploying the system in clinical\npractice, including hardware specifications, processing time, and integration with existing\nhealthcare IT infrastructure, are not thoroughly discussed.\nThe manuscript does not sufficiently explore the impact of technical variations on model\nperformance. This is particularly relevant for ultrasound-based diagnostics, where image quality\ncan vary significantly based on operator experience, equipment quality, and patient factors. The\nrobustness of the model against variations in image acquisition parameters, ultrasound machine\nspecifications, and operator technique needs more thorough evaluation. The demographic\nconsiderations deserve more attention. The study does not adequately address how ethnic\ndifferences in BA incidence might affect the model's performance, nor does it explore potential\nvariations in disease presentation across different populations. A more comprehensive analysis\nof these demographic factors would enhance the model's applicability across diverse patient\npopulations and healthcare settings. Even if such work cannot be completed, the author should\nexplain it in the discussion section. The author also does not thoroughly investigate the model's\ninterpretability from a clinical perspective. While the visualization of attention maps provides\nsome insight into the model's decision-making process, there is limited analysis of whether\nthese highlighted features align with clinically recognized diagnostic markers. The study would\nbenefit from a more detailed comparison between the features identified as significant by the AI\nsystem and those traditionally used by experienced clinicians. This gap in interpretability could\naffect clinicians' trust and acceptance of the system in real-world practice.\nThe study lacks comprehensive evaluation of the model's performance in challenging clinical\nscenarios, including special patient populations and edge cases. The study also does not address\nthe model's reliability in cases where some input data are missing or of poor quality, which is a\ncommon scenario in clinical practice. Understanding the model's limitations in these challenging\ncases is crucial for safe clinical implementation and appropriate use by healthcare providers.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03962-x	Reviewed - bmc_medicine	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 1 Date: 18 Jan 2025 Reviewer's report: The authors’ response to the reviewers' comments is exceptionally detailed and well-organized, showcasing a thorough understanding of the concerns raised. I have no further comments.	Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early Detection of Biliary Atresia Version: 1 Date: 18 Jan 2025 Reviewer's report: The authors’ response to the reviewers' comments is exceptionally detailed and well-organized, showcasing a thorough understanding of the concerns raised. I have no further comments.	BMC	12916_2025_3962_ReviewerReport_V1_R2.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0.5, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 0.5, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development of an Artificial Intelligence-Based Multimodal Diagnostic System for Early\nDetection of Biliary Atresia\nVersion: 1 Date: 18 Jan 2025\nReviewer's report:\nThe authors’ response to the reviewers' comments is exceptionally detailed and well-organized,\nshowcasing a thorough understanding of the concerns raised. I have no further comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 0 Date: 05 Jun 2024 Reviewer's report: This is a systematic review and meta-analysis of ICP incidence to better understand the incidence of ICP globally. The authors performed a systematic review and did not limit by language or peer-reviewed journal to include all possible studies. They removed articles that used a similar, but smaller cohort so the same cohort was not included multiple times. The authors also performed a risk of bias analysis on all articles. Overall they find that the incidence of ICP varies by region and report this variable incidence. I have proposed revisions below to make this paper stronger. The authors note that studies with larger sample size had lower incidences of ICP, suggesting that those with smaller sample sizes overestimate incidence. It would benefit this paper to perform an additional analysis utilizing only the large size studies (greater than their cut off of 2486) per country/region to get a more accurate estimate of actual incidence globally. The paper would also benefit from more explanation of the difference in incidence rates between studies deemed to be lower verse higher risk of bias. The authors found that lower and middle income countries have a higher incidence rates of ICP than in developed countries. It would be helpful to know the study designs for these countries. If in lower and middle income countries many uncomplicated births do not present to hospitals then this could be a selection bias- women with symptoms coming to seek medical care when they have pruritus and uncomplicated pregnancies not getting counted in the denominator because they do not present for hospital care. Please clarify if studies were population based or accumulated from patients presenting for medical care only. The authors perform analyses involving the predominant religion from each country and report that the incidence of ICP correlates with certain religions. However this appears to be confounded by country since it is not actually analyzing the religions of the people who have ICP but rather the dominant religion of the country they are in. It would be better to just leave it out and report only the countries and regions with higher incidence which they also do. If the authors feel religion needs to be included, then the discussion section needs to indicate why and what the “cultural conventions” (line 216-217) could be that lead to higher rates of ICP by country’s religion. They note that the incidence of ICP did not change over time. It would be interesting to analyze if reported fetal/birth complications (pre term labor, PPROM, stillbirth) did change over time as other studies suggest the complications have decreased. Typo in line 181- says resorptive instead of retrospective.	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 0 Date: 05 Jun 2024 Reviewer's report: This is a systematic review and meta-analysis of ICP incidence to better understand the incidence of ICP globally. The authors performed a systematic review and did not limit by language or peer-reviewed journal to include all possible studies. They removed articles that used a similar, but smaller cohort so the same cohort was not included multiple times. The authors also performed a risk of bias analysis on all articles. Overall they find that the incidence of ICP varies by region and report this variable incidence. I have proposed revisions below to make this paper stronger. The authors note that studies with larger sample size had lower incidences of ICP, suggesting that those with smaller sample sizes overestimate incidence. It would benefit this paper to perform an additional analysis utilizing only the large size studies (greater than their cut off of 2486) per country/region to get a more accurate estimate of actual incidence globally. The paper would also benefit from more explanation of the difference in incidence rates between studies deemed to be lower verse higher risk of bias. The authors found that lower and middle income countries have a higher incidence rates of ICP than in developed countries. It would be helpful to know the study designs for these countries. If in lower and middle income countries many uncomplicated births do not present to hospitals then this could be a selection bias- women with symptoms coming to seek medical care when they have pruritus and uncomplicated pregnancies not getting counted in the denominator because they do not present for hospital care. Please clarify if studies were population based or accumulated from patients presenting for medical care only. The authors perform analyses involving the predominant religion from each country and report that the incidence of ICP correlates with certain religions. However this appears to be confounded by country since it is not actually analyzing the religions of the people who have ICP but rather the dominant religion of the country they are in. It would be better to just leave it out and report only the countries and regions with higher incidence which they also do. If the authors feel religion needs to be included, then the discussion section needs to indicate why and what the “cultural conventions” (line 216-217) could be that lead to higher rates of ICP by country’s religion. They note that the incidence of ICP did not change over time. It would be interesting to analyze if reported fetal/birth complications (pre term labor, PPROM, stillbirth) did change over time as other studies suggest the complications have decreased. Typo in line 181- says resorptive instead of retrospective.	BMC	12916_2025_3935_ReviewerReport_V0_R2.pdf	{ "criticism": 1, "example": 2, "importance_and_relevance": 0, "materials_and_methods": 9, "praise": 0, "presentation_and_reporting": 5, "results_and_discussion": 4, "suggestion_and_solution": 8, "total": 20 }	{ "criticism": 0.05, "example": 0.1, "importance_and_relevance": 0, "materials_and_methods": 0.45, "praise": 0, "presentation_and_reporting": 0.25, "results_and_discussion": 0.2, "suggestion_and_solution": 0.4 }	1.45	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 0 Date: 05 Jun 2024\nReviewer's report:\nThis is a systematic review and meta-analysis of ICP incidence to better understand the incidence\nof ICP globally. The authors performed a systematic review and did not limit by language\nor peer-reviewed journal to include all possible studies. They removed articles that used a\nsimilar, but smaller cohort so the same cohort was not included multiple times. The authors\nalso performed a risk of bias analysis on all articles. Overall they find that the incidence of ICP\nvaries by region and report this variable incidence. I have proposed revisions below to make\nthis paper stronger.\nThe authors note that studies with larger sample size had lower incidences of ICP, suggesting that\nthose with smaller sample sizes overestimate incidence. It would benefit this paper to perform\nan additional analysis utilizing only the large size studies (greater than their cut off of 2486) per\ncountry/region to get a more accurate estimate of actual incidence globally. The paper would\nalso benefit from more explanation of the difference in incidence rates between studies deemed\nto be lower verse higher risk of bias.\nThe authors found that lower and middle income countries have a higher incidence rates of\nICP than in developed countries. It would be helpful to know the study designs for these\ncountries. If in lower and middle income countries many uncomplicated births do not present to\nhospitals then this could be a selection bias- women with symptoms coming to seek medical care\nwhen they have pruritus and uncomplicated pregnancies not getting counted in the denominator\nbecause they do not present for hospital care. Please clarify if studies were population based or\naccumulated from patients presenting for medical care only.\nThe authors perform analyses involving the predominant religion from each country and\nreport that the incidence of ICP correlates with certain religions. However this appears to be\nconfounded by country since it is not actually analyzing the religions of the people who have\nICP but rather the dominant religion of the country they are in. It would be better to just leave\nit out and report only the countries and regions with higher incidence which they also do. If\nthe authors feel religion needs to be included, then the discussion section needs to indicate why\nand what the “cultural conventions” (line 216-217) could be that lead to higher rates of ICP by\ncountry’s religion.\nThey note that the incidence of ICP did not change over time. It would be interesting to analyze\nif reported fetal/birth complications (pre term labor, PPROM, stillbirth) did change over time as\nother studies suggest the complications have decreased.\nTypo in line 181- says resorptive instead of retrospective.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 0 Date: 07 Jun 2024 Reviewer's report: Thank you for a very thorough review. Abstract 1.1 line 49: "Account for" would be better than "justify" Abstract 1:3 line 59 and Results lines 162 and 194: "Gestating individuals" is an awful non- English phrase! "Pregnant women" (or "Pregnant people", "Pregnant persons", or even "Gravidas", if you really cannot accept "women"!) would be much better. Abstract 1:4 line 67: "Variation" would be better than "varieties". Introduction 2 line 71: too many "commonly"s. Suggest either replace the first with "frequently" or the second with "usually". Introduction 2 line 73: Pruritus often disappears within hours or days of birth (Girling. ICP: Greentop guideline 2022). Biochemical changes may take longer, as there are physiological postpartum rises in transaminases that may be confusing. Introduction 2 line 74 and following: Both AFLP and pre-eclampsia can coexist with ICP, so "Pruritus" is not necessarily a distinguishing feature. Introduction 2 line 74 and Discussion 5 lines 249, 253, 25: while "levels" are commonly used of an analyte, it is a loose and inaccurate phrase: it is much better to talk/write of "concentrations" of analytes in body, or indeed in any, fluids. Introduction 2 line 76: "Except for maternal discomfort" is confusing and unnecessary in this context, and could be omitted. Introduction 2 line 79: "use of oestrogen" - surely not in pregnancy? Introduction 2 line 80: how about Hepatitis C? Introduction 2 line 80: Thrombocytopenia is not usually an association of ICP, except in the context of severe pre-eclampsia/AFLP. While the study of Chen et al identified an increased frequency of thrombocytopenia, there was no assessment of other potential causes of this. It was not identified as a risk factor in the second large Chinese population referenced (Gao et al). The third study referenced (Wu et al ), which appears to be from the same population as that of the Chen study, also makes no reference to thrombocytopenia. Comparison with some non- Chinese studies here would be helpful and illuminating to the discussion. Introduction 2 line 83 et passim: "incidence" appears to be used here and throughout the manuscript indistinguishably from "prevalence". Which are the authors meaning? Or are they conflating the two? It is a critical epidemiological difference. Methods 3.2 lines 109 and following, together with Discussion 5 lines 253-256: No mention has been made of the diagnostic criteria to establish ICP, in particular, of the bile acid values and whether these have been from fasting or non-fasting individuals (see Mitchell et al BJOG 2021). In addition, there are concerns about the harmonisation and commutability of bile acid assays that call into doubt the idea of comparing bile acid measurements across studies (Markus et al Clin Chem Lab Med 2023), making all such comparisons extremely difficult! Methods 3.2 lines 116-117: "studies that exclusively involved individuals with current or history of pruritus, hepatobiliary disorders, abnormal liver function tests, and dermatosis" - I don't understand how 'exclusively involved' is being used in this sentence. It needs to be written more clearly. When I eventually looked at the PRISMA diagram, it did become clearer. So, perhaps the last sentence needs to be moved forward, e.g., to the beginning of the paragraph. Methods 3.3 line 138: I am not sure what the contribution of "most widely practiced religion" is to this discussion. Methods 3.3 lines 139-40: Similarly, "the absolute value of geographical latitude" is not a helpful comparator, as countries, such as Chile, Australia, India and the USA, all extend widely across the latitudes and comparing their midpoints as the "distance from the equator line" (lines 152-153) is likely to be very unhelpful. Results 4 line 181: I am not aware what "resorptive" studies are in this context. Results 4 line 182-184: A diagram displaying the sample sizes of the different studies would perhaps be helpful, so as to assess better the validity of using the median as a cutoff for the suggested analysis. Results 4 lines 183, 193, 201: if a p-value is being quoted, it is not (in my view) necessary to say "significantly" or 'non-significantly". Let the reader understand! Results 4 line 183: compared "with", not "to". Results 4 line 184: "smaller", not "lower". Discussion 5 line 210 and Conclusion 5.2 line 281 : "Hungary" please! Discussion 5 line 220: Professor Reyes has discussed the reducing prevalence of ICP in Chile after a change in the local diet . Discussion 5 line 236: for consistency, better to use ICP rather than "obstetric cholestasis". Discussion 5 lines 249-251: the paper by Lin et al (which is confusing in describing a retrospective study with a title suggesting a prospective analysis), is a small study. It would be better to reference the Ovadia metanalysis (reference 2) in which no difference was identified in birthweight centiles of babies from ICP pregnancies compared with controls. Table 2: needs a more extensive key to the abbreviations	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 0 Date: 07 Jun 2024 Reviewer's report: Thank you for a very thorough review. Abstract 1.1 line 49: "Account for" would be better than "justify" Abstract 1:3 line 59 and Results lines 162 and 194: "Gestating individuals" is an awful non- English phrase! "Pregnant women" (or "Pregnant people", "Pregnant persons", or even "Gravidas", if you really cannot accept "women"!) would be much better. Abstract 1:4 line 67: "Variation" would be better than "varieties". Introduction 2 line 71: too many "commonly"s. Suggest either replace the first with "frequently" or the second with "usually". Introduction 2 line 73: Pruritus often disappears within hours or days of birth (Girling. ICP: Greentop guideline 2022). Biochemical changes may take longer, as there are physiological postpartum rises in transaminases that may be confusing. Introduction 2 line 74 and following: Both AFLP and pre-eclampsia can coexist with ICP, so "Pruritus" is not necessarily a distinguishing feature. Introduction 2 line 74 and Discussion 5 lines 249, 253, 25: while "levels" are commonly used of an analyte, it is a loose and inaccurate phrase: it is much better to talk/write of "concentrations" of analytes in body, or indeed in any, fluids. Introduction 2 line 76: "Except for maternal discomfort" is confusing and unnecessary in this context, and could be omitted. Introduction 2 line 79: "use of oestrogen" - surely not in pregnancy? Introduction 2 line 80: how about Hepatitis C? Introduction 2 line 80: Thrombocytopenia is not usually an association of ICP, except in the context of severe pre-eclampsia/AFLP. While the study of Chen et al identified an increased frequency of thrombocytopenia, there was no assessment of other potential causes of this. It was not identified as a risk factor in the second large Chinese population referenced (Gao et al). The third study referenced (Wu et al ), which appears to be from the same population as that of the Chen study, also makes no reference to thrombocytopenia. Comparison with some non- Chinese studies here would be helpful and illuminating to the discussion. Introduction 2 line 83 et passim: "incidence" appears to be used here and throughout the manuscript indistinguishably from "prevalence". Which are the authors meaning? Or are they conflating the two? It is a critical epidemiological difference. Methods 3.2 lines 109 and following, together with Discussion 5 lines 253-256: No mention has been made of the diagnostic criteria to establish ICP, in particular, of the bile acid values and whether these have been from fasting or non-fasting individuals (see Mitchell et al BJOG 2021). In addition, there are concerns about the harmonisation and commutability of bile acid assays that call into doubt the idea of comparing bile acid measurements across studies (Markus et al Clin Chem Lab Med 2023), making all such comparisons extremely difficult! Methods 3.2 lines 116-117: "studies that exclusively involved individuals with current or history of pruritus, hepatobiliary disorders, abnormal liver function tests, and dermatosis" - I don't understand how 'exclusively involved' is being used in this sentence. It needs to be written more clearly. When I eventually looked at the PRISMA diagram, it did become clearer. So, perhaps the last sentence needs to be moved forward, e.g., to the beginning of the paragraph. Methods 3.3 line 138: I am not sure what the contribution of "most widely practiced religion" is to this discussion. Methods 3.3 lines 139-40: Similarly, "the absolute value of geographical latitude" is not a helpful comparator, as countries, such as Chile, Australia, India and the USA, all extend widely across the latitudes and comparing their midpoints as the "distance from the equator line" (lines 152-153) is likely to be very unhelpful. Results 4 line 181: I am not aware what "resorptive" studies are in this context. Results 4 line 182-184: A diagram displaying the sample sizes of the different studies would perhaps be helpful, so as to assess better the validity of using the median as a cutoff for the suggested analysis. Results 4 lines 183, 193, 201: if a p-value is being quoted, it is not (in my view) necessary to say "significantly" or 'non-significantly". Let the reader understand! Results 4 line 183: compared "with", not "to". Results 4 line 184: "smaller", not "lower". Discussion 5 line 210 and Conclusion 5.2 line 281 : "Hungary" please! Discussion 5 line 220: Professor Reyes has discussed the reducing prevalence of ICP in Chile after a change in the local diet . Discussion 5 line 236: for consistency, better to use ICP rather than "obstetric cholestasis". Discussion 5 lines 249-251: the paper by Lin et al (which is confusing in describing a retrospective study with a title suggesting a prospective analysis), is a small study. It would be better to reference the Ovadia metanalysis (reference 2) in which no difference was identified in birthweight centiles of babies from ICP pregnancies compared with controls. Table 2: needs a more extensive key to the abbreviations	BMC	12916_2025_3935_ReviewerReport_V0_R1.pdf	{ "criticism": 14, "example": 26, "importance_and_relevance": 1, "materials_and_methods": 9, "praise": 2, "presentation_and_reporting": 21, "results_and_discussion": 8, "suggestion_and_solution": 15, "total": 43 }	{ "criticism": 0.32558139534883723, "example": 0.6046511627906976, "importance_and_relevance": 0.023255813953488372, "materials_and_methods": 0.20930232558139536, "praise": 0.046511627906976744, "presentation_and_reporting": 0.4883720930232558, "results_and_discussion": 0.18604651162790697, "suggestion_and_solution": 0.3488372093023256 }	2.232558	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 0 Date: 07 Jun 2024\nReviewer's report:\nThank you for a very thorough review.\nAbstract 1.1 line 49: \"Account for\" would be better than \"justify\"\nAbstract 1:3 line 59 and Results lines 162 and 194: \"Gestating individuals\" is an awful non-\nEnglish phrase! \"Pregnant women\" (or \"Pregnant people\", \"Pregnant persons\", or even\n\"Gravidas\", if you really cannot accept \"women\"!) would be much better.\nAbstract 1:4 line 67: \"Variation\" would be better than \"varieties\".\nIntroduction 2 line 71: too many \"commonly\"s. Suggest either replace the first with \"frequently\"\nor the second with \"usually\".\nIntroduction 2 line 73: Pruritus often disappears within hours or days of birth (Girling. ICP:\nGreentop guideline 2022). Biochemical changes may take longer, as there are physiological\npostpartum rises in transaminases that may be confusing.\nIntroduction 2 line 74 and following: Both AFLP and pre-eclampsia can coexist with ICP, so\n\"Pruritus\" is not necessarily a distinguishing feature.\nIntroduction 2 line 74 and Discussion 5 lines 249, 253, 25: while \"levels\" are commonly used of\nan analyte, it is a loose and inaccurate phrase: it is much better to talk/write of \"concentrations\"\nof analytes in body, or indeed in any, fluids.\nIntroduction 2 line 76: \"Except for maternal discomfort\" is confusing and unnecessary in this\ncontext, and could be omitted.\nIntroduction 2 line 79: \"use of oestrogen\" - surely not in pregnancy?\nIntroduction 2 line 80: how about Hepatitis C?\nIntroduction 2 line 80: Thrombocytopenia is not usually an association of ICP, except in the\ncontext of severe pre-eclampsia/AFLP. While the study of Chen et al identified an increased\nfrequency of thrombocytopenia, there was no assessment of other potential causes of this. It\nwas not identified as a risk factor in the second large Chinese population referenced (Gao et al).\nThe third study referenced (Wu et al ), which appears to be from the same population as that\nof the Chen study, also makes no reference to thrombocytopenia. Comparison with some non-\nChinese studies here would be helpful and illuminating to the discussion.\nIntroduction 2 line 83 et passim: \"incidence\" appears to be used here and throughout the\nmanuscript indistinguishably from \"prevalence\". Which are the authors meaning? Or are they\nconflating the two? It is a critical epidemiological difference.\nMethods 3.2 lines 109 and following, together with Discussion 5 lines 253-256: No mention has\nbeen made of the diagnostic criteria to establish ICP, in particular, of the bile acid values and\nwhether these have been from fasting or non-fasting individuals (see Mitchell et al BJOG 2021).\nIn addition, there are concerns about the harmonisation and commutability of bile acid assays\nthat call into doubt the idea of comparing bile acid measurements across studies (Markus et al\nClin Chem Lab Med 2023), making all such comparisons extremely difficult!\nMethods 3.2 lines 116-117: \"studies that exclusively involved individuals with current or history\nof pruritus, hepatobiliary disorders, abnormal liver function tests, and dermatosis\" - I don't\nunderstand how 'exclusively involved' is being used in this sentence. It needs to be written\nmore clearly. When I eventually looked at the PRISMA diagram, it did become clearer. So,\nperhaps the last sentence needs to be moved forward, e.g., to the beginning of the paragraph.\nMethods 3.3 line 138: I am not sure what the contribution of \"most widely practiced religion\"\nis to this discussion.\nMethods 3.3 lines 139-40: Similarly, \"the absolute value of geographical latitude\" is not a\nhelpful comparator, as countries, such as Chile, Australia, India and the USA, all extend widely\nacross the latitudes and comparing their midpoints as the \"distance from the equator line\" (lines\n152-153) is likely to be very unhelpful.\nResults 4 line 181: I am not aware what \"resorptive\" studies are in this context.\nResults 4 line 182-184: A diagram displaying the sample sizes of the different studies would\nperhaps be helpful, so as to assess better the validity of using the median as a cutoff for the\nsuggested analysis.\nResults 4 lines 183, 193, 201: if a p-value is being quoted, it is not (in my view) necessary to\nsay \"significantly\" or 'non-significantly\". Let the reader understand!\nResults 4 line 183: compared \"with\", not \"to\".\nResults 4 line 184: \"smaller\", not \"lower\".\nDiscussion 5 line 210 and Conclusion 5.2 line 281 : \"Hungary\" please!\nDiscussion 5 line 220: Professor Reyes has discussed the reducing prevalence of ICP in Chile\nafter a change in the local diet .\nDiscussion 5 line 236: for consistency, better to use ICP rather than \"obstetric cholestasis\".\nDiscussion 5 lines 249-251: the paper by Lin et al (which is confusing in describing a\nretrospective study with a title suggesting a prospective analysis), is a small study. It would be\nbetter to reference the Ovadia metanalysis (reference 2) in which no difference was identified\nin birthweight centiles of babies from ICP pregnancies compared with controls.\nTable 2: needs a more extensive key to the abbreviations", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 1 Date: 24 Jul 2024 Reviewer's report: I reviewed the revised manuscript and appreciate the time the authors took to address the issues brought up on original review. I find the paper to be improved and acceptable for publication.	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 1 Date: 24 Jul 2024 Reviewer's report: I reviewed the revised manuscript and appreciate the time the authors took to address the issues brought up on original review. I find the paper to be improved and acceptable for publication.	BMC	12916_2025_3935_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0.5 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 1 Date: 24 Jul 2024\nReviewer's report:\nI reviewed the revised manuscript and appreciate the time the authors took to address the issues\nbrought up on original review. I find the paper to be improved and acceptable for publication.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 1 Date: 14 Aug 2024 Reviewer's report: Thank you for your generally excellent responses to the reviewers' comments. A few things remain: Line 57 and throughout: I thought you had decided to omit references to religion? Line 61: suggest square brackets for "(95% confidence interval)", i.e., [95% confidence interval], so as to correspond with the following values. Line 79-81: ... pruritus, which occurs due to increased serum concentrations of bile acids, may not necessarily distinguish ICP .... The pruritus is NOT due to the increased serum concentrations of BA (see Beuers et al Nat Rev Gastroenterol Hepatol 2023 Vol. 20 (1): 26-36 DOI: 10.1038/s41575-022-00687-7). Line 130: "were excluded" is now tautologous, following the earlier correction, and can be removed. Line 146: "in" is not necessary. Line 177-8: The Wikstrom-Shemer study [reference 32] and the Li study [reference 37] are both population-based cohort studies Line 180: "were" should be "was". Line 186: "As our" should read "As in our". Line 188 et passim: p values only need to be included to a maximum of 2 decimal places, unless they are =<0.05, when a single number beyond any 0s after the decimal point (e.g., 0.01, 0.002, 0.0005, etc) can be given. They would also be better written "p=0.xx". Line 191: a comma is required after (Table 3). Line 199: "each" is not necessary. Line 200: The "," after "grouping" is not necessary. Lines 225 and 230: "ROB" should be replaced with "RoB". Line 236 and line 320: "Hungry" has not yet been altered! Line 247: "powerful in detecting" should read "powered to detect". Line 272: You need to discuss, or at least to reference, some of the recent genetic literature, (e.g, Dixon et al. Nature Communications 2022 DOI: 10.1038/s41467-022-29931-z; Dixon and Williamson Clin Res Hepatol Gastroenterol 2016 DOI: 10.1016/j.clinre.2015.12.008). There is clearly a large genetic component to ICP. Line 292: needs a "," after "criteria". Line 313: "overtime" needs to be "over time". Line 314: "time spans" and "time trends" need hyphenation, while "introduce" should be "introduces". Line 345-6: "ICP: Intrahepatic Cholestais of Pregnancy" is duplicated.	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 1 Date: 14 Aug 2024 Reviewer's report: Thank you for your generally excellent responses to the reviewers' comments. A few things remain: Line 57 and throughout: I thought you had decided to omit references to religion? Line 61: suggest square brackets for "(95% confidence interval)", i.e., [95% confidence interval], so as to correspond with the following values. Line 79-81: ... pruritus, which occurs due to increased serum concentrations of bile acids, may not necessarily distinguish ICP .... The pruritus is NOT due to the increased serum concentrations of BA (see Beuers et al Nat Rev Gastroenterol Hepatol 2023 Vol. 20 (1): 26-36 DOI: 10.1038/s41575-022-00687-7). Line 130: "were excluded" is now tautologous, following the earlier correction, and can be removed. Line 146: "in" is not necessary. Line 177-8: The Wikstrom-Shemer study [reference 32] and the Li study [reference 37] are both population-based cohort studies Line 180: "were" should be "was". Line 186: "As our" should read "As in our". Line 188 et passim: p values only need to be included to a maximum of 2 decimal places, unless they are =<0.05, when a single number beyond any 0s after the decimal point (e.g., 0.01, 0.002, 0.0005, etc) can be given. They would also be better written "p=0.xx". Line 191: a comma is required after (Table 3). Line 199: "each" is not necessary. Line 200: The "," after "grouping" is not necessary. Lines 225 and 230: "ROB" should be replaced with "RoB". Line 236 and line 320: "Hungry" has not yet been altered! Line 247: "powerful in detecting" should read "powered to detect". Line 272: You need to discuss, or at least to reference, some of the recent genetic literature, (e.g, Dixon et al. Nature Communications 2022 DOI: 10.1038/s41467-022-29931-z; Dixon and Williamson Clin Res Hepatol Gastroenterol 2016 DOI: 10.1016/j.clinre.2015.12.008). There is clearly a large genetic component to ICP. Line 292: needs a "," after "criteria". Line 313: "overtime" needs to be "over time". Line 314: "time spans" and "time trends" need hyphenation, while "introduce" should be "introduces". Line 345-6: "ICP: Intrahepatic Cholestais of Pregnancy" is duplicated.	BMC	12916_2025_3935_ReviewerReport_V1_R1.pdf	{ "criticism": 1, "example": 20, "importance_and_relevance": 0, "materials_and_methods": 2, "praise": 1, "presentation_and_reporting": 17, "results_and_discussion": 1, "suggestion_and_solution": 13, "total": 25 }	{ "criticism": 0.04, "example": 0.8, "importance_and_relevance": 0, "materials_and_methods": 0.08, "praise": 0.04, "presentation_and_reporting": 0.68, "results_and_discussion": 0.04, "suggestion_and_solution": 0.52 }	2.2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 1 Date: 14 Aug 2024\nReviewer's report:\nThank you for your generally excellent responses to the reviewers' comments.\nA few things remain:\nLine 57 and throughout: I thought you had decided to omit references to religion?\nLine 61: suggest square brackets for \"(95% confidence interval)\", i.e., [95% confidence\ninterval], so as to correspond with the following values.\nLine 79-81: ... pruritus, which occurs due to increased serum concentrations of bile acids, may\nnot necessarily distinguish ICP ....\nThe pruritus is NOT due to the increased serum concentrations of BA (see Beuers et al Nat Rev\nGastroenterol Hepatol 2023 Vol. 20 (1): 26-36 DOI: 10.1038/s41575-022-00687-7).\nLine 130: \"were excluded\" is now tautologous, following the earlier correction, and can be\nremoved.\nLine 146: \"in\" is not necessary.\nLine 177-8: The Wikstrom-Shemer study [reference 32] and the Li study [reference 37] are\nboth population-based cohort studies\nLine 180: \"were\" should be \"was\".\nLine 186: \"As our\" should read \"As in our\".\nLine 188 et passim: p values only need to be included to a maximum of 2 decimal places, unless\nthey are =<0.05, when a single number beyond any 0s after the decimal point (e.g., 0.01, 0.002,\n0.0005, etc) can be given. They would also be better written \"p=0.xx\".\nLine 191: a comma is required after (Table 3).\nLine 199: \"each\" is not necessary.\nLine 200: The \",\" after \"grouping\" is not necessary.\nLines 225 and 230: \"ROB\" should be replaced with \"RoB\".\nLine 236 and line 320: \"Hungry\" has not yet been altered!\nLine 247: \"powerful in detecting\" should read \"powered to detect\".\nLine 272: You need to discuss, or at least to reference, some of the recent genetic literature,\n(e.g, Dixon et al. Nature Communications 2022 DOI: 10.1038/s41467-022-29931-z; Dixon and\nWilliamson Clin Res Hepatol Gastroenterol 2016 DOI: 10.1016/j.clinre.2015.12.008). There\nis clearly a large genetic component to ICP.\nLine 292: needs a \",\" after \"criteria\".\nLine 313: \"overtime\" needs to be \"over time\".\nLine 314: \"time spans\" and \"time trends\" need hyphenation, while \"introduce\" should be\n\"introduces\".\nLine 345-6: \"ICP: Intrahepatic Cholestais of Pregnancy\" is duplicated.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 2 Date: 01 Nov 2024 Reviewer's report: Generally, this manuscript has been much improved by the recent revision. I still feel that the opening sentence of both the Abstract and the Background section does not address the enormous distress that many women with ICP experience: it DOES directly impact the well-being of the woman (who may not yet be a mother!). Some affected women become suicidal with the itch, while a stillbirth, especially if it is recurrent, can lead to major psychopathology (see the ICP support website ). I also feel that the authors have not taken on board the comments from the Beuers paper (ref 2), where it is clarified that bile acids are MOST UNLIKELY pruritogens, and that, in some cholestatic diseases, the pruritus actually IMPROVES with the rising bile acid concentrations. In page 4, line 80 "acid" is missing after ursodeoxycholic acid. Rifampicin is currently the subject of a RCT in women with severe early onset ICP (Hague et al, BMC Pregnancy and Childbirth, 2021) and there are potential risks of side effects that should be discussed if it is mentioned. Perhaps better to leave it out altogether for the purpose of this review? The genetics section (lines 342 onwards) has focussed on some of the less frequent genotype variants, and has not mentioned the important previous observations of Dixon et al, mentioned in passing in the reference quoted, that variants in (italic) ABCB4 and (italic) ABCB11 genes may be present in 20-25% of women with severe ICP (see more recent discussion in Zollner, Williamson and Dixon, Obstetric Medicine 2024).	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 2 Date: 01 Nov 2024 Reviewer's report: Generally, this manuscript has been much improved by the recent revision. I still feel that the opening sentence of both the Abstract and the Background section does not address the enormous distress that many women with ICP experience: it DOES directly impact the well-being of the woman (who may not yet be a mother!). Some affected women become suicidal with the itch, while a stillbirth, especially if it is recurrent, can lead to major psychopathology (see the ICP support website ). I also feel that the authors have not taken on board the comments from the Beuers paper (ref 2), where it is clarified that bile acids are MOST UNLIKELY pruritogens, and that, in some cholestatic diseases, the pruritus actually IMPROVES with the rising bile acid concentrations. In page 4, line 80 "acid" is missing after ursodeoxycholic acid. Rifampicin is currently the subject of a RCT in women with severe early onset ICP (Hague et al, BMC Pregnancy and Childbirth, 2021) and there are potential risks of side effects that should be discussed if it is mentioned. Perhaps better to leave it out altogether for the purpose of this review? The genetics section (lines 342 onwards) has focussed on some of the less frequent genotype variants, and has not mentioned the important previous observations of Dixon et al, mentioned in passing in the reference quoted, that variants in (italic) ABCB4 and (italic) ABCB11 genes may be present in 20-25% of women with severe ICP (see more recent discussion in Zollner, Williamson and Dixon, Obstetric Medicine 2024).	BMC	12916_2025_3935_ReviewerReport_V2_R1.pdf	{ "criticism": 1, "example": 2, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 2, "results_and_discussion": 1, "suggestion_and_solution": 2, "total": 8 }	{ "criticism": 0.125, "example": 0.25, "importance_and_relevance": 0, "materials_and_methods": 0.125, "praise": 0.125, "presentation_and_reporting": 0.25, "results_and_discussion": 0.125, "suggestion_and_solution": 0.25 }	1.25	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 2 Date: 01 Nov 2024\nReviewer's report:\nGenerally, this manuscript has been much improved by the recent revision.\nI still feel that the opening sentence of both the Abstract and the Background section does\nnot address the enormous distress that many women with ICP experience: it DOES directly\nimpact the well-being of the woman (who may not yet be a mother!). Some affected women\nbecome suicidal with the itch, while a stillbirth, especially if it is recurrent, can lead to major\npsychopathology (see the ICP support website ).\nI also feel that the authors have not taken on board the comments from the Beuers paper (ref\n2), where it is clarified that bile acids are MOST UNLIKELY pruritogens, and that, in some\ncholestatic diseases, the pruritus actually IMPROVES with the rising bile acid concentrations.\nIn page 4, line 80 \"acid\" is missing after ursodeoxycholic acid. Rifampicin is currently the\nsubject of a RCT in women with severe early onset ICP (Hague et al, BMC Pregnancy and\nChildbirth, 2021) and there are potential risks of side effects that should be discussed if it is\nmentioned. Perhaps better to leave it out altogether for the purpose of this review?\nThe genetics section (lines 342 onwards) has focussed on some of the less frequent genotype\nvariants, and has not mentioned the important previous observations of Dixon et al, mentioned\nin passing in the reference quoted, that variants in (italic) ABCB4 and (italic) ABCB11 genes\nmay be present in 20-25% of women with severe ICP (see more recent discussion in Zollner,\nWilliamson and Dixon, Obstetric Medicine 2024).", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03935-0	Reviewed - bmc_medicine	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 4 Date: 22 Jan 2025 Reviewer's report: You have done a great job with revising this manuscript, in particular, with adding to the search criteria to include more recent material. The edits suggested now read very well, and I am happy to accept them as provided.	Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis Version: 4 Date: 22 Jan 2025 Reviewer's report: You have done a great job with revising this manuscript, in particular, with adding to the search criteria to include more recent material. The edits suggested now read very well, and I am happy to accept them as provided.	BMC	12916_2025_3935_ReviewerReport_V4_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 2, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 1, "presentation_and_reporting": 0.5, "results_and_discussion": 0, "suggestion_and_solution": 0 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Global and Regional Incidence of Intrahepatic Cholestasis of Pregnancy: A Systematic\nReview and Meta-Analysis\nVersion: 4 Date: 22 Jan 2025\nReviewer's report:\nYou have done a great job with revising this manuscript, in particular, with adding to the search\ncriteria to include more recent material.\nThe edits suggested now read very well, and I am happy to accept them as provided.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 03 Nov 2024 Reviewer's report: Upon analysis of the manuscript entitled "Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications," it is evident that the manuscript follows a well-structured and coherent logic, drawing on data from three databases and employing descriptive statistics and statistical tests to identify patterns and discrepancies in the findings. The topic is highly pertinent to BMC Medicine, and the methodology and results presentation are of good quality. Nonetheless, it is recommended that the manuscript undergo a linguistic review to enhance clarity and precision, addressing any typographical, syntactic, and punctuation issues.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 03 Nov 2024 Reviewer's report: Upon analysis of the manuscript entitled "Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications," it is evident that the manuscript follows a well-structured and coherent logic, drawing on data from three databases and employing descriptive statistics and statistical tests to identify patterns and discrepancies in the findings. The topic is highly pertinent to BMC Medicine, and the methodology and results presentation are of good quality. Nonetheless, it is recommended that the manuscript undergo a linguistic review to enhance clarity and precision, addressing any typographical, syntactic, and punctuation issues.	BMC	12916_2025_3965_ReviewerReport_V0_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 2, "praise": 2, "presentation_and_reporting": 1, "results_and_discussion": 2, "suggestion_and_solution": 1, "total": 3 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.3333333333333333, "materials_and_methods": 0.6666666666666666, "praise": 0.6666666666666666, "presentation_and_reporting": 0.3333333333333333, "results_and_discussion": 0.6666666666666666, "suggestion_and_solution": 0.3333333333333333 }	3	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 0 Date: 03 Nov 2024\nReviewer's report:\nUpon analysis of the manuscript entitled \"Temporal Trends, Characteristics, and Citations of\nRetracted Stem Cell Publications,\" it is evident that the manuscript follows a well-structured\nand coherent logic, drawing on data from three databases and employing descriptive statistics\nand statistical tests to identify patterns and discrepancies in the findings. The topic is highly\npertinent to BMC Medicine, and the methodology and results presentation are of good quality.\nNonetheless, it is recommended that the manuscript undergo a linguistic review to enhance\nclarity and precision, addressing any typographical, syntactic, and punctuation issues.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 14 Nov 2024 Reviewer's report: Thank you for the author's efforts in exploring the landscape of retracted publications within stem cell research and examining their continued citation impact. Although the study collected substantial data and followed rigorous methods, including comparing retracted and non-retracted papers to assess citation patterns, the research ultimately lacks innovation. The emphasis on descriptive data, without deeper theoretical insights or mechanisms explaining why retracted papers continue to be cited, limits the academic contribution of this work. Additionally, the analysis on the likelihood of retracted papers being cited by subsequently retracted publications appears to add limited value. While the statistics reveal citation trends, they do not provide actionable insights or solutions for mitigating the dissemination of flawed research. Overall, the study's contribution seems minimal.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 14 Nov 2024 Reviewer's report: Thank you for the author's efforts in exploring the landscape of retracted publications within stem cell research and examining their continued citation impact. Although the study collected substantial data and followed rigorous methods, including comparing retracted and non-retracted papers to assess citation patterns, the research ultimately lacks innovation. The emphasis on descriptive data, without deeper theoretical insights or mechanisms explaining why retracted papers continue to be cited, limits the academic contribution of this work. Additionally, the analysis on the likelihood of retracted papers being cited by subsequently retracted publications appears to add limited value. While the statistics reveal citation trends, they do not provide actionable insights or solutions for mitigating the dissemination of flawed research. Overall, the study's contribution seems minimal.	BMC	12916_2025_3965_ReviewerReport_V0_R2.pdf	{ "criticism": 5, "example": 0, "importance_and_relevance": 5, "materials_and_methods": 4, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 1, "suggestion_and_solution": 0, "total": 6 }	{ "criticism": 0.8333333333333334, "example": 0, "importance_and_relevance": 0.8333333333333334, "materials_and_methods": 0.6666666666666666, "praise": 0.16666666666666666, "presentation_and_reporting": 0, "results_and_discussion": 0.16666666666666666, "suggestion_and_solution": 0 }	2.666667	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 0 Date: 14 Nov 2024\nReviewer's report:\nThank you for the author's efforts in exploring the landscape of retracted publications within\nstem cell research and examining their continued citation impact. Although the study collected\nsubstantial data and followed rigorous methods, including comparing retracted and non-retracted\npapers to assess citation patterns, the research ultimately lacks innovation. The emphasis on\ndescriptive data, without deeper theoretical insights or mechanisms explaining why retracted\npapers continue to be cited, limits the academic contribution of this work. Additionally, the\nanalysis on the likelihood of retracted papers being cited by subsequently retracted publications\nappears to add limited value. While the statistics reveal citation trends, they do not provide\nactionable insights or solutions for mitigating the dissemination of flawed research. Overall, the\nstudy's contribution seems minimal.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 18 Nov 2024 Reviewer's report: Strengths: The manuscript addresses an important issue by exploring the characteristics and impacts of retracted publications in stem cell research. The study is timely and well-executed, employing rigorous methods (e.g., PRISMA guidelines and OSF registration) to ensure transparency and reproducibility. The integration of diverse data sources and statistical techniques is a notable strength, and the findings on post-retraction citations and citation patterns are both novel and significant for improving research integrity. Suggestions for Improvement: 1. Data Presentation: Tables and figures are informative but could benefit from additional context. For instance: o In Table 1, “data problems” (with subcategories), “error in data”, and “falsification of data” seem to be overlapping categories. What is the distinction between these? This should be clarified if even in a footnote. 2. Discussion Depth: o The discussion would benefit from expanding on Figure 3 – i.e., clarifying the implications of decreasing time-to-retraction over time. o Expand on the implications of the finding that retracted papers continue to be cited without referencing their retraction notice. Discuss potential interventions (e.g., automated systems to flag retracted papers in citation databases) to mitigate this issue. o Provide more discussion on the observed geographic trends in retractions, such as why certain countries or institutions might have higher rates of retractions and how systemic factors (e.g., publication pressure) might contribute. 3. Limitations: The manuscript does acknowledge limitations, but the discussion could explicitly address potential biases in citation tracking, especially regarding the exclusion of papers not indexed by Web of Science. Consider including alternative interpretations of the results to provide a balanced perspective. 4. Editorial Suggestions: o In the Abstract, rephrase “scientific misconduct is not uncommon” for precision, as the study focuses on retracted publications, which may not all be due to misconduct. o Add ‘systematic survey’ or ‘survey’ into the title to clarify the study design. I’m not sure this should be considered a “systematic review” as this is not asking a clinical question i.e., what is the effect of A compared to B in population C?	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 18 Nov 2024 Reviewer's report: Strengths: The manuscript addresses an important issue by exploring the characteristics and impacts of retracted publications in stem cell research. The study is timely and well-executed, employing rigorous methods (e.g., PRISMA guidelines and OSF registration) to ensure transparency and reproducibility. The integration of diverse data sources and statistical techniques is a notable strength, and the findings on post-retraction citations and citation patterns are both novel and significant for improving research integrity. Suggestions for Improvement: 1. Data Presentation: Tables and figures are informative but could benefit from additional context. For instance: o In Table 1, “data problems” (with subcategories), “error in data”, and “falsification of data” seem to be overlapping categories. What is the distinction between these? This should be clarified if even in a footnote. 2. Discussion Depth: o The discussion would benefit from expanding on Figure 3 – i.e., clarifying the implications of decreasing time-to-retraction over time. o Expand on the implications of the finding that retracted papers continue to be cited without referencing their retraction notice. Discuss potential interventions (e.g., automated systems to flag retracted papers in citation databases) to mitigate this issue. o Provide more discussion on the observed geographic trends in retractions, such as why certain countries or institutions might have higher rates of retractions and how systemic factors (e.g., publication pressure) might contribute. 3. Limitations: The manuscript does acknowledge limitations, but the discussion could explicitly address potential biases in citation tracking, especially regarding the exclusion of papers not indexed by Web of Science. Consider including alternative interpretations of the results to provide a balanced perspective. 4. Editorial Suggestions: o In the Abstract, rephrase “scientific misconduct is not uncommon” for precision, as the study focuses on retracted publications, which may not all be due to misconduct. o Add ‘systematic survey’ or ‘survey’ into the title to clarify the study design. I’m not sure this should be considered a “systematic review” as this is not asking a clinical question i.e., what is the effect of A compared to B in population C?	BMC	12916_2025_3965_ReviewerReport_V0_R4.pdf	{ "criticism": 2, "example": 2, "importance_and_relevance": 3, "materials_and_methods": 7, "praise": 4, "presentation_and_reporting": 6, "results_and_discussion": 5, "suggestion_and_solution": 9, "total": 20 }	{ "criticism": 0.1, "example": 0.1, "importance_and_relevance": 0.15, "materials_and_methods": 0.35, "praise": 0.2, "presentation_and_reporting": 0.3, "results_and_discussion": 0.25, "suggestion_and_solution": 0.45 }	1.9	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 0 Date: 18 Nov 2024\nReviewer's report:\nStrengths:\nThe manuscript addresses an important issue by exploring the characteristics and impacts of\nretracted publications in stem cell research. The study is timely and well-executed, employing\nrigorous methods (e.g., PRISMA guidelines and OSF registration) to ensure transparency and\nreproducibility. The integration of diverse data sources and statistical techniques is a notable\nstrength, and the findings on post-retraction citations and citation patterns are both novel and\nsignificant for improving research integrity.\nSuggestions for Improvement:\n1. Data Presentation:\nTables and figures are informative but could benefit from additional context. For instance:\no In Table 1, “data problems” (with subcategories), “error in data”, and “falsification of data”\nseem to be overlapping categories. What is the distinction between these? This should be\nclarified if even in a footnote.\n2. Discussion Depth:\no The discussion would benefit from expanding on Figure 3 – i.e., clarifying the implications\nof decreasing time-to-retraction over time.\no Expand on the implications of the finding that retracted papers continue to be cited without\nreferencing their retraction notice. Discuss potential interventions (e.g., automated systems to\nflag retracted papers in citation databases) to mitigate this issue.\no Provide more discussion on the observed geographic trends in retractions, such as why certain\ncountries or institutions might have higher rates of retractions and how systemic factors (e.g.,\npublication pressure) might contribute.\n3. Limitations:\nThe manuscript does acknowledge limitations, but the discussion could explicitly address\npotential biases in citation tracking, especially regarding the exclusion of papers not indexed\nby Web of Science. Consider including alternative interpretations of the results to provide a\nbalanced perspective.\n4. Editorial Suggestions:\no In the Abstract, rephrase “scientific misconduct is not uncommon” for precision, as the study\nfocuses on retracted publications, which may not all be due to misconduct.\no Add ‘systematic survey’ or ‘survey’ into the title to clarify the study design. I’m not sure this\nshould be considered a “systematic review” as this is not asking a clinical question i.e., what is\nthe effect of A compared to B in population C?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 18 Dec 2024 Reviewer's report: The manuscript dealt with an analysis of retracted publications in stem cell and the topic is of interest. However, it needs revision before acceptance. 1. Language is very poor. For example, a sentence reads "A total of 1,421 records were identified, with 517 retracted publications included in the final analysis.", "Data were collected in 07/25/2024", "The 517 retracted publications involved 83 publishers and 235 journals. Each retracted article could have multiple reasons for retraction" 2. In table 1, the authors provided percentage value. But it is confusing. For example, under the hospitals involved, there are two: China and others. For both, they calculated the percentage from the total number of retractions instead of hospitals involved. It should be checked throughout the manuscript. 3. Reasons for retractions are not based on the standard classification. For example, investigation is not a reason. Similarly, there are two different headings for data problem and fabrication of data and error in data. It is suggested to refer the previous studies like https://doi.org/10.1007/ s11192-021-03895-1. 4. Heading of 3.3 reads "Citations of Retractions" which should be revised as "citations to retracted publications" 5. Authors stated that "472 retracted publications have valid citations" is not clear.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 0 Date: 18 Dec 2024 Reviewer's report: The manuscript dealt with an analysis of retracted publications in stem cell and the topic is of interest. However, it needs revision before acceptance. 1. Language is very poor. For example, a sentence reads "A total of 1,421 records were identified, with 517 retracted publications included in the final analysis.", "Data were collected in 07/25/2024", "The 517 retracted publications involved 83 publishers and 235 journals. Each retracted article could have multiple reasons for retraction" 2. In table 1, the authors provided percentage value. But it is confusing. For example, under the hospitals involved, there are two: China and others. For both, they calculated the percentage from the total number of retractions instead of hospitals involved. It should be checked throughout the manuscript. 3. Reasons for retractions are not based on the standard classification. For example, investigation is not a reason. Similarly, there are two different headings for data problem and fabrication of data and error in data. It is suggested to refer the previous studies like https://doi.org/10.1007/ s11192-021-03895-1. 4. Heading of 3.3 reads "Citations of Retractions" which should be revised as "citations to retracted publications" 5. Authors stated that "472 retracted publications have valid citations" is not clear.	BMC	12916_2025_3965_ReviewerReport_V0_R3.pdf	{ "criticism": 5, "example": 3, "importance_and_relevance": 1, "materials_and_methods": 5, "praise": 1, "presentation_and_reporting": 7, "results_and_discussion": 0, "suggestion_and_solution": 5, "total": 20 }	{ "criticism": 0.25, "example": 0.15, "importance_and_relevance": 0.05, "materials_and_methods": 0.25, "praise": 0.05, "presentation_and_reporting": 0.35, "results_and_discussion": 0, "suggestion_and_solution": 0.25 }	1.35	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 0 Date: 18 Dec 2024\nReviewer's report:\nThe manuscript dealt with an analysis of retracted publications in stem cell and the topic is of\ninterest. However, it needs revision before acceptance.\n1. Language is very poor. For example, a sentence reads \"A total of 1,421 records were\nidentified, with 517 retracted publications included in the final analysis.\", \"Data were collected\nin 07/25/2024\", \"The 517 retracted publications involved 83 publishers and 235 journals. Each\nretracted article could have multiple reasons for retraction\"\n2. In table 1, the authors provided percentage value. But it is confusing. For example,\nunder the hospitals involved, there are two: China and others. For both, they calculated the\npercentage from the total number of retractions instead of hospitals involved. It should be\nchecked throughout the manuscript.\n3. Reasons for retractions are not based on the standard classification. For example, investigation\nis not a reason. Similarly, there are two different headings for data problem and fabrication of\ndata and error in data. It is suggested to refer the previous studies like https://doi.org/10.1007/\ns11192-021-03895-1.\n4. Heading of 3.3 reads \"Citations of Retractions\" which should be revised as \"citations to\nretracted publications\"\n5. Authors stated that \"472 retracted publications have valid citations\" is not clear.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 16 Jan 2025 Reviewer's report: I thank the reviewer and the authors for the opportunity to review the manuscript. I believe that the second version submitted addresses the comments and evaluations provided.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 16 Jan 2025 Reviewer's report: I thank the reviewer and the authors for the opportunity to review the manuscript. I believe that the second version submitted addresses the comments and evaluations provided.	BMC	12916_2025_3965_ReviewerReport_V2_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 2, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0.5, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 2 Date: 16 Jan 2025\nReviewer's report:\nI thank the reviewer and the authors for the opportunity to review the manuscript. I believe that\nthe second version submitted addresses the comments and evaluations provided.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 17 Jan 2025 Reviewer's report: All revisions suggested have been incorporated.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 17 Jan 2025 Reviewer's report: All revisions suggested have been incorporated.	BMC	12916_2025_3965_ReviewerReport_V2_R4.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 2 Date: 17 Jan 2025\nReviewer's report:\nAll revisions suggested have been incorporated.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03965-8	Reviewed - bmc_medicine	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 20 Jan 2025 Reviewer's report: Thanks to the authors for making the changes, I think perhaps the letter format is more appropriate for journals, based on the innovativeness of the article and its contribution to future research.	Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted Stem Cell Publications Version: 2 Date: 20 Jan 2025 Reviewer's report: Thanks to the authors for making the changes, I think perhaps the letter format is more appropriate for journals, based on the innovativeness of the article and its contribution to future research.	BMC	12916_2025_3965_ReviewerReport_V2_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1 }	4	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: A Systematic Analysis of Temporal Trends, Characteristics, and Citations of Retracted\nStem Cell Publications\nVersion: 2 Date: 20 Jan 2025\nReviewer's report:\nThanks to the authors for making the changes, I think perhaps the letter format is more\nappropriate for journals, based on the innovativeness of the article and its contribution to future\nresearch.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03879-5	Reviewed - bmc_medicine	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 09 Oct 2024 Reviewer's report: This paper is an excellent review of the state of art of LUS. Deserves to be published. Description of LUS signs are accurate, images of LUS very clear and well done. Potentially a very good guideline for LUS users.	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 09 Oct 2024 Reviewer's report: This paper is an excellent review of the state of art of LUS. Deserves to be published. Description of LUS signs are accurate, images of LUS very clear and well done. Potentially a very good guideline for LUS users.	BMC	12916_2025_3879_ReviewerReport_V0_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 4, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 4 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.25, "praise": 1, "presentation_and_reporting": 0.25, "results_and_discussion": 0, "suggestion_and_solution": 0.25 }	1.75	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal\nrespiratory distress: international expert consensus\nVersion: 0 Date: 09 Oct 2024\nReviewer's report:\nThis paper is an excellent review of the state of art of LUS. Deserves to be published. Description\nof LUS signs are accurate, images of LUS very clear and well done. Potentially a very good\nguideline for LUS users.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03879-5	Reviewed - bmc_medicine	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 31 Oct 2024 Reviewer: Kari D. Roberts Reviewer's report: This manuscript is very important and contributes to current knowledge gaps as lung ultrasound becomes more common in clinical practice. I commend you for this Dephi and also for your willingness to make specific rather than vague recommendations. Overall, well thought out with good questions to address clinical practice an knowledge gaps. Recommendations/ concerns: 1) Many grammar, spelling, formatting issues 2) Abbreviations: I believe PTX should be pneumothorax rather than pneumonia 3) Abbreviations: Add EVLWI and PCH 4) This statement is not correct. MV is not indicated for mild RDS. "Simply, the MV treatment should be provided if the diagnosis was RDS on LUS, whether it is mild, moderate or severe RDS [61] [Fig.1]. " 5) Places where PTX and BAL are misspelled 6) Unclear that this sentence means "Maintaining normal oxygenation in infants with minimum ventilator parameters is not appropriate for administering ventilator applications under the monitoring of LUS, while the fundamental principle of guiding the ventilator parameter adjustments under ultrasound monitoring is to ensure that the lung can be fully expension under the parameter settings [Fig.8]." 7) Is this statement true? If so, need to add a citation. "When using under ultrasound guidance, the dose of PS is usually one-half the dose recommended by the European guidelines for the management of RDS."	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 31 Oct 2024 Reviewer: Kari D. Roberts Reviewer's report: This manuscript is very important and contributes to current knowledge gaps as lung ultrasound becomes more common in clinical practice. I commend you for this Dephi and also for your willingness to make specific rather than vague recommendations. Overall, well thought out with good questions to address clinical practice an knowledge gaps. Recommendations/ concerns: 1) Many grammar, spelling, formatting issues 2) Abbreviations: I believe PTX should be pneumothorax rather than pneumonia 3) Abbreviations: Add EVLWI and PCH 4) This statement is not correct. MV is not indicated for mild RDS. "Simply, the MV treatment should be provided if the diagnosis was RDS on LUS, whether it is mild, moderate or severe RDS [61] [Fig.1]. " 5) Places where PTX and BAL are misspelled 6) Unclear that this sentence means "Maintaining normal oxygenation in infants with minimum ventilator parameters is not appropriate for administering ventilator applications under the monitoring of LUS, while the fundamental principle of guiding the ventilator parameter adjustments under ultrasound monitoring is to ensure that the lung can be fully expension under the parameter settings [Fig.8]." 7) Is this statement true? If so, need to add a citation. "When using under ultrasound guidance, the dose of PS is usually one-half the dose recommended by the European guidelines for the management of RDS."	BMC	12916_2025_3879_ReviewerReport_V0_R2.pdf	{ "criticism": 1, "example": 2, "importance_and_relevance": 2, "materials_and_methods": 3, "praise": 2, "presentation_and_reporting": 4, "results_and_discussion": 0, "suggestion_and_solution": 3, "total": 10 }	{ "criticism": 0.1, "example": 0.2, "importance_and_relevance": 0.2, "materials_and_methods": 0.3, "praise": 0.2, "presentation_and_reporting": 0.4, "results_and_discussion": 0, "suggestion_and_solution": 0.3 }	1.7	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal\nrespiratory distress: international expert consensus\nVersion: 0 Date: 31 Oct 2024\nReviewer: Kari D. Roberts\nReviewer's report:\nThis manuscript is very important and contributes to current knowledge gaps as lung ultrasound\nbecomes more common in clinical practice. I commend you for this Dephi and also for your\nwillingness to make specific rather than vague recommendations.\nOverall, well thought out with good questions to address clinical practice an knowledge gaps.\nRecommendations/ concerns:\n1) Many grammar, spelling, formatting issues\n2) Abbreviations: I believe PTX should be pneumothorax rather than pneumonia\n3) Abbreviations: Add EVLWI and PCH\n4) This statement is not correct. MV is not indicated for mild RDS. \"Simply, the MV treatment\nshould be provided if the diagnosis was RDS on LUS, whether it is mild, moderate or severe\nRDS [61] [Fig.1]. \"\n5) Places where PTX and BAL are misspelled\n6) Unclear that this sentence means \"Maintaining normal oxygenation in infants with minimum\nventilator parameters is not appropriate for administering ventilator applications under the\nmonitoring of LUS, while the fundamental principle of guiding the ventilator parameter\nadjustments under ultrasound monitoring is to ensure that the lung can be fully expension under\nthe parameter settings [Fig.8].\"\n7) Is this statement true? If so, need to add a citation. \"When using under ultrasound guidance,\nthe dose of PS is usually one-half the dose recommended by the European guidelines for the\nmanagement of RDS.\"", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03879-5	Reviewed - bmc_medicine	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 01 Dec 2024 Reviewer: Ruixi Zhou Reviewer's report: The study examines the application of lung ultrasound (LUS) in neonatal respiratory management, particularly within the current context where chest X-rays (CXR) remain the primary diagnostic tool for neonatal lung diseases. For neonates, CXR procedures are complex and involve radiation exposure, posing potential harm, especially for those requiring repeated evaluations. This consensus was developed using the Delphi method to gather input from international experts, ensuring its authority and broad applicability. Contributions from experts across multiple countries and disciplines enhance the consensus’s global relevance and diversity. The statements provide valuable guidance for clinical practice, aligning with the trends of precision medicine and non-invasive diagnostics. However, the study could be improved by addressing gaps in methodological transparency, limitations, and language clarity. 1. The study provides limited information about the qualifications and distribution of the expert panel and the data analysis process, such as the specific application of the interquartile range (IQR). To improve transparency, the authors should include statistical descriptions of the experts’ credentials (e.g., years of clinical experience, geographic representation) and elaborate on the methodologies employed in data analysis. 2. While the article emphasizes the advantages of LUS, it insufficiently explores its limitations and challenges for broader implementation. Key issues include: 1)Comparison with CXR: What are the specific limitations of LUS compared to CXR, and in which clinical scenarios should CXR be preferred? 2)Operator Dependency: LUS requires a high level of technical expertise, introducing subjectivity in its interpretation. This reliance on operator skill should be further discussed, particularly in resource-limited settings. The study could also address practical challenges such as the cost of equipment and training requirements for healthcare providers. 3) Validation of Consensus Statements: The current consensus relies heavily on expert opinion, emphasizing the need for large-scale prospective studies to validate its effectiveness. Clearer recommendations for future research, such as specific randomized controlled trials, would strengthen the manuscript. 3. Although the article provides a comprehensive list of references, some are outdated and fail to incorporate recent research findings. Additionally, the study lacks a systematic analysis of critical background issues, such as barriers to adopting LUS and its comparative efficacy against CXR. Recommendation: Include high-quality randomized controlled trials and meta-analyses published after 2020, particularly those evaluating the clinical efficacy of LUS in neonatal intensive care settings. 4. The abstract states that “LUS is more accurate and reliable than the chest X-ray (CXR) in diagnosis and management of pulmonary disease.” However, this claim requires stronger evidence. In many regions, CXR remains the predominant diagnostic tool for neonatal lung diseases. The authors should provide additional data or clarify the basis for this assertion to ensure the claim is substantiated.	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 0 Date: 01 Dec 2024 Reviewer: Ruixi Zhou Reviewer's report: The study examines the application of lung ultrasound (LUS) in neonatal respiratory management, particularly within the current context where chest X-rays (CXR) remain the primary diagnostic tool for neonatal lung diseases. For neonates, CXR procedures are complex and involve radiation exposure, posing potential harm, especially for those requiring repeated evaluations. This consensus was developed using the Delphi method to gather input from international experts, ensuring its authority and broad applicability. Contributions from experts across multiple countries and disciplines enhance the consensus’s global relevance and diversity. The statements provide valuable guidance for clinical practice, aligning with the trends of precision medicine and non-invasive diagnostics. However, the study could be improved by addressing gaps in methodological transparency, limitations, and language clarity. 1. The study provides limited information about the qualifications and distribution of the expert panel and the data analysis process, such as the specific application of the interquartile range (IQR). To improve transparency, the authors should include statistical descriptions of the experts’ credentials (e.g., years of clinical experience, geographic representation) and elaborate on the methodologies employed in data analysis. 2. While the article emphasizes the advantages of LUS, it insufficiently explores its limitations and challenges for broader implementation. Key issues include: 1)Comparison with CXR: What are the specific limitations of LUS compared to CXR, and in which clinical scenarios should CXR be preferred? 2)Operator Dependency: LUS requires a high level of technical expertise, introducing subjectivity in its interpretation. This reliance on operator skill should be further discussed, particularly in resource-limited settings. The study could also address practical challenges such as the cost of equipment and training requirements for healthcare providers. 3) Validation of Consensus Statements: The current consensus relies heavily on expert opinion, emphasizing the need for large-scale prospective studies to validate its effectiveness. Clearer recommendations for future research, such as specific randomized controlled trials, would strengthen the manuscript. 3. Although the article provides a comprehensive list of references, some are outdated and fail to incorporate recent research findings. Additionally, the study lacks a systematic analysis of critical background issues, such as barriers to adopting LUS and its comparative efficacy against CXR. Recommendation: Include high-quality randomized controlled trials and meta-analyses published after 2020, particularly those evaluating the clinical efficacy of LUS in neonatal intensive care settings. 4. The abstract states that “LUS is more accurate and reliable than the chest X-ray (CXR) in diagnosis and management of pulmonary disease.” However, this claim requires stronger evidence. In many regions, CXR remains the predominant diagnostic tool for neonatal lung diseases. The authors should provide additional data or clarify the basis for this assertion to ensure the claim is substantiated.	BMC	12916_2025_3879_ReviewerReport_V0_R4.pdf	{ "criticism": 3, "example": 0, "importance_and_relevance": 7, "materials_and_methods": 13, "praise": 3, "presentation_and_reporting": 3, "results_and_discussion": 1, "suggestion_and_solution": 7, "total": 25 }	{ "criticism": 0.12, "example": 0, "importance_and_relevance": 0.28, "materials_and_methods": 0.52, "praise": 0.12, "presentation_and_reporting": 0.12, "results_and_discussion": 0.04, "suggestion_and_solution": 0.28 }	1.48	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal\nrespiratory distress: international expert consensus\nVersion: 0 Date: 01 Dec 2024\nReviewer: Ruixi Zhou\nReviewer's report:\nThe study examines the application of lung ultrasound (LUS) in neonatal respiratory\nmanagement, particularly within the current context where chest X-rays (CXR) remain the\nprimary diagnostic tool for neonatal lung diseases. For neonates, CXR procedures are complex\nand involve radiation exposure, posing potential harm, especially for those requiring repeated\nevaluations. This consensus was developed using the Delphi method to gather input from\ninternational experts, ensuring its authority and broad applicability. Contributions from experts\nacross multiple countries and disciplines enhance the consensus’s global relevance and diversity.\nThe statements provide valuable guidance for clinical practice, aligning with the trends of\nprecision medicine and non-invasive diagnostics. However, the study could be improved by\naddressing gaps in methodological transparency, limitations, and language clarity.\n1. The study provides limited information about the qualifications and distribution of the\nexpert panel and the data analysis process, such as the specific application of the interquartile\nrange (IQR). To improve transparency, the authors should include statistical descriptions of the\nexperts’ credentials (e.g., years of clinical experience, geographic representation) and elaborate\non the methodologies employed in data analysis.\n2. While the article emphasizes the advantages of LUS, it insufficiently explores its limitations\nand challenges for broader implementation. Key issues include: 1)Comparison with CXR:\nWhat are the specific limitations of LUS compared to CXR, and in which clinical scenarios\nshould CXR be preferred? 2)Operator Dependency: LUS requires a high level of technical\nexpertise, introducing subjectivity in its interpretation. This reliance on operator skill should\nbe further discussed, particularly in resource-limited settings. The study could also address\npractical challenges such as the cost of equipment and training requirements for healthcare\nproviders. 3) Validation of Consensus Statements: The current consensus relies heavily on expert\nopinion, emphasizing the need for large-scale prospective studies to validate its effectiveness.\nClearer recommendations for future research, such as specific randomized controlled trials,\nwould strengthen the manuscript.\n3. Although the article provides a comprehensive list of references, some are outdated and fail\nto incorporate recent research findings. Additionally, the study lacks a systematic analysis of\ncritical background issues, such as barriers to adopting LUS and its comparative efficacy against\nCXR. Recommendation: Include high-quality randomized controlled trials and meta-analyses\npublished after 2020, particularly those evaluating the clinical efficacy of LUS in neonatal\nintensive care settings.\n4. The abstract states that “LUS is more accurate and reliable than the chest X-ray (CXR)\nin diagnosis and management of pulmonary disease.” However, this claim requires stronger\nevidence. In many regions, CXR remains the predominant diagnostic tool for neonatal lung\ndiseases. The authors should provide additional data or clarify the basis for this assertion to\nensure the claim is substantiated.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03879-5	Reviewed - bmc_medicine	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 1 Date: 06 Jan 2025 Reviewer: Ruixi Zhou Reviewer's report: The authors adequately addressed all the comments.	Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal respiratory distress: international expert consensus Version: 1 Date: 06 Jan 2025 Reviewer: Ruixi Zhou Reviewer's report: The authors adequately addressed all the comments.	BMC	12916_2025_3879_ReviewerReport_V1_R4.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Guidelines for the use of lung ultrasound to optimise the management of neonatal\nrespiratory distress: international expert consensus\nVersion: 1 Date: 06 Jan 2025\nReviewer: Ruixi Zhou\nReviewer's report:\nThe authors adequately addressed all the comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03786-1	Reviewed - bmc_medicine	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 0 Date: 24 Mar 2024 Reviewer's report: Major Comments: - Supplemental Table 1 should list the antibiotic classes, while it lists the first- line chemo-immuno treatments. Please add the information about antibiotic classes to the text. - While the analysis of the different routes of administration or the preferential ABT clearance is of some interest, I wonder why there is no analysis of the impact of the different classes of antibiotics on survival outcomes. It is known that different classes of antibiotics have a different impact on the gut microbiome and the duration of the antibiotic-induced dysbiosis before return to the steady- state (for instance, reviewed in DOI: 10.1016/j.jinf.2019.10.008, or reported using population-based registries in DOI: 10.1200/JCO.22.00074). Are the differences found by the Authors regarding route of administration and clearance independent from the classes of antibiotics or not? Can those differences be attributed the different antibiotic classes? Therefore, I recommend the Authors to test 1) the effects of the different classes of antibiotics on outcomes 2) the potential confounding bias/interaction of the variable "class of antibiotics" on route of administration/clearance organ. - Did the Author see differences among patients receiving different ICI treatments +/- antibiotics? From Supplementary Table 1, it seems there may be enough patients to perform exploratory subgroup analysis. Minor comments: - Funding (on first page): "NCI (funding), this expired recently" seems to be a typo or misprint, please check - Please check the correctness of reference #30 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 further assessment in your comments to the editors. I recommend additional statistical review 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 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 interests 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. I declare that I have no competing interests Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? Yes 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	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 0 Date: 24 Mar 2024 Reviewer's report: Major Comments: - Supplemental Table 1 should list the antibiotic classes, while it lists the first- line chemo-immuno treatments. Please add the information about antibiotic classes to the text. - While the analysis of the different routes of administration or the preferential ABT clearance is of some interest, I wonder why there is no analysis of the impact of the different classes of antibiotics on survival outcomes. It is known that different classes of antibiotics have a different impact on the gut microbiome and the duration of the antibiotic-induced dysbiosis before return to the steady- state (for instance, reviewed in DOI: 10.1016/j.jinf.2019.10.008, or reported using population-based registries in DOI: 10.1200/JCO.22.00074). Are the differences found by the Authors regarding route of administration and clearance independent from the classes of antibiotics or not? Can those differences be attributed the different antibiotic classes? Therefore, I recommend the Authors to test 1) the effects of the different classes of antibiotics on outcomes 2) the potential confounding bias/interaction of the variable "class of antibiotics" on route of administration/clearance organ. - Did the Author see differences among patients receiving different ICI treatments +/- antibiotics? From Supplementary Table 1, it seems there may be enough patients to perform exploratory subgroup analysis. Minor comments: - Funding (on first page): "NCI (funding), this expired recently" seems to be a typo or misprint, please check - Please check the correctness of reference #30 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 further assessment in your comments to the editors. I recommend additional statistical review 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 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 interests 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. I declare that I have no competing interests Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? Yes 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	BMC	12916_2024_3786_ReviewerReport_V0_R1.pdf	{ "criticism": 2, "example": 3, "importance_and_relevance": 1, "materials_and_methods": 15, "praise": 0, "presentation_and_reporting": 10, "results_and_discussion": 3, "suggestion_and_solution": 15, "total": 45 }	{ "criticism": 0.044444444444444446, "example": 0.06666666666666667, "importance_and_relevance": 0.022222222222222223, "materials_and_methods": 0.3333333333333333, "praise": 0, "presentation_and_reporting": 0.2222222222222222, "results_and_discussion": 0.06666666666666667, "suggestion_and_solution": 0.3333333333333333 }	1.088889	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Reviewer’s report\nTitle: \nAssociation between antibiotics and treatment efficacy in metastatic\nurothelial carcinoma patients\nVersion: \n0 \nDate: \n24 Mar 2024\nReviewer's report:\nMajor Comments:\n- Supplemental Table 1 should list the antibiotic classes, while it lists the first-\nline chemo-immuno treatments. Please add the information about antibiotic\nclasses to the text. \n- While the analysis of the different routes of administration or the preferential\nABT clearance is of some interest, I wonder why there is no analysis of the\nimpact of the different classes of antibiotics on survival outcomes. It is known\nthat different classes of antibiotics have a different impact on the gut microbiome\nand the duration of the antibiotic-induced dysbiosis before return to the steady-\nstate (for instance, reviewed in DOI: 10.1016/j.jinf.2019.10.008, or reported\nusing population-based registries in DOI: 10.1200/JCO.22.00074). Are the\ndifferences found by the Authors regarding route of administration and clearance\nindependent from the classes of antibiotics or not? Can those differences be\nattributed the different antibiotic classes?\nTherefore, I recommend the Authors to test 1) the effects of the different classes\nof antibiotics on outcomes 2) the potential confounding bias/interaction of the\nvariable \"class of antibiotics\" on route of administration/clearance organ. \n- Did the Author see differences among patients receiving different ICI\ntreatments +/- antibiotics? From Supplementary Table 1, it seems there may be\nenough patients to perform exploratory subgroup analysis.\nMinor comments:\n- Funding (on first page): \"NCI (funding), this expired recently\" seems to be a\ntypo or misprint, please check\n- Please check the correctness of reference #30\nAre you able to assess any statistics in the manuscript or would you\nrecommend an additional statistical review?\nIf an additional statistical review\nis recommended, please specify what aspects require further assessment in your\ncomments to the editors.\nI recommend additional statistical review\nDeclaration of competing interests\nPlease complete a declaration of competing\ninterests, considering the following questions:\n1\n. \nHave you in the past five years received reimbursements, fees, funding, or\nsalary from an organisation that may in any way gain or lose financially\nfrom the publication of this manuscript, either now or in the future?\n2\n. \nDo you hold any stocks or shares in an organisation that may in any way\ngain or lose financially from the publication of this manuscript, either now\nor in the future?\n3\n. \nDo you hold or are you currently applying for any patents relating to the\ncontent of the manuscript?\n4\n. \nHave you received reimbursements, fees, funding, or salary from an\norganization that holds or has applied for patents relating to the content of\nthe manuscript?\n5\n. \nDo you have any other financial competing interests?\n6\n. \nDo you have any non-financial competing interests in relation to this\npaper?\nIf you can answer no to all of the above, write 'I declare that I have no competing\ninterests' below. If your reply is yes to any, please give details below.\nI declare that I have no competing interests\nStatement on potential review bias\n Please complete a \nstatement on potential\nreview bias, considering the following questions:\n1. Did you co-author any publication with an author of this manuscript\nin the last 5 years? 2. Are you currently or recently affiliated at the\nsame institution as an author of this manuscript?\nIf you can answer no to all of the above, write 'I declare that I did not publish\nwith these authors in the last 5 years and also meet the affiliation criteria”. If\nyour reply is yes to any, please give details below.\nI declare that I did not publish with these authors in the last 5 years and also\nmeet the affiliation criteria\nReviewer Publication Consent.\n I agree for my report to be made available\nunder an Open Access Creative Commons CC-BY License (\nhttp://creativecommons.org/licenses/by/4.0\n) if this manuscript is accepted for\npublication. Any comments that I do not wish to be included in the published\nreport have been included as confidential comments to the editor, which will not\nbe published.\nIf you are not happy for us to publish this report, please contact the\neditorial office before completing the review.\nIf you wish, you can include your\nname in your published report. Please note you must decide whether to include\nyour name at the start of the process and confirm this decision whenever\nprompted. If you change your decision later, we will not be able to publish your\nname.\nI agree to the terms of the CC-BY 4.0 license; please \ndo not\n publish my name\nwith my report. (default)\nIs the study design appropriate to answer the research question (including the use\nof appropriate controls), and are the conclusions supported by the evidence\npresented?\nYes\nAre the methods sufficiently described to allow the study to be repeated?\nYes\nIs the use of statistics and treatment of uncertainties appropriate?\nYes\nIs the presentation of the work clear?\nYes\nAre the images in this manuscript (including electrophoretic gels and blots) free\nfrom apparent manipulation?\nYes", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03786-1	Reviewed - bmc_medicine	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 0 Date: 29 Mar 2024 Reviewer's report: This paper further validates the negative impact of ATB in patients treated with ICI which has now been demonstrated in more than 100 studies including randomized phase III clinical trials in urothelial cancer. The strength of this paper comes from the presence of a control chemo only arm whereby ATB don't influence chemotherapy efficacy but only IO. However, several major efforts need to be included: - The paper needs to be improved especially regarding the timing of the ATB. It is really not clear from the text and main figure how many patients received ATB before vs after ICI initiation. Most literature including Derosa Cancer Discovey 2022 revealed that it's the ATB window prior to ICI that is the most deleterious in 23,000 patients. Various ATB window need to be tested and properly presented. - For example did the authors observed a difference when they look at ATB within 1 month prior to ICI initiation. - The baseline characteristic of ICI is lacking. How many patients received the EV-Pembro? If the number of patients included on this drug is low the authors need to soften the language in the discussion. - Multivariate analysis taking into consideration several biomarkers of response is also required 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 further assessment in your comments to the editors. I am able to assess the statistics 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 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 interests 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 Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. none Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? No Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation? Yes	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 0 Date: 29 Mar 2024 Reviewer's report: This paper further validates the negative impact of ATB in patients treated with ICI which has now been demonstrated in more than 100 studies including randomized phase III clinical trials in urothelial cancer. The strength of this paper comes from the presence of a control chemo only arm whereby ATB don't influence chemotherapy efficacy but only IO. However, several major efforts need to be included: - The paper needs to be improved especially regarding the timing of the ATB. It is really not clear from the text and main figure how many patients received ATB before vs after ICI initiation. Most literature including Derosa Cancer Discovey 2022 revealed that it's the ATB window prior to ICI that is the most deleterious in 23,000 patients. Various ATB window need to be tested and properly presented. - For example did the authors observed a difference when they look at ATB within 1 month prior to ICI initiation. - The baseline characteristic of ICI is lacking. How many patients received the EV-Pembro? If the number of patients included on this drug is low the authors need to soften the language in the discussion. - Multivariate analysis taking into consideration several biomarkers of response is also required 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 further assessment in your comments to the editors. I am able to assess the statistics 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 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 interests 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 Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. none Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? No Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation? Yes	BMC	12916_2024_3786_ReviewerReport_V0_R2.pdf	{ "criticism": 3, "example": 1, "importance_and_relevance": 0, "materials_and_methods": 16, "praise": 0, "presentation_and_reporting": 10, "results_and_discussion": 2, "suggestion_and_solution": 15, "total": 46 }	{ "criticism": 0.06521739130434782, "example": 0.021739130434782608, "importance_and_relevance": 0, "materials_and_methods": 0.34782608695652173, "praise": 0, "presentation_and_reporting": 0.21739130434782608, "results_and_discussion": 0.043478260869565216, "suggestion_and_solution": 0.32608695652173914 }	1.021739	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Reviewer’s report\nTitle: \nAssociation between antibiotics and treatment efficacy in metastatic\nurothelial carcinoma patients\nVersion: \n0 \nDate: \n29 Mar 2024\nReviewer's report:\nThis paper further validates the negative impact of ATB in patients treated with\nICI which has now been demonstrated in more than 100 studies including\nrandomized phase III clinical trials in urothelial cancer. The strength of this\npaper comes from the presence of a control chemo only arm whereby ATB don't\ninfluence chemotherapy efficacy but only IO.\nHowever, several major efforts need to be included:\n- The paper needs to be improved especially regarding the timing of the ATB. It\nis really not clear from the text and main figure how many patients received ATB\nbefore vs after ICI initiation. Most literature including Derosa Cancer Discovey\n2022 revealed that it's the ATB window prior to ICI that is the most deleterious\nin 23,000 patients. Various ATB window need to be tested and properly\npresented.\n- For example did the authors observed a difference when they look at ATB\nwithin 1 month prior to ICI initiation.\n- The baseline characteristic of ICI is lacking. How many patients received the\nEV-Pembro? If the number of patients included on this drug is low the authors\nneed to soften the language in the discussion.\n- Multivariate analysis taking into consideration several biomarkers of response\nis also required\nAre you able to assess any statistics in the manuscript or would you\nrecommend an additional statistical review?\nIf an additional statistical review\nis recommended, please specify what aspects require further assessment in your\ncomments to the editors.\nI am able to assess the statistics\nDeclaration of competing interests\nPlease complete a declaration of competing\ninterests, considering the following questions:\n1\n. \nHave you in the past five years received reimbursements, fees, funding, or\nsalary from an organisation that may in any way gain or lose financially\nfrom the publication of this manuscript, either now or in the future?\n2\n. \nDo you hold any stocks or shares in an organisation that may in any way\ngain or lose financially from the publication of this manuscript, either now\nor in the future?\n3\n. \nDo you hold or are you currently applying for any patents relating to the\ncontent of the manuscript?\n4\n. \nHave you received reimbursements, fees, funding, or salary from an\norganization that holds or has applied for patents relating to the content of\nthe manuscript?\n5\n. \nDo you have any other financial competing interests?\n6\n. \nDo you have any non-financial competing interests in relation to this\npaper?\nIf you can answer no to all of the above, write 'I declare that I have no competing\ninterests' below. If your reply is yes to any, please give details below.\nnone\nStatement on potential review bias\n Please complete a \nstatement on potential\nreview bias, considering the following questions:\n1. Did you co-author any publication with an author of this manuscript\nin the last 5 years? 2. Are you currently or recently affiliated at the\nsame institution as an author of this manuscript?\nIf you can answer no to all of the above, write 'I declare that I did not publish\nwith these authors in the last 5 years and also meet the affiliation criteria”. If\nyour reply is yes to any, please give details below.\nnone\nReviewer Publication Consent.\n I agree for my report to be made available\nunder an Open Access Creative Commons CC-BY License (\nhttp://creativecommons.org/licenses/by/4.0\n) if this manuscript is accepted for\npublication. Any comments that I do not wish to be included in the published\nreport have been included as confidential comments to the editor, which will not\nbe published.\nIf you are not happy for us to publish this report, please contact the\neditorial office before completing the review.\nIf you wish, you can include your\nname in your published report. Please note you must decide whether to include\nyour name at the start of the process and confirm this decision whenever\nprompted. If you change your decision later, we will not be able to publish your\nname.\nI agree to the terms of the CC-BY 4.0 license; please \ndo not\n publish my name\nwith my report. (default)\nIs the study design appropriate to answer the research question (including the use\nof appropriate controls), and are the conclusions supported by the evidence\npresented?\nNo\nAre the methods sufficiently described to allow the study to be repeated?\nYes\nIs the use of statistics and treatment of uncertainties appropriate?\nYes\nIs the presentation of the work clear?\nNo\nAre the images in this manuscript (including electrophoretic gels and blots) free\nfrom apparent manipulation?\nYes", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03786-1	Reviewed - bmc_medicine	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 1 Date: 09 Sep 2024 Reviewer's report: The Authors addressed the Reviewers' comments. Minor edits: - Introduction, third paragraph: Enfortumab Vedotin-ejfv is mispelled in its first appearance, please correct the typo - Introduction, third paragraph: "PD1/PDL-1" should be corrected in "PD-1/PD- L1" 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 further assessment in your comments to the editors. I am able to assess the statistics 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 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 interests 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. I declare that I have no competing interests Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? Yes 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	Reviewer’s report Title: Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients Version: 1 Date: 09 Sep 2024 Reviewer's report: The Authors addressed the Reviewers' comments. Minor edits: - Introduction, third paragraph: Enfortumab Vedotin-ejfv is mispelled in its first appearance, please correct the typo - Introduction, third paragraph: "PD1/PDL-1" should be corrected in "PD-1/PD- L1" 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 further assessment in your comments to the editors. I am able to assess the statistics 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 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 interests 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. I declare that I have no competing interests Statement on potential review bias Please complete a statement on potential review bias, considering the following questions: 1. Did you co-author any publication with an author of this manuscript in the last 5 years? 2. Are you currently or recently affiliated at the same institution as an author of this manuscript? If you can answer no to all of the above, write 'I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria”. If your reply is yes to any, please give details below. I declare that I did not publish with these authors in the last 5 years and also meet the affiliation criteria Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License ( http://creativecommons.org/licenses/by/4.0 ) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published. If you are not happy for us to publish this report, please contact the editorial office before completing the review. If you wish, you can include your name in your published report. Please note you must decide whether to include your name at the start of the process and confirm this decision whenever prompted. If you change your decision later, we will not be able to publish your name. I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default) 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? Yes 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	BMC	12916_2024_3786_ReviewerReport_V1_R1.pdf	{ "criticism": 1, "example": 2, "importance_and_relevance": 0, "materials_and_methods": 9, "praise": 0, "presentation_and_reporting": 8, "results_and_discussion": 1, "suggestion_and_solution": 12, "total": 37 }	{ "criticism": 0.02702702702702703, "example": 0.05405405405405406, "importance_and_relevance": 0, "materials_and_methods": 0.24324324324324326, "praise": 0, "presentation_and_reporting": 0.21621621621621623, "results_and_discussion": 0.02702702702702703, "suggestion_and_solution": 0.32432432432432434 }	0.891892	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Reviewer’s report\nTitle: \nAssociation between antibiotics and treatment efficacy in metastatic\nurothelial carcinoma patients\nVersion: \n1 \nDate: \n09 Sep 2024\nReviewer's report:\nThe Authors addressed the Reviewers' comments.\nMinor edits:\n- Introduction, third paragraph: Enfortumab Vedotin-ejfv is mispelled in its first\nappearance, please correct the typo\n- Introduction, third paragraph: \"PD1/PDL-1\" should be corrected in \"PD-1/PD-\nL1\"\nAre you able to assess any statistics in the manuscript or would you\nrecommend an additional statistical review?\nIf an additional statistical review\nis recommended, please specify what aspects require further assessment in your\ncomments to the editors.\nI am able to assess the statistics\nDeclaration of competing interests\nPlease complete a declaration of competing\ninterests, considering the following questions:\n1\n. \nHave you in the past five years received reimbursements, fees, funding, or\nsalary from an organisation that may in any way gain or lose financially\nfrom the publication of this manuscript, either now or in the future?\n2\n. \nDo you hold any stocks or shares in an organisation that may in any way\ngain or lose financially from the publication of this manuscript, either now\nor in the future?\n3\n. \nDo you hold or are you currently applying for any patents relating to the\ncontent of the manuscript?\n4\n. \nHave you received reimbursements, fees, funding, or salary from an\norganization that holds or has applied for patents relating to the content of\nthe manuscript?\n5\n. \nDo you have any other financial competing interests?\n6\n. \nDo you have any non-financial competing interests in relation to this\npaper?\nIf you can answer no to all of the above, write 'I declare that I have no competing\ninterests' below. If your reply is yes to any, please give details below.\nI declare that I have no competing interests\nStatement on potential review bias\n Please complete a \nstatement on potential\nreview bias, considering the following questions:\n1. Did you co-author any publication with an author of this manuscript\nin the last 5 years? 2. Are you currently or recently affiliated at the\nsame institution as an author of this manuscript?\nIf you can answer no to all of the above, write 'I declare that I did not publish\nwith these authors in the last 5 years and also meet the affiliation criteria”. If\nyour reply is yes to any, please give details below.\nI declare that I did not publish with these authors in the last 5 years and also\nmeet the affiliation criteria\nReviewer Publication Consent.\n I agree for my report to be made available\nunder an Open Access Creative Commons CC-BY License (\nhttp://creativecommons.org/licenses/by/4.0\n) if this manuscript is accepted for\npublication. Any comments that I do not wish to be included in the published\nreport have been included as confidential comments to the editor, which will not\nbe published.\nIf you are not happy for us to publish this report, please contact the\neditorial office before completing the review.\nIf you wish, you can include your\nname in your published report. Please note you must decide whether to include\nyour name at the start of the process and confirm this decision whenever\nprompted. If you change your decision later, we will not be able to publish your\nname.\nI agree to the terms of the CC-BY 4.0 license; please \ndo not\n publish my name\nwith my report. (default)\nIs the study design appropriate to answer the research question (including the use\nof appropriate controls), and are the conclusions supported by the evidence\npresented?\nYes\nAre the methods sufficiently described to allow the study to be repeated?\nYes\nIs the use of statistics and treatment of uncertainties appropriate?\nYes\nIs the presentation of the work clear?\nYes\nAre the images in this manuscript (including electrophoretic gels and blots) free\nfrom apparent manipulation?\nYes", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03857-x	Reviewed - bmc_medicine	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 0 Date: 20 Sep 2024 Reviewer: Kyung-Won Hong Reviewer's report: Thank you for the opportunity to review this intriguing paper. I have several suggestions for improvement: 1. The Results section of the abstract is excessively lengthy, making it challenging to quickly understand the main findings. I recommend removing the OR and CI notations and consolidating related diseases (e.g., atrial fibrillation, heart failure, hypertension) into a single category, such as "cardiovascular diseases." 2. Instead of merely stating that HI, VI, and DSI increase the risk of chronic diseases, it would be beneficial to elaborate on the physiological mechanisms by which these factors impact the outcome diseases. 3. Throughout the manuscript, there seems to be significant repetition of similar explanations. The content presented in tables and figures should be summarized more succinctly, focusing on the key findings that the authors wish to emphasize. 4. It would be helpful to begin the Discussion with a brief summary of the study results, followed by an analysis that incorporates relevant literature. 5. Many statements in the Discussion lack appropriate citations. For instance, lines 421-424 would benefit from referencing relevant literature. A thorough review of the entire Discussion for unreferenced claims is necessary. 6. While the detailed discussions provide valuable insights, the parallel explanation of various disease states makes it challenging to digest quickly. A representative figure or graph summarizing these discussion points would enhance clarity. In conclusion, while the research topic and methodology adhere to established protocols related to MR, the paper attempts to encompass a wide range of exposures and outcomes, resulting in a lengthy manuscript with repetitive patterns. A more concise presentation focused on core content, along with rounding numerical data to three decimal places for clarity, would greatly improve readability.	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 0 Date: 20 Sep 2024 Reviewer: Kyung-Won Hong Reviewer's report: Thank you for the opportunity to review this intriguing paper. I have several suggestions for improvement: 1. The Results section of the abstract is excessively lengthy, making it challenging to quickly understand the main findings. I recommend removing the OR and CI notations and consolidating related diseases (e.g., atrial fibrillation, heart failure, hypertension) into a single category, such as "cardiovascular diseases." 2. Instead of merely stating that HI, VI, and DSI increase the risk of chronic diseases, it would be beneficial to elaborate on the physiological mechanisms by which these factors impact the outcome diseases. 3. Throughout the manuscript, there seems to be significant repetition of similar explanations. The content presented in tables and figures should be summarized more succinctly, focusing on the key findings that the authors wish to emphasize. 4. It would be helpful to begin the Discussion with a brief summary of the study results, followed by an analysis that incorporates relevant literature. 5. Many statements in the Discussion lack appropriate citations. For instance, lines 421-424 would benefit from referencing relevant literature. A thorough review of the entire Discussion for unreferenced claims is necessary. 6. While the detailed discussions provide valuable insights, the parallel explanation of various disease states makes it challenging to digest quickly. A representative figure or graph summarizing these discussion points would enhance clarity. In conclusion, while the research topic and methodology adhere to established protocols related to MR, the paper attempts to encompass a wide range of exposures and outcomes, resulting in a lengthy manuscript with repetitive patterns. A more concise presentation focused on core content, along with rounding numerical data to three decimal places for clarity, would greatly improve readability.	BMC	12916_2025_3857_ReviewerReport_V0_R2.pdf	{ "criticism": 3, "example": 1, "importance_and_relevance": 4, "materials_and_methods": 4, "praise": 3, "presentation_and_reporting": 8, "results_and_discussion": 9, "suggestion_and_solution": 9, "total": 20 }	{ "criticism": 0.15, "example": 0.05, "importance_and_relevance": 0.2, "materials_and_methods": 0.2, "praise": 0.15, "presentation_and_reporting": 0.4, "results_and_discussion": 0.45, "suggestion_and_solution": 0.45 }	2.05	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly\nIndividuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective\nCohort Studies and Mendelian Randomization Analysis\nVersion: 0 Date: 20 Sep 2024\nReviewer: Kyung-Won Hong\nReviewer's report:\nThank you for the opportunity to review this intriguing paper.\nI have several suggestions for improvement:\n1. The Results section of the abstract is excessively lengthy, making it challenging to quickly\nunderstand the main findings. I recommend removing the OR and CI notations and consolidating\nrelated diseases (e.g., atrial fibrillation, heart failure, hypertension) into a single category, such\nas \"cardiovascular diseases.\"\n2. Instead of merely stating that HI, VI, and DSI increase the risk of chronic diseases, it would\nbe beneficial to elaborate on the physiological mechanisms by which these factors impact the\noutcome diseases.\n3. Throughout the manuscript, there seems to be significant repetition of similar explanations.\nThe content presented in tables and figures should be summarized more succinctly, focusing on\nthe key findings that the authors wish to emphasize.\n4. It would be helpful to begin the Discussion with a brief summary of the study results, followed\nby an analysis that incorporates relevant literature.\n5. Many statements in the Discussion lack appropriate citations. For instance, lines 421-424\nwould benefit from referencing relevant literature. A thorough review of the entire Discussion\nfor unreferenced claims is necessary.\n6. While the detailed discussions provide valuable insights, the parallel explanation of various\ndisease states makes it challenging to digest quickly. A representative figure or graph\nsummarizing these discussion points would enhance clarity.\nIn conclusion, while the research topic and methodology adhere to established protocols related\nto MR, the paper attempts to encompass a wide range of exposures and outcomes, resulting\nin a lengthy manuscript with repetitive patterns. A more concise presentation focused on core\ncontent, along with rounding numerical data to three decimal places for clarity, would greatly\nimprove readability.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03857-x	Reviewed - bmc_medicine	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 0 Date: 30 Sep 2024 Reviewer's report:	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 0 Date: 30 Sep 2024 Reviewer's report:	BMC	12916_2025_3857_ReviewerReport_V0_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly\nIndividuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective\nCohort Studies and Mendelian Randomization Analysis\nVersion: 0 Date: 30 Sep 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03857-x	Reviewed - bmc_medicine	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 2 Date: 17 Oct 2024 Reviewer: Kyung-Won Hong Reviewer's report: The manuscript presents a comprehensive exploration of a vast research topic, and I appreciate the authors' efforts to condense their findings into a single paper. While the Methods and Results sections remain lengthy and somewhat repetitive, the authors have effectively addressed the reviewers' questions, and their responses are well integrated into the revised manuscript. Notably, Figure 5 provides a clear and concise summary of the overall results, enhancing the reader's understanding of the study's findings. I believe that the current version of the manuscript is sufficiently polished and ready for publication. In conclusion, I have no further comments to add regarding this manuscript and recommend it for acceptance as it stands.	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 2 Date: 17 Oct 2024 Reviewer: Kyung-Won Hong Reviewer's report: The manuscript presents a comprehensive exploration of a vast research topic, and I appreciate the authors' efforts to condense their findings into a single paper. While the Methods and Results sections remain lengthy and somewhat repetitive, the authors have effectively addressed the reviewers' questions, and their responses are well integrated into the revised manuscript. Notably, Figure 5 provides a clear and concise summary of the overall results, enhancing the reader's understanding of the study's findings. I believe that the current version of the manuscript is sufficiently polished and ready for publication. In conclusion, I have no further comments to add regarding this manuscript and recommend it for acceptance as it stands.	BMC	12916_2025_3857_ReviewerReport_V2_R2.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 1, "materials_and_methods": 2, "praise": 4, "presentation_and_reporting": 1, "results_and_discussion": 3, "suggestion_and_solution": 1, "total": 5 }	{ "criticism": 0.4, "example": 0.2, "importance_and_relevance": 0.2, "materials_and_methods": 0.4, "praise": 0.8, "presentation_and_reporting": 0.2, "results_and_discussion": 0.6, "suggestion_and_solution": 0.2 }	3	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly\nIndividuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective\nCohort Studies and Mendelian Randomization Analysis\nVersion: 2 Date: 17 Oct 2024\nReviewer: Kyung-Won Hong\nReviewer's report:\nThe manuscript presents a comprehensive exploration of a vast research topic, and I appreciate\nthe authors' efforts to condense their findings into a single paper. While the Methods and Results\nsections remain lengthy and somewhat repetitive, the authors have effectively addressed the\nreviewers' questions, and their responses are well integrated into the revised manuscript.\nNotably, Figure 5 provides a clear and concise summary of the overall results, enhancing the\nreader's understanding of the study's findings. I believe that the current version of the manuscript\nis sufficiently polished and ready for publication.\nIn conclusion, I have no further comments to add regarding this manuscript and recommend it\nfor acceptance as it stands.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03857-x	Reviewed - bmc_medicine	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 2 Date: 07 Nov 2024 Reviewer's report:	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 2 Date: 07 Nov 2024 Reviewer's report:	BMC	12916_2025_3857_ReviewerReport_V2_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly\nIndividuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective\nCohort Studies and Mendelian Randomization Analysis\nVersion: 2 Date: 07 Nov 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03857-x	Reviewed - bmc_medicine	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 3 Date: 17 Nov 2024 Reviewer's report:	Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly Individuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective Cohort Studies and Mendelian Randomization Analysis Version: 3 Date: 17 Nov 2024 Reviewer's report:	BMC	12916_2025_3857_ReviewerReport_V3_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Increased Risk of Chronic Diseases and Multimorbidity in Middle-Aged and Elderly\nIndividuals with Early Vision, Hearing, or Dual Sensory Impairments: Insights from Prospective\nCohort Studies and Mendelian Randomization Analysis\nVersion: 3 Date: 17 Nov 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03886-6	Reviewed - bmc_medicine	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 04 Jul 2024 Reviewer's report: This large-scale retrospective cohort study compared the risk of developmental disorders between general anesthesia and neuraxial anesthesia using a nationwide registry and claim database. The study has large sample size, valid exposure and outcome information based on payment code and ICD code, and considers multiple key potential confounders in analysis. Here are some issues/errors that I hope to point out to help improve quality of this manuscript. Introduction: The whole section is clear but the authors are expected to emphasize the innovation of this study, that is, what specific research gaps in the area would be filled in current study? Methods: 1. The authors should provide references for some guidelines that they mentioned, including the Helsinki Declaration (line 118) and the two epidemiology guidelines at line 154. 2. There was a typo error for autism at line 137. 3. The age variable in covariates section is not very clear, is it refers to maternal age at delivery? 4. The definition of gestational status variable in models is not clear (line 175). The authors listed a lot of maternal and fetal conditions in the covariates section but did not explain the relationship between these conditions and gestational status in the analysis. By the way, there was some repeated words when authors listed maternal and fetal conditions, which makes readers confused (line 148). 5. The categories of developmental disorders in Additional File 3 were not consistent with the list in the outcome section. 6. I feel confused about the statement that " The CIs that overlapped with the value one were considered statistically significant". I think the value one should not be in the range of CIs when reporting statistically significant results, like 1.17 (1.07 - 1.28) that the authors mentioned in the abstract. 7. The subgroup analysis is not enough for the statement of "interaction" (line 190). I think authors should test the statistical significance of interaction terms. Additionally, why did the authors not do subgroup analysis for the 1-min Apgar score? Also, I'm curious about the association between Apgar scores and developmental disorders in this dataset. Results: 1. It is important to differentiate whether the association decreased (like line 219) or diminished after adjusting for Apgar scores. "decreased association" sounds like the association is still significant but has decreased effect size (point estimate). The authors should state conclusion accurately and consistently in Abstract, Results, Discussion, and Conclusion sections. 2. I feel a little confused about the arrow in Figure 2 and 3. Some lines had arrows showing direction, while others did not. The criteria should be explained. 3. By the way, Table 2 was missed in the main manuscript. Discussion 1. The authors reviewed and summarized previous literature about anesthesia and neurodevelopment, which is good. But I think it would be better to focus more on why the results contradict the original hypothesis, like what could be the potential explanation. 2. The authors summarized a lot of limitations, which is good. But the third point about accuracy and validity was not supported by a solid explanation. The authors are expected to explain what the specific concern is in terms of accuracy and validity.	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 04 Jul 2024 Reviewer's report: This large-scale retrospective cohort study compared the risk of developmental disorders between general anesthesia and neuraxial anesthesia using a nationwide registry and claim database. The study has large sample size, valid exposure and outcome information based on payment code and ICD code, and considers multiple key potential confounders in analysis. Here are some issues/errors that I hope to point out to help improve quality of this manuscript. Introduction: The whole section is clear but the authors are expected to emphasize the innovation of this study, that is, what specific research gaps in the area would be filled in current study? Methods: 1. The authors should provide references for some guidelines that they mentioned, including the Helsinki Declaration (line 118) and the two epidemiology guidelines at line 154. 2. There was a typo error for autism at line 137. 3. The age variable in covariates section is not very clear, is it refers to maternal age at delivery? 4. The definition of gestational status variable in models is not clear (line 175). The authors listed a lot of maternal and fetal conditions in the covariates section but did not explain the relationship between these conditions and gestational status in the analysis. By the way, there was some repeated words when authors listed maternal and fetal conditions, which makes readers confused (line 148). 5. The categories of developmental disorders in Additional File 3 were not consistent with the list in the outcome section. 6. I feel confused about the statement that " The CIs that overlapped with the value one were considered statistically significant". I think the value one should not be in the range of CIs when reporting statistically significant results, like 1.17 (1.07 - 1.28) that the authors mentioned in the abstract. 7. The subgroup analysis is not enough for the statement of "interaction" (line 190). I think authors should test the statistical significance of interaction terms. Additionally, why did the authors not do subgroup analysis for the 1-min Apgar score? Also, I'm curious about the association between Apgar scores and developmental disorders in this dataset. Results: 1. It is important to differentiate whether the association decreased (like line 219) or diminished after adjusting for Apgar scores. "decreased association" sounds like the association is still significant but has decreased effect size (point estimate). The authors should state conclusion accurately and consistently in Abstract, Results, Discussion, and Conclusion sections. 2. I feel a little confused about the arrow in Figure 2 and 3. Some lines had arrows showing direction, while others did not. The criteria should be explained. 3. By the way, Table 2 was missed in the main manuscript. Discussion 1. The authors reviewed and summarized previous literature about anesthesia and neurodevelopment, which is good. But I think it would be better to focus more on why the results contradict the original hypothesis, like what could be the potential explanation. 2. The authors summarized a lot of limitations, which is good. But the third point about accuracy and validity was not supported by a solid explanation. The authors are expected to explain what the specific concern is in terms of accuracy and validity.	BMC	12916_2025_3886_ReviewerReport_V0_R1.pdf	{ "criticism": 13, "example": 9, "importance_and_relevance": 2, "materials_and_methods": 13, "praise": 4, "presentation_and_reporting": 12, "results_and_discussion": 11, "suggestion_and_solution": 10, "total": 41 }	{ "criticism": 0.3170731707317073, "example": 0.21951219512195122, "importance_and_relevance": 0.04878048780487805, "materials_and_methods": 0.3170731707317073, "praise": 0.0975609756097561, "presentation_and_reporting": 0.2926829268292683, "results_and_discussion": 0.2682926829268293, "suggestion_and_solution": 0.24390243902439024 }	1.804878	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Association between general anesthesia for cesarean delivery and subsequent\ndevelopmental disorders in children: A nationwide retrospective cohort study\nVersion: 0 Date: 04 Jul 2024\nReviewer's report:\nThis large-scale retrospective cohort study compared the risk of developmental disorders\nbetween general anesthesia and neuraxial anesthesia using a nationwide registry and claim\ndatabase. The study has large sample size, valid exposure and outcome information based on\npayment code and ICD code, and considers multiple key potential confounders in analysis.\nHere are some issues/errors that I hope to point out to help improve quality of this manuscript.\nIntroduction: The whole section is clear but the authors are expected to emphasize the innovation\nof this study, that is, what specific research gaps in the area would be filled in current study?\nMethods:\n1. The authors should provide references for some guidelines that they mentioned, including the\nHelsinki Declaration (line 118) and the two epidemiology guidelines at line 154.\n2. There was a typo error for autism at line 137.\n3. The age variable in covariates section is not very clear, is it refers to maternal age at delivery?\n4. The definition of gestational status variable in models is not clear (line 175). The authors listed\na lot of maternal and fetal conditions in the covariates section but did not explain the relationship\nbetween these conditions and gestational status in the analysis. By the way, there was some\nrepeated words when authors listed maternal and fetal conditions, which makes readers confused\n(line 148).\n5. The categories of developmental disorders in Additional File 3 were not consistent with the\nlist in the outcome section.\n6. I feel confused about the statement that \" The CIs that overlapped with the value one were\nconsidered statistically significant\". I think the value one should not be in the range of CIs when\nreporting statistically significant results, like 1.17 (1.07 - 1.28) that the authors mentioned in\nthe abstract.\n7. The subgroup analysis is not enough for the statement of \"interaction\" (line 190). I think\nauthors should test the statistical significance of interaction terms. Additionally, why did the\nauthors not do subgroup analysis for the 1-min Apgar score? Also, I'm curious about the\nassociation between Apgar scores and developmental disorders in this dataset.\nResults:\n1. It is important to differentiate whether the association decreased (like line 219) or diminished\nafter adjusting for Apgar scores. \"decreased association\" sounds like the association is still\nsignificant but has decreased effect size (point estimate). The authors should state conclusion\naccurately and consistently in Abstract, Results, Discussion, and Conclusion sections.\n2. I feel a little confused about the arrow in Figure 2 and 3. Some lines had arrows showing\ndirection, while others did not. The criteria should be explained.\n3. By the way, Table 2 was missed in the main manuscript.\nDiscussion\n1. The authors reviewed and summarized previous literature about anesthesia and\nneurodevelopment, which is good. But I think it would be better to focus more on why the results\ncontradict the original hypothesis, like what could be the potential explanation.\n2. The authors summarized a lot of limitations, which is good. But the third point about accuracy\nand validity was not supported by a solid explanation. The authors are expected to explain what\nthe specific concern is in terms of accuracy and validity.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03886-6	Reviewed - bmc_medicine	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 10 Jul 2024 Reviewer's report: This study highlights an increasingly growing area of interest but can be improved in some areas. 1. The authors need to better define the exposures eg neuraxial anesthesia as this can include a range of anesthetic techniques which may have differing exposures and adverse effects. Do they have any information on what portion of patients had epidurals placed in labor vs epidural placed just for cesarean delivery vs CSE vs spinal anesthetics. Similarly general anesthesia is not a monolithic thing, anesthesia maybe maintained with IV agents (propofol) vs volatile agents with some preclinical studies suggesting propofol may have less of an effect on neurodevelopmental pathways. 2. Another major issue with this study which maybe addressed in the limitations is the lack of data on duration of exposure. In general anesthesia attempts are often made to minimize the duration of exposure of the fetus to the agent by minimizing the time from induction of anesthesia to delivery. In neuraxial anesthesia this is less of a concern. I assume the authors are unable to get data on anesthesia induction (or spinal placement, epidural top up) to delivery time or as a surrogate marker skin incision to delivery time. Unfortunately the duration of surgery may noy capture this data point. 3. Interestingly there is no mention of the effect of maternal obesity when this maybe associated with neurocognitive and neurodevelopmental disoreders 4. Did the authors consider adding the use of reproductive technology (eg IVF ) and Neonatal ICU admissions as covariates. 5. Some of the terms used as covariates are outdated or unclear eg what is late pregnancy, abrupt placenta? The hypertensive terms are confusing. 6. What is social deprivation? Socioeconomic factors play a role but these need to be better defined. 7. Looking at the c-statistics it doesn’t appear that the models developed performed well at determining the associations between type of anesthesia and neurodevelopmental disorder. 8. The discussion should expand on the attenuation of the effects on anesthesia and neurodevelopmental disorder by adding in apgar scores. This may reflect the use of GA for higher risk maternal and fetal conditions eg higher rates of fetal distress preeclampsia and antepartum hemorrhage in the GA group which could have an effect on childhood outcomes independent of anethesia.	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 10 Jul 2024 Reviewer's report: This study highlights an increasingly growing area of interest but can be improved in some areas. 1. The authors need to better define the exposures eg neuraxial anesthesia as this can include a range of anesthetic techniques which may have differing exposures and adverse effects. Do they have any information on what portion of patients had epidurals placed in labor vs epidural placed just for cesarean delivery vs CSE vs spinal anesthetics. Similarly general anesthesia is not a monolithic thing, anesthesia maybe maintained with IV agents (propofol) vs volatile agents with some preclinical studies suggesting propofol may have less of an effect on neurodevelopmental pathways. 2. Another major issue with this study which maybe addressed in the limitations is the lack of data on duration of exposure. In general anesthesia attempts are often made to minimize the duration of exposure of the fetus to the agent by minimizing the time from induction of anesthesia to delivery. In neuraxial anesthesia this is less of a concern. I assume the authors are unable to get data on anesthesia induction (or spinal placement, epidural top up) to delivery time or as a surrogate marker skin incision to delivery time. Unfortunately the duration of surgery may noy capture this data point. 3. Interestingly there is no mention of the effect of maternal obesity when this maybe associated with neurocognitive and neurodevelopmental disoreders 4. Did the authors consider adding the use of reproductive technology (eg IVF ) and Neonatal ICU admissions as covariates. 5. Some of the terms used as covariates are outdated or unclear eg what is late pregnancy, abrupt placenta? The hypertensive terms are confusing. 6. What is social deprivation? Socioeconomic factors play a role but these need to be better defined. 7. Looking at the c-statistics it doesn’t appear that the models developed performed well at determining the associations between type of anesthesia and neurodevelopmental disorder. 8. The discussion should expand on the attenuation of the effects on anesthesia and neurodevelopmental disorder by adding in apgar scores. This may reflect the use of GA for higher risk maternal and fetal conditions eg higher rates of fetal distress preeclampsia and antepartum hemorrhage in the GA group which could have an effect on childhood outcomes independent of anethesia.	BMC	12916_2025_3886_ReviewerReport_V0_R2.pdf	{ "criticism": 4, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 12, "praise": 1, "presentation_and_reporting": 3, "results_and_discussion": 1, "suggestion_and_solution": 4, "total": 25 }	{ "criticism": 0.16, "example": 0, "importance_and_relevance": 0.04, "materials_and_methods": 0.48, "praise": 0.04, "presentation_and_reporting": 0.12, "results_and_discussion": 0.04, "suggestion_and_solution": 0.16 }	1.04	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Association between general anesthesia for cesarean delivery and subsequent\ndevelopmental disorders in children: A nationwide retrospective cohort study\nVersion: 0 Date: 10 Jul 2024\nReviewer's report:\nThis study highlights an increasingly growing area of interest but can be improved in some areas.\n1. The authors need to better define the exposures eg neuraxial anesthesia as this can include a\nrange of anesthetic techniques which may have differing exposures and adverse effects. Do they\nhave any information on what portion of patients had epidurals placed in labor vs epidural placed\njust for cesarean delivery vs CSE vs spinal anesthetics. Similarly general anesthesia is not a\nmonolithic thing, anesthesia maybe maintained with IV agents (propofol) vs volatile agents with\nsome preclinical studies suggesting propofol may have less of an effect on neurodevelopmental\npathways.\n2. Another major issue with this study which maybe addressed in the limitations is the lack of\ndata on duration of exposure. In general anesthesia attempts are often made to minimize the\nduration of exposure of the fetus to the agent by minimizing the time from induction of anesthesia\nto delivery. In neuraxial anesthesia this is less of a concern. I assume the authors are unable to\nget data on anesthesia induction (or spinal placement, epidural top up) to delivery time or as a\nsurrogate marker skin incision to delivery time. Unfortunately the duration of surgery may noy\ncapture this data point.\n3. Interestingly there is no mention of the effect of maternal obesity when this maybe associated\nwith neurocognitive and neurodevelopmental disoreders\n4. Did the authors consider adding the use of reproductive technology (eg IVF ) and Neonatal\nICU admissions as covariates.\n5. Some of the terms used as covariates are outdated or unclear eg what is late pregnancy, abrupt\nplacenta? The hypertensive terms are confusing.\n6. What is social deprivation? Socioeconomic factors play a role but these need to be better\ndefined.\n7. Looking at the c-statistics it doesn’t appear that the models developed performed well at\ndetermining the associations between type of anesthesia and neurodevelopmental disorder.\n8. The discussion should expand on the attenuation of the effects on anesthesia and\nneurodevelopmental disorder by adding in apgar scores. This may reflect the use of GA for\nhigher risk maternal and fetal conditions eg higher rates of fetal distress preeclampsia and\nantepartum hemorrhage in the GA group which could have an effect on childhood outcomes\nindependent of anethesia.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03886-6	Reviewed - bmc_medicine	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 10 Jul 2024 Reviewer: John J. Kowalczyk Reviewer's report: Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Summary: This is a retrospective cohort study evaluating the association between DD in GA vs for CD with propensity score matching. Strengths: Overall, the information is presented well in a well-organized, succinct manner consistent with the requirements of the journal. Weaknesses: General Comments: Would recommend abbreviate general anesthesia to GA and neuraxial anesthesia to NA throughout the manuscript. From Table 1 and Line 178: Does Length of Stay refer to maternal or infant length of stay. It appears to be maternal length of stay, but should be specified. Abstract: Line 36: Would change to something similar to: Exposure to general anesthetics in early childhood are associated with… Line 37: Would change to something similar to: few studies have addressed in-utero exposure to anesthetics during delivery and subsequent Line 59-60 Would recommend changing: “This association diminished when…” to This association was no longer present when…” Background: Line 75-76: Would change to something similar to: patients with contraindications to neuraxial anesthesia. Methods – Statistical Analyses: Line 184-185: Did you mean to say: CIs that did not overlap with the value one were considered statistically significant. Results: Line 219-221: It is important to be clear that any association was no longer present when including Apgar scores. I would suggest a change here to: The observed association between GA for cesarean delivery and subsequent developmental disorders disappeared upon incorporating Apgar scores as covariates to achieve balance through propensity score weighting Discussion: Line 235: Add comma: cause deficits in long-term cognitive function and neuronal cell apoptosis in animals, including non-human primates Line 247: Add space: 31 studies… Line 254: Would change to something similar to: Because most general anesthetics readily cross the placenta Line 254: Would change to something similar to: fetuses of pregnant women undergoing surgery… Line 294: Would change to psychiatrics to psychiatry Limitations: Please add discussion related to Apgars related to GA versus underlying fetal compromise Conclusion: The conclusion appears needlessly repetitive and wordy. Furthermore the conclusion should be clearly supported by the data. Line 311-314: Would change to something similar to: when controlling for Apgar scores, the association between general anesthesia for cesarean delivery and subsequent developmental disorders was no longer present. Line 313-315: Would recommend changing “Hence, general anesthesia for cesarean delivery could be associated with a higher risk of developing developmental disorders 2–4 years after birth because of lower Apgar scores at birth.” To something similar to “It is unclear whether this represents an effect of GA on neonatal Apgars or, more likely, represents the compromised in-utero status leading to GA for urgent or emergent CD.” Would recommend adding your line from the abstract: There is no evidence of a direct relationship between general anesthesia-related neurotoxicity and subsequent developmental disorders.	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 0 Date: 10 Jul 2024 Reviewer: John J. Kowalczyk Reviewer's report: Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Summary: This is a retrospective cohort study evaluating the association between DD in GA vs for CD with propensity score matching. Strengths: Overall, the information is presented well in a well-organized, succinct manner consistent with the requirements of the journal. Weaknesses: General Comments: Would recommend abbreviate general anesthesia to GA and neuraxial anesthesia to NA throughout the manuscript. From Table 1 and Line 178: Does Length of Stay refer to maternal or infant length of stay. It appears to be maternal length of stay, but should be specified. Abstract: Line 36: Would change to something similar to: Exposure to general anesthetics in early childhood are associated with… Line 37: Would change to something similar to: few studies have addressed in-utero exposure to anesthetics during delivery and subsequent Line 59-60 Would recommend changing: “This association diminished when…” to This association was no longer present when…” Background: Line 75-76: Would change to something similar to: patients with contraindications to neuraxial anesthesia. Methods – Statistical Analyses: Line 184-185: Did you mean to say: CIs that did not overlap with the value one were considered statistically significant. Results: Line 219-221: It is important to be clear that any association was no longer present when including Apgar scores. I would suggest a change here to: The observed association between GA for cesarean delivery and subsequent developmental disorders disappeared upon incorporating Apgar scores as covariates to achieve balance through propensity score weighting Discussion: Line 235: Add comma: cause deficits in long-term cognitive function and neuronal cell apoptosis in animals, including non-human primates Line 247: Add space: 31 studies… Line 254: Would change to something similar to: Because most general anesthetics readily cross the placenta Line 254: Would change to something similar to: fetuses of pregnant women undergoing surgery… Line 294: Would change to psychiatrics to psychiatry Limitations: Please add discussion related to Apgars related to GA versus underlying fetal compromise Conclusion: The conclusion appears needlessly repetitive and wordy. Furthermore the conclusion should be clearly supported by the data. Line 311-314: Would change to something similar to: when controlling for Apgar scores, the association between general anesthesia for cesarean delivery and subsequent developmental disorders was no longer present. Line 313-315: Would recommend changing “Hence, general anesthesia for cesarean delivery could be associated with a higher risk of developing developmental disorders 2–4 years after birth because of lower Apgar scores at birth.” To something similar to “It is unclear whether this represents an effect of GA on neonatal Apgars or, more likely, represents the compromised in-utero status leading to GA for urgent or emergent CD.” Would recommend adding your line from the abstract: There is no evidence of a direct relationship between general anesthesia-related neurotoxicity and subsequent developmental disorders.	BMC	12916_2025_3886_ReviewerReport_V0_R3.pdf	{ "criticism": 0, "example": 7, "importance_and_relevance": 0, "materials_and_methods": 6, "praise": 1, "presentation_and_reporting": 5, "results_and_discussion": 4, "suggestion_and_solution": 8, "total": 12 }	{ "criticism": 0, "example": 0.5833333333333334, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 0.08333333333333333, "presentation_and_reporting": 0.4166666666666667, "results_and_discussion": 0.3333333333333333, "suggestion_and_solution": 0.6666666666666666 }	2.583333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Association between general anesthesia for cesarean delivery and subsequent\ndevelopmental disorders in children: A nationwide retrospective cohort study\nVersion: 0 Date: 10 Jul 2024\nReviewer: John J. Kowalczyk\nReviewer's report:\nTitle: Association between general anesthesia for cesarean delivery and subsequent\ndevelopmental disorders in children: A nationwide retrospective cohort study\nSummary: This is a retrospective cohort study evaluating the association between DD in GA vs\nfor CD with propensity score matching.\nStrengths: Overall, the information is presented well in a well-organized, succinct manner\nconsistent with the requirements of the journal.\nWeaknesses:\nGeneral Comments:\nWould recommend abbreviate general anesthesia to GA and neuraxial anesthesia to NA\nthroughout the manuscript.\nFrom Table 1 and Line 178: Does Length of Stay refer to maternal or infant length of stay. It\nappears to be maternal length of stay, but should be specified.\nAbstract:\nLine 36: Would change to something similar to: Exposure to general anesthetics in early\nchildhood are associated with…\nLine 37: Would change to something similar to: few studies have addressed in-utero exposure\nto anesthetics during delivery and subsequent\nLine 59-60 Would recommend changing: “This association diminished when…” to This\nassociation was no longer present when…”\nBackground:\nLine 75-76: Would change to something similar to: patients with contraindications to neuraxial\nanesthesia.\nMethods – Statistical Analyses:\nLine 184-185: Did you mean to say: CIs that did not overlap with the value one were considered\nstatistically significant.\nResults:\nLine 219-221: It is important to be clear that any association was no longer present when\nincluding Apgar scores. I would suggest a change here to: The observed association between GA\nfor cesarean delivery and subsequent developmental disorders disappeared upon incorporating\nApgar scores as covariates to achieve balance through propensity score weighting\nDiscussion:\nLine 235: Add comma: cause deficits in long-term cognitive function and neuronal cell apoptosis\nin animals, including non-human primates\nLine 247: Add space: 31 studies…\nLine 254: Would change to something similar to: Because most general anesthetics readily cross\nthe placenta\nLine 254: Would change to something similar to: fetuses of pregnant women undergoing\nsurgery…\nLine 294: Would change to psychiatrics to psychiatry\nLimitations: Please add discussion related to Apgars related to GA versus underlying fetal\ncompromise\nConclusion:\nThe conclusion appears needlessly repetitive and wordy. Furthermore the conclusion should be\nclearly supported by the data.\nLine 311-314: Would change to something similar to: when controlling for Apgar scores, the\nassociation between general anesthesia for cesarean delivery and subsequent developmental\ndisorders was no longer present.\nLine 313-315: Would recommend changing “Hence, general anesthesia for cesarean delivery\ncould be associated with a higher risk of developing developmental disorders 2–4 years after\nbirth because of lower Apgar scores at birth.” To something similar to “It is unclear whether\nthis represents an effect of GA on neonatal Apgars or, more likely, represents the compromised\nin-utero status leading to GA for urgent or emergent CD.”\nWould recommend adding your line from the abstract: There is no evidence of a direct\nrelationship between general anesthesia-related neurotoxicity and subsequent developmental\ndisorders.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03886-6	Reviewed - bmc_medicine	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 1 Date: 18 Sep 2024 Reviewer's report: The authors carefully provided a point-by-point response to the comments and addressed most of the reviewers' concerns. I still have two remaining concerns about the manuscript. 1) Results: Can the author provide a little more statistical information about the interaction analysis on the Apgar score? I feel confused about the substantial significance of interaction terms while "no significant association was found between anesthesia for cesarean delivery and subsequent developmental disorders in either subgroup." In the additional file 5, the results for NA, Apgar score <7 and GA, Apgar Score < 7 groups were quite similar, but the interaction p values were far from 0.05. Can the authors explain more about the Type III test mentioned in the footnote? 2) Discussion: In the limitation paragraph, the authors mentioned concerns about the accuracy and validity of data. The authors added more about validation studies in the revision, which is good. But my original question is, what are specific concerns about the accuracy and validity of a claim database? For example, misclassification from doctors? As the authors mentioned, some people unfamiliar with the data might question the accuracy and validity, then what could be their specific question, and why might these concerns influence the results?	Title: Association between general anesthesia for cesarean delivery and subsequent developmental disorders in children: A nationwide retrospective cohort study Version: 1 Date: 18 Sep 2024 Reviewer's report: The authors carefully provided a point-by-point response to the comments and addressed most of the reviewers' concerns. I still have two remaining concerns about the manuscript. 1) Results: Can the author provide a little more statistical information about the interaction analysis on the Apgar score? I feel confused about the substantial significance of interaction terms while "no significant association was found between anesthesia for cesarean delivery and subsequent developmental disorders in either subgroup." In the additional file 5, the results for NA, Apgar score <7 and GA, Apgar Score < 7 groups were quite similar, but the interaction p values were far from 0.05. Can the authors explain more about the Type III test mentioned in the footnote? 2) Discussion: In the limitation paragraph, the authors mentioned concerns about the accuracy and validity of data. The authors added more about validation studies in the revision, which is good. But my original question is, what are specific concerns about the accuracy and validity of a claim database? For example, misclassification from doctors? As the authors mentioned, some people unfamiliar with the data might question the accuracy and validity, then what could be their specific question, and why might these concerns influence the results?	BMC	12916_2025_3886_ReviewerReport_V1_R1.pdf	{ "criticism": 3, "example": 1, "importance_and_relevance": 0, "materials_and_methods": 6, "praise": 2, "presentation_and_reporting": 1, "results_and_discussion": 4, "suggestion_and_solution": 2, "total": 11 }	{ "criticism": 0.2727272727272727, "example": 0.09090909090909091, "importance_and_relevance": 0, "materials_and_methods": 0.5454545454545454, "praise": 0.18181818181818182, "presentation_and_reporting": 0.09090909090909091, "results_and_discussion": 0.36363636363636365, "suggestion_and_solution": 0.18181818181818182 }	1.727273	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Association between general anesthesia for cesarean delivery and subsequent\ndevelopmental disorders in children: A nationwide retrospective cohort study\nVersion: 1 Date: 18 Sep 2024\nReviewer's report:\nThe authors carefully provided a point-by-point response to the comments and addressed most\nof the reviewers' concerns. I still have two remaining concerns about the manuscript.\n1) Results: Can the author provide a little more statistical information about the interaction\nanalysis on the Apgar score? I feel confused about the substantial significance of interaction\nterms while \"no significant association was found between anesthesia for cesarean delivery and\nsubsequent developmental disorders in either subgroup.\" In the additional file 5, the results for\nNA, Apgar score <7 and GA, Apgar Score < 7 groups were quite similar, but the interaction\np values were far from 0.05. Can the authors explain more about the Type III test mentioned\nin the footnote?\n2) Discussion: In the limitation paragraph, the authors mentioned concerns about the accuracy\nand validity of data. The authors added more about validation studies in the revision, which is\ngood. But my original question is, what are specific concerns about the accuracy and validity\nof a claim database? For example, misclassification from doctors? As the authors mentioned,\nsome people unfamiliar with the data might question the accuracy and validity, then what could\nbe their specific question, and why might these concerns influence the results?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03959-6	Reviewed - bmc_medicine	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 0 Date: 13 Sep 2024 Reviewer's report: Authors in this manuscript investigated clonal evolution in the context of breast cancer and proposed tumor clonal evolution rate as a prognostic indicator for metastatic breast cancer. In addition, authors also discussed the limitations of their study. I have the following comments which should be addressed before the manuscript can be accepted for publication. 1. Line 48- Space should be added after the word progression. 2. The word PFS should be expanded in text as it is being introduced for the first time here. 3. I would request the authors to add a flow chart describing the complete workflow as separate figure. This will help readers to easily understand process of ample selection and the analysis. 4. Authors mentioned that the study training set included 139 patients. Authors mentioned that they excluded patients who were currently undergoing neoadjuvant therapy. However, while selecting this training set did the authors also look if these patients had undergone any treatments before being enrolling in the study. If yes, how these treatments could affect the overall results?	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 0 Date: 13 Sep 2024 Reviewer's report: Authors in this manuscript investigated clonal evolution in the context of breast cancer and proposed tumor clonal evolution rate as a prognostic indicator for metastatic breast cancer. In addition, authors also discussed the limitations of their study. I have the following comments which should be addressed before the manuscript can be accepted for publication. 1. Line 48- Space should be added after the word progression. 2. The word PFS should be expanded in text as it is being introduced for the first time here. 3. I would request the authors to add a flow chart describing the complete workflow as separate figure. This will help readers to easily understand process of ample selection and the analysis. 4. Authors mentioned that the study training set included 139 patients. Authors mentioned that they excluded patients who were currently undergoing neoadjuvant therapy. However, while selecting this training set did the authors also look if these patients had undergone any treatments before being enrolling in the study. If yes, how these treatments could affect the overall results?	BMC	12916_2025_3959_ReviewerReport_V0_R2.pdf	{ "criticism": 0, "example": 1, "importance_and_relevance": 0, "materials_and_methods": 6, "praise": 1, "presentation_and_reporting": 4, "results_and_discussion": 1, "suggestion_and_solution": 4, "total": 15 }	{ "criticism": 0, "example": 0.06666666666666667, "importance_and_relevance": 0, "materials_and_methods": 0.4, "praise": 0.06666666666666667, "presentation_and_reporting": 0.26666666666666666, "results_and_discussion": 0.06666666666666667, "suggestion_and_solution": 0.26666666666666666 }	1.133333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as\na prognostic indicator in metastatic breast cancer\nVersion: 0 Date: 13 Sep 2024\nReviewer's report:\nAuthors in this manuscript investigated clonal evolution in the context of breast cancer and\nproposed tumor clonal evolution rate as a prognostic indicator for metastatic breast cancer. In\naddition, authors also discussed the limitations of their study. I have the following comments\nwhich should be addressed before the manuscript can be accepted for publication.\n1. Line 48- Space should be added after the word progression.\n2. The word PFS should be expanded in text as it is being introduced for the first time here.\n3. I would request the authors to add a flow chart describing the complete workflow as separate\nfigure. This will help readers to easily understand process of ample selection and the analysis.\n4. Authors mentioned that the study training set included 139 patients. Authors mentioned that\nthey excluded patients who were currently undergoing neoadjuvant therapy. However, while\nselecting this training set did the authors also look if these patients had undergone any treatments\nbefore being enrolling in the study. If yes, how these treatments could affect the overall results?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03959-6	Reviewed - bmc_medicine	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 0 Date: 01 Oct 2024 Reviewer's report: Lv, Lan and colleagues report on the analysis of breast tumor evolution in ctDNA liquid biopsies from patients with metastatic disease. The paper is generally well-written and the analyses appear to be performed with competence. The study included 406 MBC patients, although the power in survival analyses in the training cohort was limited due to missing followup to 86 or fewer patients. The results indicate that more rapidly evolving tumors (high tumor evolution rate), but those with linear evolution pattern (in contrast to branched evolution with many subclones) have poorer outcomes. While the results are interesting, there are a number of issues which need to be addressed: 1. These two observations (linear evolution = worse outcome, but high TER = worse outcome) are somewhat at odds with each other conceptually. Tumors that are able to select for advantageous mutations under therapeutic pressure (branched evolution and higher evolution rate) may have greater ability to resist treatment and progress. The authors should discuss this in greater detail. 2. Do the linear vs branched evolution survival analyses show similar results in the validation cohort? Only the results for TER are shown. 3. The authors should provide a better description of the number of blood samples collected per patient and the timing of the samples. This should be provided in both summarized form, such as in tables and the text, but also may be provided in indivualized form, such as a swimmer plot. How many patients had 2 timepoints, 3 timepoints, etc? What was the timeframe between timepoints and their relationship to treatments and progression/death? 4. The type of blood collection tubes and the volumes of blood and plasma should be described and also provided in summarized form. The yields of ctDNA per mL plasma should be provided. 5. The sentence “The allele frequency of a mutation is defined as the number of variant allele reads divided by the total number of reads in the sequencing” probably is a misstatement, in that the denominator is the total number of reads mapping to the variant position? 6. What is the performance characteristics of the ctDNA assay used? Above what MAF is a mutation reliably called? 7. Given that TER = (AFmax2/U2 - AFmax1/U1)/t, have the authors considered the effect of increased tumor burden? Conceptually, increased tumor burden will result in higher ctDNA concentrations in the plasma, which could mean that more genome copies (nanograms) of cfDNA is input into the sequencing. Depending on the noise-level of the sequencing, greater cfDNA ng input could simply be increasing the level of noise, which means a greater number of low allele frequency “mutations” (noise) will be detected. Conceptually, this could artificially increase the AFmax/U value but simply be a proxy for increased ctDNA and less related to subclonality. Have the authors considered this possibility? 8. In the 86 patients with PFS data and 2nd ctDNA test, was there any association between chemo vs no-chemo and linear vs branched evolution? 9. It would be good to if the authors would present information regarding specific mutations and molecular subtypes and adjuvant treatment and treatments between T1 and T2. For example, are most ESR1 mutants found in ER+ patients who received prior endocrine therapy? Are most PIK3CA mutants in ER+ and HER2+ disease? Is there an enrichment of TP53 mutation amongst HR-/HER2-? Perhaps this information could be illustrated in a patient-sample vs gene “heatmap” figure? 10. Several relevant prior publications should be cited at the appropriate places in the text: Dawson et al, N Engl J Med. 2013 Mar 28;368(13):1199-209; Garcia-Murillas et al, Sci Transl Med. 2015 Aug 26;7(302):302ra133; Olsson et al, EMBO Mol Med. 2015 Aug;7(8):1034-47; Hu et al, EBioMedicine. 2018 Jun:32:111-118; Liu et al, The Breast. 2022 Oct:65:116-123.	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 0 Date: 01 Oct 2024 Reviewer's report: Lv, Lan and colleagues report on the analysis of breast tumor evolution in ctDNA liquid biopsies from patients with metastatic disease. The paper is generally well-written and the analyses appear to be performed with competence. The study included 406 MBC patients, although the power in survival analyses in the training cohort was limited due to missing followup to 86 or fewer patients. The results indicate that more rapidly evolving tumors (high tumor evolution rate), but those with linear evolution pattern (in contrast to branched evolution with many subclones) have poorer outcomes. While the results are interesting, there are a number of issues which need to be addressed: 1. These two observations (linear evolution = worse outcome, but high TER = worse outcome) are somewhat at odds with each other conceptually. Tumors that are able to select for advantageous mutations under therapeutic pressure (branched evolution and higher evolution rate) may have greater ability to resist treatment and progress. The authors should discuss this in greater detail. 2. Do the linear vs branched evolution survival analyses show similar results in the validation cohort? Only the results for TER are shown. 3. The authors should provide a better description of the number of blood samples collected per patient and the timing of the samples. This should be provided in both summarized form, such as in tables and the text, but also may be provided in indivualized form, such as a swimmer plot. How many patients had 2 timepoints, 3 timepoints, etc? What was the timeframe between timepoints and their relationship to treatments and progression/death? 4. The type of blood collection tubes and the volumes of blood and plasma should be described and also provided in summarized form. The yields of ctDNA per mL plasma should be provided. 5. The sentence “The allele frequency of a mutation is defined as the number of variant allele reads divided by the total number of reads in the sequencing” probably is a misstatement, in that the denominator is the total number of reads mapping to the variant position? 6. What is the performance characteristics of the ctDNA assay used? Above what MAF is a mutation reliably called? 7. Given that TER = (AFmax2/U2 - AFmax1/U1)/t, have the authors considered the effect of increased tumor burden? Conceptually, increased tumor burden will result in higher ctDNA concentrations in the plasma, which could mean that more genome copies (nanograms) of cfDNA is input into the sequencing. Depending on the noise-level of the sequencing, greater cfDNA ng input could simply be increasing the level of noise, which means a greater number of low allele frequency “mutations” (noise) will be detected. Conceptually, this could artificially increase the AFmax/U value but simply be a proxy for increased ctDNA and less related to subclonality. Have the authors considered this possibility? 8. In the 86 patients with PFS data and 2nd ctDNA test, was there any association between chemo vs no-chemo and linear vs branched evolution? 9. It would be good to if the authors would present information regarding specific mutations and molecular subtypes and adjuvant treatment and treatments between T1 and T2. For example, are most ESR1 mutants found in ER+ patients who received prior endocrine therapy? Are most PIK3CA mutants in ER+ and HER2+ disease? Is there an enrichment of TP53 mutation amongst HR-/HER2-? Perhaps this information could be illustrated in a patient-sample vs gene “heatmap” figure? 10. Several relevant prior publications should be cited at the appropriate places in the text: Dawson et al, N Engl J Med. 2013 Mar 28;368(13):1199-209; Garcia-Murillas et al, Sci Transl Med. 2015 Aug 26;7(302):302ra133; Olsson et al, EMBO Mol Med. 2015 Aug;7(8):1034-47; Hu et al, EBioMedicine. 2018 Jun:32:111-118; Liu et al, The Breast. 2022 Oct:65:116-123.	BMC	12916_2025_3959_ReviewerReport_V0_R1.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 1, "materials_and_methods": 21, "praise": 2, "presentation_and_reporting": 10, "results_and_discussion": 7, "suggestion_and_solution": 11, "total": 45 }	{ "criticism": 0.044444444444444446, "example": 0.022222222222222223, "importance_and_relevance": 0.022222222222222223, "materials_and_methods": 0.4666666666666667, "praise": 0.044444444444444446, "presentation_and_reporting": 0.2222222222222222, "results_and_discussion": 0.15555555555555556, "suggestion_and_solution": 0.24444444444444444 }	1.222222	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as\na prognostic indicator in metastatic breast cancer\nVersion: 0 Date: 01 Oct 2024\nReviewer's report:\nLv, Lan and colleagues report on the analysis of breast tumor evolution in ctDNA liquid biopsies\nfrom patients with metastatic disease. The paper is generally well-written and the analyses\nappear to be performed with competence. The study included 406 MBC patients, although the\npower in survival analyses in the training cohort was limited due to missing followup to 86 or\nfewer patients. The results indicate that more rapidly evolving tumors (high tumor evolution\nrate), but those with linear evolution pattern (in contrast to branched evolution with many\nsubclones) have poorer outcomes. While the results are interesting, there are a number of issues\nwhich need to be addressed:\n1. These two observations (linear evolution = worse outcome, but high TER = worse outcome)\nare somewhat at odds with each other conceptually. Tumors that are able to select for\nadvantageous mutations under therapeutic pressure (branched evolution and higher evolution\nrate) may have greater ability to resist treatment and progress. The authors should discuss this\nin greater detail.\n2. Do the linear vs branched evolution survival analyses show similar results in the validation\ncohort? Only the results for TER are shown.\n3. The authors should provide a better description of the number of blood samples collected per\npatient and the timing of the samples. This should be provided in both summarized form, such\nas in tables and the text, but also may be provided in indivualized form, such as a swimmer\nplot. How many patients had 2 timepoints, 3 timepoints, etc? What was the timeframe between\ntimepoints and their relationship to treatments and progression/death?\n4. The type of blood collection tubes and the volumes of blood and plasma should be described\nand also provided in summarized form. The yields of ctDNA per mL plasma should be provided.\n5. The sentence “The allele frequency of a mutation is defined as the number of variant allele\nreads divided by the total number of reads in the sequencing” probably is a misstatement, in that\nthe denominator is the total number of reads mapping to the variant position?\n6. What is the performance characteristics of the ctDNA assay used? Above what MAF is a\nmutation reliably called?\n7. Given that TER = (AFmax2/U2 - AFmax1/U1)/t, have the authors considered the effect of\nincreased tumor burden? Conceptually, increased tumor burden will result in higher ctDNA\nconcentrations in the plasma, which could mean that more genome copies (nanograms) of\ncfDNA is input into the sequencing. Depending on the noise-level of the sequencing, greater\ncfDNA ng input could simply be increasing the level of noise, which means a greater number of\nlow allele frequency “mutations” (noise) will be detected. Conceptually, this could artificially\nincrease the AFmax/U value but simply be a proxy for increased ctDNA and less related to\nsubclonality. Have the authors considered this possibility?\n8. In the 86 patients with PFS data and 2nd ctDNA test, was there any association between\nchemo vs no-chemo and linear vs branched evolution?\n9. It would be good to if the authors would present information regarding specific mutations and\nmolecular subtypes and adjuvant treatment and treatments between T1 and T2. For example,\nare most ESR1 mutants found in ER+ patients who received prior endocrine therapy? Are\nmost PIK3CA mutants in ER+ and HER2+ disease? Is there an enrichment of TP53 mutation\namongst HR-/HER2-? Perhaps this information could be illustrated in a patient-sample vs gene\n“heatmap” figure?\n10. Several relevant prior publications should be cited at the appropriate places in the text:\nDawson et al, N Engl J Med. 2013 Mar 28;368(13):1199-209; Garcia-Murillas et al, Sci Transl\nMed. 2015 Aug 26;7(302):302ra133; Olsson et al, EMBO Mol Med. 2015 Aug;7(8):1034-47;\nHu et al, EBioMedicine. 2018 Jun:32:111-118; Liu et al, The Breast. 2022 Oct:65:116-123.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03959-6	Reviewed - bmc_medicine	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 1 Date: 08 Jan 2025 Reviewer's report: Thanks for addressing all my comments.	Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as a prognostic indicator in metastatic breast cancer Version: 1 Date: 08 Jan 2025 Reviewer's report: Thanks for addressing all my comments.	BMC	12916_2025_3959_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Exploration of the clonal evolution and construction of the tumor clonal evolution rate as\na prognostic indicator in metastatic breast cancer\nVersion: 1 Date: 08 Jan 2025\nReviewer's report:\nThanks for addressing all my comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03949-8	Reviewed - bmc_medicine	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 14 Aug 2024 Reviewer's report: This study investigates an important topic with a generally sound methodological approach. However, the potential for reverse causality between anti-hypertensive medication adherence and cognitive aging raises significant concerns about the interpretation of the findings. 1. The introduction states that "Hypertension is one major risk factor for dementia." While this is generally accepted, the cited Lancet Commission Report (2020) attributes only 1.9% of global dementia cases to midlife hypertension. This relatively low population-attributable fraction (PAF) might not seem like "major" to some readers. 2. Consider developing a more comprehensive SES index that incorporates multiple indicators, such as income, education, occupation, and potentially wealth indicators if available. This would provide a more nuanced and robust representation of socioeconomic status than relying on individual indicators separately. The approach used in the BMJ study (Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease, 2021, doi: https://doi.org/10.1136/bmj.n604) could serve as a useful reference. 3. To better understand the interplay between medication adherence and SES, I recommend exploring mediation and moderation effects. 4. On page 13, lines 16-17, the text states, "The proportion of anti-hypertensive medication use during wave 1 and wave 2 was presented in Figure 1B, showing an elevated proportion of using medication." However, the figure only seems to indicate a numerical increase in medication use, without any statistical analysis to support the claim of an actual "elevated proportion." Presenting this observation without statistical testing is misleading and lacks meaningful interpretation. Additionally, this sentence should end with a period, not a comma. 5. Figure 2 presents a perplexing finding: individuals with hypertension but high medication adherence exhibit significantly higher cognitive function than those with normal blood pressure. This raises concerns about potential reverse causality. Is it possible that individuals with higher cognitive function are simply more likely to adhere to their medication regimens? This could create the observed association without a true causal link between adherence and improved cognition. 6. Are there other variables (e.g., education level, socioeconomic status, access to healthcare) that could explain both higher adherence and better cognitive outcomes? The authors should address potential confounders in their analysis. 7. The second paragraph of the discussion feels unfocused and lacks conciseness. It primarily lists other studies without effectively comparing and contrasting their findings with the results of the current study. This approach diminishes the impact and clarity of the discussion. 8. The "Strengths" section would be more compelling if it focused on how the study's design and findings contribute new knowledge or challenge existing understandings. Currently, the listed strengths, while valid, don't fully highlight the study's unique value.	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 14 Aug 2024 Reviewer's report: This study investigates an important topic with a generally sound methodological approach. However, the potential for reverse causality between anti-hypertensive medication adherence and cognitive aging raises significant concerns about the interpretation of the findings. 1. The introduction states that "Hypertension is one major risk factor for dementia." While this is generally accepted, the cited Lancet Commission Report (2020) attributes only 1.9% of global dementia cases to midlife hypertension. This relatively low population-attributable fraction (PAF) might not seem like "major" to some readers. 2. Consider developing a more comprehensive SES index that incorporates multiple indicators, such as income, education, occupation, and potentially wealth indicators if available. This would provide a more nuanced and robust representation of socioeconomic status than relying on individual indicators separately. The approach used in the BMJ study (Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease, 2021, doi: https://doi.org/10.1136/bmj.n604) could serve as a useful reference. 3. To better understand the interplay between medication adherence and SES, I recommend exploring mediation and moderation effects. 4. On page 13, lines 16-17, the text states, "The proportion of anti-hypertensive medication use during wave 1 and wave 2 was presented in Figure 1B, showing an elevated proportion of using medication." However, the figure only seems to indicate a numerical increase in medication use, without any statistical analysis to support the claim of an actual "elevated proportion." Presenting this observation without statistical testing is misleading and lacks meaningful interpretation. Additionally, this sentence should end with a period, not a comma. 5. Figure 2 presents a perplexing finding: individuals with hypertension but high medication adherence exhibit significantly higher cognitive function than those with normal blood pressure. This raises concerns about potential reverse causality. Is it possible that individuals with higher cognitive function are simply more likely to adhere to their medication regimens? This could create the observed association without a true causal link between adherence and improved cognition. 6. Are there other variables (e.g., education level, socioeconomic status, access to healthcare) that could explain both higher adherence and better cognitive outcomes? The authors should address potential confounders in their analysis. 7. The second paragraph of the discussion feels unfocused and lacks conciseness. It primarily lists other studies without effectively comparing and contrasting their findings with the results of the current study. This approach diminishes the impact and clarity of the discussion. 8. The "Strengths" section would be more compelling if it focused on how the study's design and findings contribute new knowledge or challenge existing understandings. Currently, the listed strengths, while valid, don't fully highlight the study's unique value.	BMC	12916_2025_3949_ReviewerReport_V0_R1.pdf	{ "criticism": 6, "example": 2, "importance_and_relevance": 5, "materials_and_methods": 10, "praise": 2, "presentation_and_reporting": 4, "results_and_discussion": 8, "suggestion_and_solution": 7, "total": 32 }	{ "criticism": 0.1875, "example": 0.0625, "importance_and_relevance": 0.15625, "materials_and_methods": 0.3125, "praise": 0.0625, "presentation_and_reporting": 0.125, "results_and_discussion": 0.25, "suggestion_and_solution": 0.21875 }	1.375	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in\nthe Chinese community-dwelling middle-aged and older adults # 45 years: a population-based\nlongitudinal study\nVersion: 0 Date: 14 Aug 2024\nReviewer's report:\nThis study investigates an important topic with a generally sound methodological approach.\nHowever, the potential for reverse causality between anti-hypertensive medication adherence\nand cognitive aging raises significant concerns about the interpretation of the findings.\n1. The introduction states that \"Hypertension is one major risk factor for dementia.\" While\nthis is generally accepted, the cited Lancet Commission Report (2020) attributes only 1.9%\nof global dementia cases to midlife hypertension. This relatively low population-attributable\nfraction (PAF) might not seem like \"major\" to some readers.\n2. Consider developing a more comprehensive SES index that incorporates multiple indicators,\nsuch as income, education, occupation, and potentially wealth indicators if available. This would\nprovide a more nuanced and robust representation of socioeconomic status than relying on\nindividual indicators separately. The approach used in the BMJ study (Associations of healthy\nlifestyle and socioeconomic status with mortality and incident cardiovascular disease, 2021, doi:\nhttps://doi.org/10.1136/bmj.n604) could serve as a useful reference.\n3. To better understand the interplay between medication adherence and SES, I recommend\nexploring mediation and moderation effects.\n4. On page 13, lines 16-17, the text states, \"The proportion of anti-hypertensive medication use\nduring wave 1 and wave 2 was presented in Figure 1B, showing an elevated proportion of using\nmedication.\" However, the figure only seems to indicate a numerical increase in medication use,\nwithout any statistical analysis to support the claim of an actual \"elevated proportion.\" Presenting\nthis observation without statistical testing is misleading and lacks meaningful interpretation.\nAdditionally, this sentence should end with a period, not a comma.\n5. Figure 2 presents a perplexing finding: individuals with hypertension but high medication\nadherence exhibit significantly higher cognitive function than those with normal blood pressure.\nThis raises concerns about potential reverse causality. Is it possible that individuals with higher\ncognitive function are simply more likely to adhere to their medication regimens? This could\ncreate the observed association without a true causal link between adherence and improved\ncognition.\n6. Are there other variables (e.g., education level, socioeconomic status, access to healthcare)\nthat could explain both higher adherence and better cognitive outcomes? The authors should\naddress potential confounders in their analysis.\n7. The second paragraph of the discussion feels unfocused and lacks conciseness. It primarily\nlists other studies without effectively comparing and contrasting their findings with the results\nof the current study. This approach diminishes the impact and clarity of the discussion.\n8. The \"Strengths\" section would be more compelling if it focused on how the study's design and\nfindings contribute new knowledge or challenge existing understandings. Currently, the listed\nstrengths, while valid, don't fully highlight the study's unique value.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03949-8	Reviewed - bmc_medicine	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 03 Sep 2024 Reviewer's report: Please see the comments file.	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 03 Sep 2024 Reviewer's report: Please see the comments file.	BMC	12916_2025_3949_ReviewerReport_V0_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in\nthe Chinese community-dwelling middle-aged and older adults # 45 years: a population-based\nlongitudinal study\nVersion: 0 Date: 03 Sep 2024\nReviewer's report:\nPlease see the comments file.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03949-8	Reviewed - bmc_medicine	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 14 Nov 2024 Reviewer's report: Thank you for the invitation. This paper is generally well written. I have the following comments to the authors. 1. In the abstract section please provide more concrete data and also the P-value. The conclusion should be consistent with the main file. 2. In the introduction section, please make the flow more fluently and also state the knowledge gap clearly. 3. In the method section, some important parts for example participants enrollment and data collection should be described clearly. How to define the outcomes and the method used to analyze should be improved. 4. In the result sections, please provide important findings and also use more figures to illustrate the differences between groups. 5. In the discussion, authors should compare their findings with prior reports and also explain why similar or different. The implications should be specified. 6. Limitations should be expanded. 7. The statement of the conclusion should be toned down.	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 0 Date: 14 Nov 2024 Reviewer's report: Thank you for the invitation. This paper is generally well written. I have the following comments to the authors. 1. In the abstract section please provide more concrete data and also the P-value. The conclusion should be consistent with the main file. 2. In the introduction section, please make the flow more fluently and also state the knowledge gap clearly. 3. In the method section, some important parts for example participants enrollment and data collection should be described clearly. How to define the outcomes and the method used to analyze should be improved. 4. In the result sections, please provide important findings and also use more figures to illustrate the differences between groups. 5. In the discussion, authors should compare their findings with prior reports and also explain why similar or different. The implications should be specified. 6. Limitations should be expanded. 7. The statement of the conclusion should be toned down.	BMC	12916_2025_3949_ReviewerReport_V0_R3.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 3, "praise": 2, "presentation_and_reporting": 11, "results_and_discussion": 6, "suggestion_and_solution": 10, "total": 20 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.15, "praise": 0.1, "presentation_and_reporting": 0.55, "results_and_discussion": 0.3, "suggestion_and_solution": 0.5 }	1.6	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in\nthe Chinese community-dwelling middle-aged and older adults # 45 years: a population-based\nlongitudinal study\nVersion: 0 Date: 14 Nov 2024\nReviewer's report:\nThank you for the invitation. This paper is generally well written. I have the following comments\nto the authors.\n1. In the abstract section please provide more concrete data and also the P-value. The conclusion\nshould be consistent with the main file.\n2. In the introduction section, please make the flow more fluently and also state the knowledge\ngap clearly.\n3. In the method section, some important parts for example participants enrollment and data\ncollection should be described clearly. How to define the outcomes and the method used to\nanalyze should be improved.\n4. In the result sections, please provide important findings and also use more figures to illustrate\nthe differences between groups.\n5. In the discussion, authors should compare their findings with prior reports and also explain\nwhy similar or different. The implications should be specified.\n6. Limitations should be expanded.\n7. The statement of the conclusion should be toned down.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03949-8	Reviewed - bmc_medicine	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 1 Date: 03 Jan 2025 Reviewer's report: Thank you for your revisions. All the issues have been fully addressed.	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 1 Date: 03 Jan 2025 Reviewer's report: Thank you for your revisions. All the issues have been fully addressed.	BMC	12916_2025_3949_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0.5, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in\nthe Chinese community-dwelling middle-aged and older adults # 45 years: a population-based\nlongitudinal study\nVersion: 1 Date: 03 Jan 2025\nReviewer's report:\nThank you for your revisions. All the issues have been fully addressed.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03949-8	Reviewed - bmc_medicine	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 1 Date: 09 Jan 2025 Reviewer's report: The authors have addressed all my concerns and questions thoroughly. I have no further comments or suggestions. The manuscript is now significantly improved.	Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults # 45 years: a population-based longitudinal study Version: 1 Date: 09 Jan 2025 Reviewer's report: The authors have addressed all my concerns and questions thoroughly. I have no further comments or suggestions. The manuscript is now significantly improved.	BMC	12916_2025_3949_ReviewerReport_V1_R1.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 3 }	{ "criticism": 0.3333333333333333, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0.6666666666666666, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in\nthe Chinese community-dwelling middle-aged and older adults # 45 years: a population-based\nlongitudinal study\nVersion: 1 Date: 09 Jan 2025\nReviewer's report:\nThe authors have addressed all my concerns and questions thoroughly. I have no further\ncomments or suggestions. The manuscript is now significantly improved.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03936-z	Reviewed - bmc_medicine	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 20 Nov 2024 Reviewer: Giorgio Radetti Reviewer's report: I read with interest the paper by Guarino et al, concerning the relationship between thyroid Hormones, the metabolic derangement at the onset of Type 1 diabetes mellitus and renal function. The study has been well performed and paper is well written. Most of the results are in agreement with what has been previously reported on the influence of euthyroid sick syndrome on thyroid hormones, but other aspects are new, such as the increased sensitivity of the pituitary/ hypothalamus to thyroid hormones, which is the opposite of what has been previously reported. Perhaps the author should comment in the discussion, whether at the onset of diabetes a different milieu of cytokines, compared to other diseases, might explain this difference. Cytokines are known to negatively influence TSH secretion	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 20 Nov 2024 Reviewer: Giorgio Radetti Reviewer's report: I read with interest the paper by Guarino et al, concerning the relationship between thyroid Hormones, the metabolic derangement at the onset of Type 1 diabetes mellitus and renal function. The study has been well performed and paper is well written. Most of the results are in agreement with what has been previously reported on the influence of euthyroid sick syndrome on thyroid hormones, but other aspects are new, such as the increased sensitivity of the pituitary/ hypothalamus to thyroid hormones, which is the opposite of what has been previously reported. Perhaps the author should comment in the discussion, whether at the onset of diabetes a different milieu of cytokines, compared to other diseases, might explain this difference. Cytokines are known to negatively influence TSH secretion	BMC	12916_2025_3936_ReviewerReport_V0_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 0, "praise": 2, "presentation_and_reporting": 2, "results_and_discussion": 2, "suggestion_and_solution": 1, "total": 5 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.2, "materials_and_methods": 0, "praise": 0.4, "presentation_and_reporting": 0.4, "results_and_discussion": 0.4, "suggestion_and_solution": 0.2 }	1.6	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset\nof type 1 diabetes mellitus\nVersion: 0 Date: 20 Nov 2024\nReviewer: Giorgio Radetti\nReviewer's report:\nI read with interest the paper by Guarino et al, concerning the relationship between thyroid\nHormones, the metabolic derangement at the onset of Type 1 diabetes mellitus and renal\nfunction. The study has been well performed and paper is well written. Most of the results are in\nagreement with what has been previously reported on the influence of euthyroid sick syndrome\non thyroid hormones, but other aspects are new, such as the increased sensitivity of the pituitary/\nhypothalamus to thyroid hormones, which is the opposite of what has been previously reported.\nPerhaps the author should comment in the discussion, whether at the onset of diabetes a different\nmilieu of cytokines, compared to other diseases, might explain this difference. Cytokines are\nknown to negatively influence TSH secretion", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03936-z	Reviewed - bmc_medicine	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 18 Dec 2024 Reviewer's report:	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 18 Dec 2024 Reviewer's report:	BMC	12916_2025_3936_ReviewerReport_V0_R3.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset\nof type 1 diabetes mellitus\nVersion: 0 Date: 18 Dec 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03936-z	Reviewed - bmc_medicine	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 30 Dec 2024 Reviewer's report:	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 0 Date: 30 Dec 2024 Reviewer's report:	BMC	12916_2025_3936_ReviewerReport_V0_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset\nof type 1 diabetes mellitus\nVersion: 0 Date: 30 Dec 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03936-z	Reviewed - bmc_medicine	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 1 Date: 23 Jan 2025 Reviewer's report: The manuscript has been significantly improved by the revision. All my questions and points of criticism were dealt with adequately.	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 1 Date: 23 Jan 2025 Reviewer's report: The manuscript has been significantly improved by the revision. All my questions and points of criticism were dealt with adequately.	BMC	12916_2025_3936_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset\nof type 1 diabetes mellitus\nVersion: 1 Date: 23 Jan 2025\nReviewer's report:\nThe manuscript has been significantly improved by the revision. All my questions and points\nof criticism were dealt with adequately.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03936-z	Reviewed - bmc_medicine	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 1 Date: 23 Jan 2025 Reviewer: Giorgio Radetti Reviewer's report: The paper has been significantly improved, according to the reviewer's suggestions	Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset of type 1 diabetes mellitus Version: 1 Date: 23 Jan 2025 Reviewer: Giorgio Radetti Reviewer's report: The paper has been significantly improved, according to the reviewer's suggestions	BMC	12916_2025_3936_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Sensitivity to thyroid hormones in children developing acute kidney injury at the onset\nof type 1 diabetes mellitus\nVersion: 1 Date: 23 Jan 2025\nReviewer: Giorgio Radetti\nReviewer's report:\nThe paper has been significantly improved, according to the reviewer's suggestions", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03917-2	Reviewed - bmc_medicine	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 0 Date: 11 Dec 2024 Reviewer: Brendan Collins Reviewer's report: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Review by Dr Brendan Collins Overall this is a good study will be useful for health economic modellers and policy analysts going forward. I really like the methods and not sure if I have seen them used before- maybe this is the typical method used by IHME GBD. Seems a little big random to have chiropractor activity and not something else like mental health worker activity. Is it a cultural difference that lots of people in Norway see a chiropractor? I wasn’t sure what ‘well care’ is - is it like primary prevention ? Also what ‘impairments’ is specifically- as lots of different diseases and problems cause impairments. Would be good to explain these a little bit more. I am not sure I understand the rationale for the assumption that income elasticity will move towards 1 and residual growth towards zero by 2050 – I am not saying it is incorrect but it might be good to explain this a bit more and why it is chosen as the central scenario and not say the ‘cost pressures’ scenario. In the discussion it might be good to mention something about changes in multimorbidity and how this might affect future costs, as combinations or clusters of diseases may have different costs than the current sum of individual diseases. A few specific comments: Figure 2, some of the legend text goes over the coloured bit ‘GDP and residual growth’ Typo figure 3 legend, think it should say ‘Impairments’ Typo on figure 3 footnote – should say ‘calculating’ Overall a very nice paper.	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 0 Date: 11 Dec 2024 Reviewer: Brendan Collins Reviewer's report: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Review by Dr Brendan Collins Overall this is a good study will be useful for health economic modellers and policy analysts going forward. I really like the methods and not sure if I have seen them used before- maybe this is the typical method used by IHME GBD. Seems a little big random to have chiropractor activity and not something else like mental health worker activity. Is it a cultural difference that lots of people in Norway see a chiropractor? I wasn’t sure what ‘well care’ is - is it like primary prevention ? Also what ‘impairments’ is specifically- as lots of different diseases and problems cause impairments. Would be good to explain these a little bit more. I am not sure I understand the rationale for the assumption that income elasticity will move towards 1 and residual growth towards zero by 2050 – I am not saying it is incorrect but it might be good to explain this a bit more and why it is chosen as the central scenario and not say the ‘cost pressures’ scenario. In the discussion it might be good to mention something about changes in multimorbidity and how this might affect future costs, as combinations or clusters of diseases may have different costs than the current sum of individual diseases. A few specific comments: Figure 2, some of the legend text goes over the coloured bit ‘GDP and residual growth’ Typo figure 3 legend, think it should say ‘Impairments’ Typo on figure 3 footnote – should say ‘calculating’ Overall a very nice paper.	BMC	12916_2025_3917_ReviewerReport_V0_R1.pdf	{ "criticism": 3, "example": 1, "importance_and_relevance": 1, "materials_and_methods": 2, "praise": 2, "presentation_and_reporting": 3, "results_and_discussion": 2, "suggestion_and_solution": 5, "total": 10 }	{ "criticism": 0.3, "example": 0.1, "importance_and_relevance": 0.1, "materials_and_methods": 0.2, "praise": 0.2, "presentation_and_reporting": 0.3, "results_and_discussion": 0.2, "suggestion_and_solution": 0.5 }	1.9	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Forecasting total and cause-specific health expenditures for 116 health conditions in\nNorway, 2022-2050\nVersion: 0 Date: 11 Dec 2024\nReviewer: Brendan Collins\nReviewer's report:\nForecasting total and cause-specific health expenditures for 116 health conditions in Norway,\n2022-2050\nReview by Dr Brendan Collins\nOverall this is a good study will be useful for health economic modellers and policy analysts\ngoing forward. I really like the methods and not sure if I have seen them used before- maybe\nthis is the typical method used by IHME GBD.\nSeems a little big random to have chiropractor activity and not something else like mental health\nworker activity. Is it a cultural difference that lots of people in Norway see a chiropractor?\nI wasn’t sure what ‘well care’ is - is it like primary prevention ? Also what ‘impairments’ is\nspecifically- as lots of different diseases and problems cause impairments. Would be good to\nexplain these a little bit more.\nI am not sure I understand the rationale for the assumption that income elasticity will move\ntowards 1 and residual growth towards zero by 2050 – I am not saying it is incorrect but it might\nbe good to explain this a bit more and why it is chosen as the central scenario and not say the\n‘cost pressures’ scenario.\nIn the discussion it might be good to mention something about changes in multimorbidity and\nhow this might affect future costs, as combinations or clusters of diseases may have different\ncosts than the current sum of individual diseases.\nA few specific comments:\nFigure 2, some of the legend text goes over the coloured bit ‘GDP and residual growth’\nTypo figure 3 legend, think it should say ‘Impairments’\nTypo on figure 3 footnote – should say ‘calculating’\nOverall a very nice paper.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03917-2	Reviewed - bmc_medicine	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 0 Date: 15 Dec 2024 Reviewer: Tony Blakely Reviewer's report: Re: Kinge et al. Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 This is a fascinating and outstanding paper. It takes GBD historic and forecast disease rates for Norway, merges that with highly detailed disease expenditure from Norway, and forecasts future health spending for a base scenario and alternative scenarios – with drivers of change (increase) in expenditure decomposed into population size, aging, disease/epidemiological, and residual cost per case (assumed as price inflation per unit/prevalent case due to technology and other factors). Both health care and long-term care (e.g. aged care) are included in the concept of health spending (an important point, as exactly what is and is not considered health spending differs between countries and available data). The authors find substantial increases in total health spending, driven by all three of aging, population size and cost per case. (Slightly improving disease rates see disease projections slightly saving spending.) Whilst I think the paper is high quality and useful, there are a number of issues I found that in my view either need clarification or correction. My most important concerns are about the use of GDP. First, equations 1 and 2 in the main paper have GDP as covariates. It is not completely clear, but from the Supplement it appears this is GROSS GDP, not GDP per capita. Therefore, this is GDP per capita multiplied by population size. Which would mean this variable is capturing BOTH changes in population size and income (as reflected by GDP per capita), which would surely violate the assumptions of the method. (As the coefficient would be capturing population growth in Norway (about 1% per year) as a predictor of cost per prevalent case, which would (I think) UNDERESTIMATE the true impact of income (i.e. GDP per capita) on cost per prevalent case – yes?) Whether Gross GDP or GDP per capita is used in equations 1 and 2 needs clarifying, and if it is the former isn’t that erroneous? Second is the GDP forecasts for Norway. Whilst these are an important input to the method, the authors do not present these forecasts in the main paper or Appendix; they need to be. So I went back to the source cited (https://ghdx.healthdata.org/record/ihme-data/global-gdp-per- capita-1960-2050), the IHME forecasts. This is what I found for the GBD forecast for Norway: Which is odd indeed (i.e. no forecast increase in GPD per capita). So I checked Sweden: Which seems more plausible. Back to Norway, something is amiss here. Either the IHME tool I looked GDP per capita up is incorrect (and there truly is a forecast increase in GDP per capita data used in this paper), or the results for cost per case in the paper (e.g. last column of ‘unit cost’ in Table 2) are purely driven by ‘residual’ trend represented by #_2^HCE and not actually by GDP per capita. (Although if my concerns above about GROSS GDP being used in equations 1 and 2 is correct, then the validity of the coefficients is in question in the first place.) Thes above two concerns together, if correct, would affect interpretation throughout the Results and Discussion. A third concern I have about GDP is its assumption of being EXOGENOUS to predicting health care spending. In another GBD paper in the Lancet in 2024, that on fertility, they cite various studies about per capita income growth, including this one 1 that points to population growth being more likely to see negative GDP per capita growth than natural resource limits. Hard to know what it means in the current Norwegian study, but the validity of future GDP per capita increases being slowed by population growth may require mention. This might be viewed as similar to the ‘Baumols effect’ described in the supplement . Other issues I noted include: In addition to comparing the future growth rates of health spending in this study with previous studies as a cross-validation, was a back-validation undertaken where the equations in inputs were used to estimate past total health expenditure and this compared to national health accounts? Lines 166 to 169. The inclusion of X_(c,t)^' in equation 1 and 2 makes sense. But does this mean the forecasting needs to also include the confounding compositional variables as well? If not, then am I correct in assuming the future health spending estimates in this study assume the compositional variables as at 2023 continue? (This is not a major issue – perhaps for the Supplement.) Lines 239-40. For unfamiliar readers, I would spell out what these elasticity coefficients actually mean, i.e. “for each 1 percent increase in GDP per capita, a 0.554% (95% UI 0.4XX to 0.7XX) spending per prevalent case was estimated.” Lines 246 to 247. The % of GDP spent on health is quite sensitive to the GPD forecasts – yes? (And note above for my concerns about Norwegian per Capita GDP used.) Would it pay to given some sensitivity analyses for (say) 50% less and 50% more GPD growth over the forecast period? Where this not only effects the denominator in these lines of text, but also the input to the whole method? (Or include generous uncertainty about GDP growth in the Monet Carlo simulations, and back out with a tornado plot (or similar) how much the uncertainty in GDP per capita growth drives uncertainty in the final “% of GDP” estimates.) Lines 312 to 314. It is not clear to me “how the government allocates it resources” is pivotal. Are the authors getting at the fact the model forecasts based on historic relationships. But future Governments can cap allocation in salaries, or secondary care, etc, and therefore the equations become ‘redundant’ because future policy alters what happens? Or something else? I think this paragraph could be expanded. Lines 319 to 323 are similar to above. So essentially, the authors are saying “we can change the relationships of the past (and equations we used in this study) through policy”. Which is important, in explicitly recognizing that the equations used in this study (whilst really useful) are not an immutable force of nature – we can alter it. Yes? Lines 335 to 339. This is not an issue specific to Norway. It is certainly the case in Australia, and I think many other countries. That generality might warrant emphasis. Line 355 to 358. The point is well made, and critical. The Results of the paper ‘just’ give health spending in aggregate, without considering the size of the population. If the working age population is proportionately increased by some policy, it may REDUCE per capita health care spending (especially if using the working age population as the denominator, as they will be the ones paying the income tax to support the aging population). Lines 364 to 367. In high-level terms, this covers some of my above comments – I do wonder, though, whether more expansion is necessary. Table 2. If this paper uses GDP per capita forecasts that have no increases in GDP per capita, then the reader needs to be alerted to the Unit Costs in last column only arising from the residual trend (i.e. GDP per capita increases absent). If the forecast I found in IHME data is incorrect, and the forecast used in this paper indeed has increasing GDP per capita: It would be useful for the reader to have that increase in cost per case disaggregated by per capita GDP driver and residual increase in trend. And perhaps the sensitivity analyses above about variation in future GDP per capita forecasts. Figure 3 right hand panel invites more questions than it answers. For example, are the negative contributions (i.e. below the horizontal) due to increasing population size and age? Surely they are. Then I flick back to Figure 2, and carefully compare C with A and D with B. I need some help interpreting Figure 2 more; I suggest the authors need some more text on Figure 2 in their Results. For example, why does cost per case for LTC go up from the reference to reduced risk scenario? I cannot make sense of this. Some assistance in the text would help. Tony Blakely 1. Mino K, Sasaki H. Long-run consequences of population decline in an economy with exhaustible resources. Economic Modelling 2023;121. DOI: 10.1016/j.econmod.2023.106212.	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 0 Date: 15 Dec 2024 Reviewer: Tony Blakely Reviewer's report: Re: Kinge et al. Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 This is a fascinating and outstanding paper. It takes GBD historic and forecast disease rates for Norway, merges that with highly detailed disease expenditure from Norway, and forecasts future health spending for a base scenario and alternative scenarios – with drivers of change (increase) in expenditure decomposed into population size, aging, disease/epidemiological, and residual cost per case (assumed as price inflation per unit/prevalent case due to technology and other factors). Both health care and long-term care (e.g. aged care) are included in the concept of health spending (an important point, as exactly what is and is not considered health spending differs between countries and available data). The authors find substantial increases in total health spending, driven by all three of aging, population size and cost per case. (Slightly improving disease rates see disease projections slightly saving spending.) Whilst I think the paper is high quality and useful, there are a number of issues I found that in my view either need clarification or correction. My most important concerns are about the use of GDP. First, equations 1 and 2 in the main paper have GDP as covariates. It is not completely clear, but from the Supplement it appears this is GROSS GDP, not GDP per capita. Therefore, this is GDP per capita multiplied by population size. Which would mean this variable is capturing BOTH changes in population size and income (as reflected by GDP per capita), which would surely violate the assumptions of the method. (As the coefficient would be capturing population growth in Norway (about 1% per year) as a predictor of cost per prevalent case, which would (I think) UNDERESTIMATE the true impact of income (i.e. GDP per capita) on cost per prevalent case – yes?) Whether Gross GDP or GDP per capita is used in equations 1 and 2 needs clarifying, and if it is the former isn’t that erroneous? Second is the GDP forecasts for Norway. Whilst these are an important input to the method, the authors do not present these forecasts in the main paper or Appendix; they need to be. So I went back to the source cited (https://ghdx.healthdata.org/record/ihme-data/global-gdp-per- capita-1960-2050), the IHME forecasts. This is what I found for the GBD forecast for Norway: Which is odd indeed (i.e. no forecast increase in GPD per capita). So I checked Sweden: Which seems more plausible. Back to Norway, something is amiss here. Either the IHME tool I looked GDP per capita up is incorrect (and there truly is a forecast increase in GDP per capita data used in this paper), or the results for cost per case in the paper (e.g. last column of ‘unit cost’ in Table 2) are purely driven by ‘residual’ trend represented by #_2^HCE and not actually by GDP per capita. (Although if my concerns above about GROSS GDP being used in equations 1 and 2 is correct, then the validity of the coefficients is in question in the first place.) Thes above two concerns together, if correct, would affect interpretation throughout the Results and Discussion. A third concern I have about GDP is its assumption of being EXOGENOUS to predicting health care spending. In another GBD paper in the Lancet in 2024, that on fertility, they cite various studies about per capita income growth, including this one 1 that points to population growth being more likely to see negative GDP per capita growth than natural resource limits. Hard to know what it means in the current Norwegian study, but the validity of future GDP per capita increases being slowed by population growth may require mention. This might be viewed as similar to the ‘Baumols effect’ described in the supplement . Other issues I noted include: In addition to comparing the future growth rates of health spending in this study with previous studies as a cross-validation, was a back-validation undertaken where the equations in inputs were used to estimate past total health expenditure and this compared to national health accounts? Lines 166 to 169. The inclusion of X_(c,t)^' in equation 1 and 2 makes sense. But does this mean the forecasting needs to also include the confounding compositional variables as well? If not, then am I correct in assuming the future health spending estimates in this study assume the compositional variables as at 2023 continue? (This is not a major issue – perhaps for the Supplement.) Lines 239-40. For unfamiliar readers, I would spell out what these elasticity coefficients actually mean, i.e. “for each 1 percent increase in GDP per capita, a 0.554% (95% UI 0.4XX to 0.7XX) spending per prevalent case was estimated.” Lines 246 to 247. The % of GDP spent on health is quite sensitive to the GPD forecasts – yes? (And note above for my concerns about Norwegian per Capita GDP used.) Would it pay to given some sensitivity analyses for (say) 50% less and 50% more GPD growth over the forecast period? Where this not only effects the denominator in these lines of text, but also the input to the whole method? (Or include generous uncertainty about GDP growth in the Monet Carlo simulations, and back out with a tornado plot (or similar) how much the uncertainty in GDP per capita growth drives uncertainty in the final “% of GDP” estimates.) Lines 312 to 314. It is not clear to me “how the government allocates it resources” is pivotal. Are the authors getting at the fact the model forecasts based on historic relationships. But future Governments can cap allocation in salaries, or secondary care, etc, and therefore the equations become ‘redundant’ because future policy alters what happens? Or something else? I think this paragraph could be expanded. Lines 319 to 323 are similar to above. So essentially, the authors are saying “we can change the relationships of the past (and equations we used in this study) through policy”. Which is important, in explicitly recognizing that the equations used in this study (whilst really useful) are not an immutable force of nature – we can alter it. Yes? Lines 335 to 339. This is not an issue specific to Norway. It is certainly the case in Australia, and I think many other countries. That generality might warrant emphasis. Line 355 to 358. The point is well made, and critical. The Results of the paper ‘just’ give health spending in aggregate, without considering the size of the population. If the working age population is proportionately increased by some policy, it may REDUCE per capita health care spending (especially if using the working age population as the denominator, as they will be the ones paying the income tax to support the aging population). Lines 364 to 367. In high-level terms, this covers some of my above comments – I do wonder, though, whether more expansion is necessary. Table 2. If this paper uses GDP per capita forecasts that have no increases in GDP per capita, then the reader needs to be alerted to the Unit Costs in last column only arising from the residual trend (i.e. GDP per capita increases absent). If the forecast I found in IHME data is incorrect, and the forecast used in this paper indeed has increasing GDP per capita: It would be useful for the reader to have that increase in cost per case disaggregated by per capita GDP driver and residual increase in trend. And perhaps the sensitivity analyses above about variation in future GDP per capita forecasts. Figure 3 right hand panel invites more questions than it answers. For example, are the negative contributions (i.e. below the horizontal) due to increasing population size and age? Surely they are. Then I flick back to Figure 2, and carefully compare C with A and D with B. I need some help interpreting Figure 2 more; I suggest the authors need some more text on Figure 2 in their Results. For example, why does cost per case for LTC go up from the reference to reduced risk scenario? I cannot make sense of this. Some assistance in the text would help. Tony Blakely 1. Mino K, Sasaki H. Long-run consequences of population decline in an economy with exhaustible resources. Economic Modelling 2023;121. DOI: 10.1016/j.econmod.2023.106212.	BMC	12916_2025_3917_ReviewerReport_V0_R2.pdf	{ "criticism": 8, "example": 12, "importance_and_relevance": 4, "materials_and_methods": 23, "praise": 4, "presentation_and_reporting": 10, "results_and_discussion": 11, "suggestion_and_solution": 18, "total": 82 }	{ "criticism": 0.0975609756097561, "example": 0.14634146341463414, "importance_and_relevance": 0.04878048780487805, "materials_and_methods": 0.2804878048780488, "praise": 0.04878048780487805, "presentation_and_reporting": 0.12195121951219512, "results_and_discussion": 0.13414634146341464, "suggestion_and_solution": 0.21951219512195122 }	1.097561	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Forecasting total and cause-specific health expenditures for 116 health conditions in\nNorway, 2022-2050\nVersion: 0 Date: 15 Dec 2024\nReviewer: Tony Blakely\nReviewer's report:\nRe: Kinge et al. Forecasting total and cause-specific health expenditures for 116 health\nconditions in Norway, 2022-2050\nThis is a fascinating and outstanding paper. It takes GBD historic and forecast disease rates\nfor Norway, merges that with highly detailed disease expenditure from Norway, and forecasts\nfuture health spending for a base scenario and alternative scenarios – with drivers of change\n(increase) in expenditure decomposed into population size, aging, disease/epidemiological, and\nresidual cost per case (assumed as price inflation per unit/prevalent case due to technology\nand other factors). Both health care and long-term care (e.g. aged care) are included in the\nconcept of health spending (an important point, as exactly what is and is not considered health\nspending differs between countries and available data). The authors find substantial increases\nin total health spending, driven by all three of aging, population size and cost per case. (Slightly\nimproving disease rates see disease projections slightly saving spending.)\nWhilst I think the paper is high quality and useful, there are a number of issues I found that in\nmy view either need clarification or correction.\nMy most important concerns are about the use of GDP.\nFirst, equations 1 and 2 in the main paper have GDP as covariates. It is not completely clear,\nbut from the Supplement it appears this is GROSS GDP, not GDP per capita. Therefore, this\nis GDP per capita multiplied by population size. Which would mean this variable is capturing\nBOTH changes in population size and income (as reflected by GDP per capita), which would\nsurely violate the assumptions of the method. (As the coefficient would be capturing population\ngrowth in Norway (about 1% per year) as a predictor of cost per prevalent case, which would (I\nthink) UNDERESTIMATE the true impact of income (i.e. GDP per capita) on cost per prevalent\ncase – yes?) Whether Gross GDP or GDP per capita is used in equations 1 and 2 needs clarifying,\nand if it is the former isn’t that erroneous?\nSecond is the GDP forecasts for Norway. Whilst these are an important input to the method,\nthe authors do not present these forecasts in the main paper or Appendix; they need to be. So\nI went back to the source cited (https://ghdx.healthdata.org/record/ihme-data/global-gdp-per-\ncapita-1960-2050), the IHME forecasts. This is what I found for the GBD forecast for Norway:\nWhich is odd indeed (i.e. no forecast increase in GPD per capita). So I checked Sweden:\nWhich seems more plausible.\nBack to Norway, something is amiss here. Either the IHME tool I looked GDP per capita up is\nincorrect (and there truly is a forecast increase in GDP per capita data used in this paper), or the\nresults for cost per case in the paper (e.g. last column of ‘unit cost’ in Table 2) are purely driven\nby ‘residual’ trend represented by #_2^HCE and not actually by GDP per capita. (Although\nif my concerns above about GROSS GDP being used in equations 1 and 2 is correct, then the\nvalidity of the coefficients is in question in the first place.)\nThes above two concerns together, if correct, would affect interpretation throughout the Results\nand Discussion.\nA third concern I have about GDP is its assumption of being EXOGENOUS to predicting health\ncare spending. In another GBD paper in the Lancet in 2024, that on fertility, they cite various\nstudies about per capita income growth, including this one 1 that points to population growth\nbeing more likely to see negative GDP per capita growth than natural resource limits. Hard to\nknow what it means in the current Norwegian study, but the validity of future GDP per capita\nincreases being slowed by population growth may require mention. This might be viewed as\nsimilar to the ‘Baumols effect’ described in the supplement .\nOther issues I noted include:\nIn addition to comparing the future growth rates of health spending in this study with previous\nstudies as a cross-validation, was a back-validation undertaken where the equations in inputs\nwere used to estimate past total health expenditure and this compared to national health\naccounts?\nLines 166 to 169. The inclusion of X_(c,t)^' in equation 1 and 2 makes sense. But does this\nmean the forecasting needs to also include the confounding compositional variables as well?\nIf not, then am I correct in assuming the future health spending estimates in this study assume\nthe compositional variables as at 2023 continue? (This is not a major issue – perhaps for the\nSupplement.)\nLines 239-40. For unfamiliar readers, I would spell out what these elasticity coefficients actually\nmean, i.e. “for each 1 percent increase in GDP per capita, a 0.554% (95% UI 0.4XX to 0.7XX)\nspending per prevalent case was estimated.”\nLines 246 to 247. The % of GDP spent on health is quite sensitive to the GPD forecasts – yes?\n(And note above for my concerns about Norwegian per Capita GDP used.) Would it pay to\ngiven some sensitivity analyses for (say) 50% less and 50% more GPD growth over the forecast\nperiod? Where this not only effects the denominator in these lines of text, but also the input\nto the whole method? (Or include generous uncertainty about GDP growth in the Monet Carlo\nsimulations, and back out with a tornado plot (or similar) how much the uncertainty in GDP per\ncapita growth drives uncertainty in the final “% of GDP” estimates.)\nLines 312 to 314. It is not clear to me “how the government allocates it resources” is pivotal.\nAre the authors getting at the fact the model forecasts based on historic relationships. But future\nGovernments can cap allocation in salaries, or secondary care, etc, and therefore the equations\nbecome ‘redundant’ because future policy alters what happens? Or something else? I think this\nparagraph could be expanded.\nLines 319 to 323 are similar to above. So essentially, the authors are saying “we can change\nthe relationships of the past (and equations we used in this study) through policy”. Which is\nimportant, in explicitly recognizing that the equations used in this study (whilst really useful)\nare not an immutable force of nature – we can alter it. Yes?\nLines 335 to 339. This is not an issue specific to Norway. It is certainly the case in Australia,\nand I think many other countries. That generality might warrant emphasis.\nLine 355 to 358. The point is well made, and critical. The Results of the paper ‘just’ give\nhealth spending in aggregate, without considering the size of the population. If the working age\npopulation is proportionately increased by some policy, it may REDUCE per capita health care\nspending (especially if using the working age population as the denominator, as they will be the\nones paying the income tax to support the aging population).\nLines 364 to 367. In high-level terms, this covers some of my above comments – I do wonder,\nthough, whether more expansion is necessary.\nTable 2. If this paper uses GDP per capita forecasts that have no increases in GDP per capita,\nthen the reader needs to be alerted to the Unit Costs in last column only arising from the residual\ntrend (i.e. GDP per capita increases absent). If the forecast I found in IHME data is incorrect,\nand the forecast used in this paper indeed has increasing GDP per capita:\nIt would be useful for the reader to have that increase in cost per case disaggregated by per capita\nGDP driver and residual increase in trend.\nAnd perhaps the sensitivity analyses above about variation in future GDP per capita forecasts.\nFigure 3 right hand panel invites more questions than it answers. For example, are the negative\ncontributions (i.e. below the horizontal) due to increasing population size and age? Surely they\nare. Then I flick back to Figure 2, and carefully compare C with A and D with B. I need some\nhelp interpreting Figure 2 more; I suggest the authors need some more text on Figure 2 in their\nResults. For example, why does cost per case for LTC go up from the reference to reduced risk\nscenario? I cannot make sense of this. Some assistance in the text would help.\nTony Blakely\n1. Mino K, Sasaki H. Long-run consequences of population decline in an economy with\nexhaustible resources. Economic Modelling 2023;121. DOI: 10.1016/j.econmod.2023.106212.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03917-2	Reviewed - bmc_medicine	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 1 Date: 16 Jan 2025 Reviewer: Brendan Collins Reviewer's report: Happy with all of the responses and changes made.	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 1 Date: 16 Jan 2025 Reviewer: Brendan Collins Reviewer's report: Happy with all of the responses and changes made.	BMC	12916_2025_3917_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Forecasting total and cause-specific health expenditures for 116 health conditions in\nNorway, 2022-2050\nVersion: 1 Date: 16 Jan 2025\nReviewer: Brendan Collins\nReviewer's report:\nHappy with all of the responses and changes made.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03917-2	Reviewed - bmc_medicine	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 1 Date: 17 Jan 2025 Reviewer: Tony Blakely Reviewer's report: The authors have addressed all my comments. I look forward to seeing the paper in print/on-line.	Title: Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050 Version: 1 Date: 17 Jan 2025 Reviewer: Tony Blakely Reviewer's report: The authors have addressed all my comments. I look forward to seeing the paper in print/on-line.	BMC	12916_2025_3917_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0.5, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Forecasting total and cause-specific health expenditures for 116 health conditions in\nNorway, 2022-2050\nVersion: 1 Date: 17 Jan 2025\nReviewer: Tony Blakely\nReviewer's report:\nThe authors have addressed all my comments. I look forward to seeing the paper in print/on-line.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 26 Jun 2024 Reviewer's report: The authors described the link between dietary patterns and premature aging. It is well-written and with a strong methodology. The use of the DAI is a good proxy of premature aging. Working on diet patterns in this specific population is novel and confirms the usefulness of plant-based diet patterns found in other populations. The results are consistent with previous literature. My specific comments are as follows: Methods: L70: How were the extreme energy intakes identified? Several methods exist (basal metabolic rate as estimated by the Henry equation, for example). L90: The way the dietary patterns are identified is crucial for this study. Thus, a complete description of the method could be added to the supplementary materials. L118: “(female and male).” there should be a comma instead of the period. A description of the statistical software and its version is needed. Results: Table 1: were lsmeans used for group-by-group comparisons? If not, it could be interesting to confirm the significant differences. Supplementary Table 1: SD should be added to understand the variation in the food intake. Comparison between food patterns could also be done. L142: “All dietary patterns were associated with the DAI.” I am not sure what you meant by this sentence. If you are talking about correlations between DAI and dietary patterns, it is not shown in Supplementary Table 3. Table 2: the total number of individuals in the study should be stated in the title. L151-152: this sentence is not very clear and could be simplified. Figure 1: the total number of individuals in the study should be stated in the title. What is the purpose of panel D? If I understand correctly, it is the opposite of panel A and thus should be in supplementary figure 1. Discussion: L199-206: to complete the discussion, it should be interesting to discuss the level of protein consumption, which is highly above the recommendation in Western diets (Mariotti and Gardner, 2019) L218: highest diet quality score or the best diet quality	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 26 Jun 2024 Reviewer's report: The authors described the link between dietary patterns and premature aging. It is well-written and with a strong methodology. The use of the DAI is a good proxy of premature aging. Working on diet patterns in this specific population is novel and confirms the usefulness of plant-based diet patterns found in other populations. The results are consistent with previous literature. My specific comments are as follows: Methods: L70: How were the extreme energy intakes identified? Several methods exist (basal metabolic rate as estimated by the Henry equation, for example). L90: The way the dietary patterns are identified is crucial for this study. Thus, a complete description of the method could be added to the supplementary materials. L118: “(female and male).” there should be a comma instead of the period. A description of the statistical software and its version is needed. Results: Table 1: were lsmeans used for group-by-group comparisons? If not, it could be interesting to confirm the significant differences. Supplementary Table 1: SD should be added to understand the variation in the food intake. Comparison between food patterns could also be done. L142: “All dietary patterns were associated with the DAI.” I am not sure what you meant by this sentence. If you are talking about correlations between DAI and dietary patterns, it is not shown in Supplementary Table 3. Table 2: the total number of individuals in the study should be stated in the title. L151-152: this sentence is not very clear and could be simplified. Figure 1: the total number of individuals in the study should be stated in the title. What is the purpose of panel D? If I understand correctly, it is the opposite of panel A and thus should be in supplementary figure 1. Discussion: L199-206: to complete the discussion, it should be interesting to discuss the level of protein consumption, which is highly above the recommendation in Western diets (Mariotti and Gardner, 2019) L218: highest diet quality score or the best diet quality	BMC	12916_2025_3940_ReviewerReport_V0_R2.pdf	{ "criticism": 2, "example": 4, "importance_and_relevance": 1, "materials_and_methods": 10, "praise": 4, "presentation_and_reporting": 11, "results_and_discussion": 5, "suggestion_and_solution": 11, "total": 23 }	{ "criticism": 0.08695652173913043, "example": 0.17391304347826086, "importance_and_relevance": 0.043478260869565216, "materials_and_methods": 0.43478260869565216, "praise": 0.17391304347826086, "presentation_and_reporting": 0.4782608695652174, "results_and_discussion": 0.21739130434782608, "suggestion_and_solution": 0.4782608695652174 }	2.086957	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 0 Date: 26 Jun 2024\nReviewer's report:\nThe authors described the link between dietary patterns and premature aging. It is well-written\nand with a strong methodology. The use of the DAI is a good proxy of premature aging. Working\non diet patterns in this specific population is novel and confirms the usefulness of plant-based\ndiet patterns found in other populations. The results are consistent with previous literature.\nMy specific comments are as follows:\nMethods:\nL70: How were the extreme energy intakes identified? Several methods exist (basal metabolic\nrate as estimated by the Henry equation, for example).\nL90: The way the dietary patterns are identified is crucial for this study. Thus, a complete\ndescription of the method could be added to the supplementary materials.\nL118: “(female and male).” there should be a comma instead of the period.\nA description of the statistical software and its version is needed.\nResults:\nTable 1: were lsmeans used for group-by-group comparisons? If not, it could be interesting to\nconfirm the significant differences.\nSupplementary Table 1: SD should be added to understand the variation in the food intake.\nComparison between food patterns could also be done.\nL142: “All dietary patterns were associated with the DAI.” I am not sure what you meant by\nthis sentence. If you are talking about correlations between DAI and dietary patterns, it is not\nshown in Supplementary Table 3.\nTable 2: the total number of individuals in the study should be stated in the title.\nL151-152: this sentence is not very clear and could be simplified.\nFigure 1: the total number of individuals in the study should be stated in the title. What is the\npurpose of panel D? If I understand correctly, it is the opposite of panel A and thus should be\nin supplementary figure 1.\nDiscussion:\nL199-206: to complete the discussion, it should be interesting to discuss the level of protein\nconsumption, which is highly above the recommendation in Western diets (Mariotti and\nGardner, 2019)\nL218: highest diet quality score or the best diet quality", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 27 Aug 2024 Reviewer's report: To the authors, The authors are providing an important overview of the effect of dietary patterns and aging on adult survivors of childhood cancer. A diet rich in fibre and micronutrients can improve health in general. It is interesting how the identified dietary patterns are distributed by sex, educational level and socioeconomical status. The results seem to be consistent for the studied population and supported by previous findings. However, there are few minor observations: -In the abstract, the methods section, the last sentence should be improved to clearly state the outcome. -Introduction, second paragraph: “However, the role of diet in aging in adult survivors of childhood cancer, whose cancer treatments may already have a detrimental impact on aging is not known”. This statement is important, would you provide a reference. And, in the same paragraph, review the next sentence, it seems incomplete. -For the adjustments would be interesting to have a specific physical activity indicator for the adjustments. Is it available? And if so, is it possible to add it. -I found interesting the results of smoking (never) in the multivariable models, but they are not commented in the discussion. Any chance to know if some of them are exposed to second hand smoking? -Regardless the dietary pattern, alcohol intake might influence the proposed outcome. It might be useful to run a sensitivity analysis either adjusting for or excluding alcohol from the equation. -To strength your results and potential recommendations, you should consider to add a substitutional analysis, to check how the DAI could improve by substituting a % of the other diets with the % of plant-based diet.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 27 Aug 2024 Reviewer's report: To the authors, The authors are providing an important overview of the effect of dietary patterns and aging on adult survivors of childhood cancer. A diet rich in fibre and micronutrients can improve health in general. It is interesting how the identified dietary patterns are distributed by sex, educational level and socioeconomical status. The results seem to be consistent for the studied population and supported by previous findings. However, there are few minor observations: -In the abstract, the methods section, the last sentence should be improved to clearly state the outcome. -Introduction, second paragraph: “However, the role of diet in aging in adult survivors of childhood cancer, whose cancer treatments may already have a detrimental impact on aging is not known”. This statement is important, would you provide a reference. And, in the same paragraph, review the next sentence, it seems incomplete. -For the adjustments would be interesting to have a specific physical activity indicator for the adjustments. Is it available? And if so, is it possible to add it. -I found interesting the results of smoking (never) in the multivariable models, but they are not commented in the discussion. Any chance to know if some of them are exposed to second hand smoking? -Regardless the dietary pattern, alcohol intake might influence the proposed outcome. It might be useful to run a sensitivity analysis either adjusting for or excluding alcohol from the equation. -To strength your results and potential recommendations, you should consider to add a substitutional analysis, to check how the DAI could improve by substituting a % of the other diets with the % of plant-based diet.	BMC	12916_2025_3940_ReviewerReport_V0_R5.pdf	{ "criticism": 3, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 7, "praise": 3, "presentation_and_reporting": 5, "results_and_discussion": 6, "suggestion_and_solution": 6, "total": 16 }	{ "criticism": 0.1875, "example": 0, "importance_and_relevance": 0.0625, "materials_and_methods": 0.4375, "praise": 0.1875, "presentation_and_reporting": 0.3125, "results_and_discussion": 0.375, "suggestion_and_solution": 0.375 }	1.9375	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 0 Date: 27 Aug 2024\nReviewer's report:\nTo the authors,\nThe authors are providing an important overview of the effect of dietary patterns and aging on\nadult survivors of childhood cancer. A diet rich in fibre and micronutrients can improve health\nin general. It is interesting how the identified dietary patterns are distributed by sex, educational\nlevel and socioeconomical status. The results seem to be consistent for the studied population\nand supported by previous findings.\nHowever, there are few minor observations:\n-In the abstract, the methods section, the last sentence should be improved to clearly state the\noutcome.\n-Introduction, second paragraph: “However, the role of diet in aging in adult survivors of\nchildhood cancer, whose cancer treatments may already have a detrimental impact on aging\nis not known”. This statement is important, would you provide a reference. And, in the same\nparagraph, review the next sentence, it seems incomplete.\n-For the adjustments would be interesting to have a specific physical activity indicator for the\nadjustments. Is it available? And if so, is it possible to add it.\n-I found interesting the results of smoking (never) in the multivariable models, but they are not\ncommented in the discussion. Any chance to know if some of them are exposed to second hand\nsmoking?\n-Regardless the dietary pattern, alcohol intake might influence the proposed outcome. It might\nbe useful to run a sensitivity analysis either adjusting for or excluding alcohol from the equation.\n-To strength your results and potential recommendations, you should consider to add a\nsubstitutional analysis, to check how the DAI could improve by substituting a % of the other\ndiets with the % of plant-based diet.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 27 Aug 2024 Reviewer's report: A good manuscript. General Please add line numbers to help in reviewing. Methods Page 6: Other Risk Factor Assessment 1) Body weight and height: How were they assessed? 2) Area deprivation index: Provide a brief description. 3) Was physical activity and/or sedentary behavior assessed? Page 7: Statistical analysis 1) Confounders: Was physical activity considered? 2) For the stratified analyses, explain the criteria for age and cancer diagnosis cut-points. Results Page 9: Survivors consuming a Western contemporary diet are reported as tending to be non- Hispanic White and obese. However, data on BMI are missing in Table 1. Discussion Page 9: After the summary of findings, explain upfront what is unique about this study. Page 10: For the sentence “In previous studies, higher protein intake was associated with a lower premature aging risk, in particular, physical frailty, overall frailty, and cognitive decline in older adults.33-35”, specify/clarify the type of protein – plant? animal? both? Tables Table 1 1) Include data on BMI. 2) Race/Ethnicity: Footnote races/ethnicities in the “Others” category. 3) Education: Footnote the types of education in the Other” category. 4) Cancer treatment: Footnote the types of treatment in the “Other Chemotherapy” category.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 0 Date: 27 Aug 2024 Reviewer's report: A good manuscript. General Please add line numbers to help in reviewing. Methods Page 6: Other Risk Factor Assessment 1) Body weight and height: How were they assessed? 2) Area deprivation index: Provide a brief description. 3) Was physical activity and/or sedentary behavior assessed? Page 7: Statistical analysis 1) Confounders: Was physical activity considered? 2) For the stratified analyses, explain the criteria for age and cancer diagnosis cut-points. Results Page 9: Survivors consuming a Western contemporary diet are reported as tending to be non- Hispanic White and obese. However, data on BMI are missing in Table 1. Discussion Page 9: After the summary of findings, explain upfront what is unique about this study. Page 10: For the sentence “In previous studies, higher protein intake was associated with a lower premature aging risk, in particular, physical frailty, overall frailty, and cognitive decline in older adults.33-35”, specify/clarify the type of protein – plant? animal? both? Tables Table 1 1) Include data on BMI. 2) Race/Ethnicity: Footnote races/ethnicities in the “Others” category. 3) Education: Footnote the types of education in the Other” category. 4) Cancer treatment: Footnote the types of treatment in the “Other Chemotherapy” category.	BMC	12916_2025_3940_ReviewerReport_V0_R4.pdf	{ "criticism": 1, "example": 6, "importance_and_relevance": 0, "materials_and_methods": 8, "praise": 1, "presentation_and_reporting": 10, "results_and_discussion": 2, "suggestion_and_solution": 8, "total": 17 }	{ "criticism": 0.058823529411764705, "example": 0.35294117647058826, "importance_and_relevance": 0, "materials_and_methods": 0.47058823529411764, "praise": 0.058823529411764705, "presentation_and_reporting": 0.5882352941176471, "results_and_discussion": 0.11764705882352941, "suggestion_and_solution": 0.47058823529411764 }	2.117647	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 0 Date: 27 Aug 2024\nReviewer's report:\nA good manuscript.\nGeneral\nPlease add line numbers to help in reviewing.\nMethods\nPage 6: Other Risk Factor Assessment\n1) Body weight and height: How were they assessed?\n2) Area deprivation index: Provide a brief description.\n3) Was physical activity and/or sedentary behavior assessed?\nPage 7: Statistical analysis\n1) Confounders: Was physical activity considered?\n2) For the stratified analyses, explain the criteria for age and cancer diagnosis cut-points.\nResults\nPage 9: Survivors consuming a Western contemporary diet are reported as tending to be non-\nHispanic White and obese. However, data on BMI are missing in Table 1.\nDiscussion\nPage 9: After the summary of findings, explain upfront what is unique about this study.\nPage 10: For the sentence “In previous studies, higher protein intake was associated with a lower\npremature aging risk, in particular, physical frailty, overall frailty, and cognitive decline in older\nadults.33-35”, specify/clarify the type of protein – plant? animal? both?\nTables\nTable 1\n1) Include data on BMI.\n2) Race/Ethnicity: Footnote races/ethnicities in the “Others” category.\n3) Education: Footnote the types of education in the Other” category.\n4) Cancer treatment: Footnote the types of treatment in the “Other Chemotherapy” category.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 09 Dec 2024 Reviewer's report: The authors answered all observations. I did not find other modifications or clarifications needed.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 09 Dec 2024 Reviewer's report: The authors answered all observations. I did not find other modifications or clarifications needed.	BMC	12916_2025_3940_ReviewerReport_V1_R2.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0.5, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 0, "presentation_and_reporting": 0.5, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 1 Date: 09 Dec 2024\nReviewer's report:\nThe authors answered all observations. I did not find other modifications or clarifications needed.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 10 Dec 2024 Reviewer's report: Since this analysis focuses on diet and aging it is acceptable not to adjust for physical activity. However, the questionnaire to construct the DAI score is not designed to evaluate physical activity but physical impairments (as stated in L98), just to be clear DAI is not a surrogate measure of physical activity. Please consider adding second-hand smoke for future studies/questionnaires. Regardless that alcohol consumption is part of dietary patterns, its role is not negligible. As stated by WHO there is no safe level of alcohol consumption. Fortunately, the authors are highlighting the role of the food components. Please be aware that lay audiences may get mixed messages by just looking at Supplementary Table 1, since plant-based diet has the highest proportion of wine consumption.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 10 Dec 2024 Reviewer's report: Since this analysis focuses on diet and aging it is acceptable not to adjust for physical activity. However, the questionnaire to construct the DAI score is not designed to evaluate physical activity but physical impairments (as stated in L98), just to be clear DAI is not a surrogate measure of physical activity. Please consider adding second-hand smoke for future studies/questionnaires. Regardless that alcohol consumption is part of dietary patterns, its role is not negligible. As stated by WHO there is no safe level of alcohol consumption. Fortunately, the authors are highlighting the role of the food components. Please be aware that lay audiences may get mixed messages by just looking at Supplementary Table 1, since plant-based diet has the highest proportion of wine consumption.	BMC	12916_2025_3940_ReviewerReport_V1_R5.pdf	{ "criticism": 2, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 2, "praise": 1, "presentation_and_reporting": 2, "results_and_discussion": 0, "suggestion_and_solution": 2, "total": 7 }	{ "criticism": 0.2857142857142857, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.2857142857142857, "praise": 0.14285714285714285, "presentation_and_reporting": 0.2857142857142857, "results_and_discussion": 0, "suggestion_and_solution": 0.2857142857142857 }	1.285714	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 1 Date: 10 Dec 2024\nReviewer's report:\nSince this analysis focuses on diet and aging it is acceptable not to adjust for physical activity.\nHowever, the questionnaire to construct the DAI score is not designed to evaluate physical\nactivity but physical impairments (as stated in L98), just to be clear DAI is not a surrogate\nmeasure of physical activity.\nPlease consider adding second-hand smoke for future studies/questionnaires.\nRegardless that alcohol consumption is part of dietary patterns, its role is not negligible. As stated\nby WHO there is no safe level of alcohol consumption. Fortunately, the authors are highlighting\nthe role of the food components. Please be aware that lay audiences may get mixed messages\nby just looking at Supplementary Table 1, since plant-based diet has the highest proportion of\nwine consumption.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 21 Dec 2024 Reviewer's report: Previous comments have been addressed. However in future you need to state the line numbers for your responses to facilitate review. For this iteration, please note point #2 on statistical analysis. Methods 1) Area deprivation index: Please indicate the line numbers corresponding to the description. 2) Statistical analysis: The explanation for the criteria for age and cancer diagnosis cut-points should be included in the manuscript text or in the supplementary material. Discussion 1) What is unique about this study: Please indicate the line numbers. 2) Specify/clarify the type of protein: Please indicate the line number(s).	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 1 Date: 21 Dec 2024 Reviewer's report: Previous comments have been addressed. However in future you need to state the line numbers for your responses to facilitate review. For this iteration, please note point #2 on statistical analysis. Methods 1) Area deprivation index: Please indicate the line numbers corresponding to the description. 2) Statistical analysis: The explanation for the criteria for age and cancer diagnosis cut-points should be included in the manuscript text or in the supplementary material. Discussion 1) What is unique about this study: Please indicate the line numbers. 2) Specify/clarify the type of protein: Please indicate the line number(s).	BMC	12916_2025_3940_ReviewerReport_V1_R4.pdf	{ "criticism": 0, "example": 1, "importance_and_relevance": 0, "materials_and_methods": 4, "praise": 0, "presentation_and_reporting": 6, "results_and_discussion": 1, "suggestion_and_solution": 6, "total": 7 }	{ "criticism": 0, "example": 0.14285714285714285, "importance_and_relevance": 0, "materials_and_methods": 0.5714285714285714, "praise": 0, "presentation_and_reporting": 0.8571428571428571, "results_and_discussion": 0.14285714285714285, "suggestion_and_solution": 0.8571428571428571 }	2.571429	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 1 Date: 21 Dec 2024\nReviewer's report:\nPrevious comments have been addressed. However in future you need to state the line numbers\nfor your responses to facilitate review. For this iteration, please note point #2 on statistical\nanalysis.\nMethods\n1) Area deprivation index:\nPlease indicate the line numbers corresponding to the description.\n2) Statistical analysis:\nThe explanation for the criteria for age and cancer diagnosis cut-points should be included in\nthe manuscript text or in the supplementary material.\nDiscussion\n1) What is unique about this study: Please indicate the line numbers.\n2) Specify/clarify the type of protein: Please indicate the line number(s).", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 2 Date: 13 Jan 2025 Reviewer's report: No further modification or clarifications are needed.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 2 Date: 13 Jan 2025 Reviewer's report: No further modification or clarifications are needed.	BMC	12916_2025_3940_ReviewerReport_V2_R5.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 2 Date: 13 Jan 2025\nReviewer's report:\nNo further modification or clarifications are needed.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03940-3	Reviewed - bmc_medicine	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 2 Date: 24 Jan 2025 Reviewer's report: Comments have been addressed adequately.	Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and Risk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study Version: 2 Date: 24 Jan 2025 Reviewer's report: Comments have been addressed adequately.	BMC	12916_2025_3940_ReviewerReport_V2_R4.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Plant-based, Fast-food, Western-contemporary, and Animal-based Dietary Patterns and\nRisk of Premature Aging in Adult Survivors of Childhood Cancer: a cross-sectional study\nVersion: 2 Date: 24 Jan 2025\nReviewer's report:\nComments have been addressed adequately.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03833-x	Reviewed - bmc_medicine	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 06 Oct 2024 Reviewer: Zhilei Shan Reviewer's report:	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 06 Oct 2024 Reviewer: Zhilei Shan Reviewer's report:	BMC	12916_2024_3833_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in\nrelation to all-cause mortality risk\nVersion: 1 Date: 06 Oct 2024\nReviewer: Zhilei Shan\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03833-x	Reviewed - bmc_medicine	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 07 Oct 2024 Reviewer's report: Stamatakis et al conducted a very innovative analysis unraveling the triangulation of combined effect of sleep, physical activity, and nutrition, and their association with all-cause mortality. The authors have already addressed the comments from previous reviewers which I also share. In addition, I have few more comments. Title What does the minimum and optimal variations imply here? Background -What is the rationale of focusing on sleep, PA, and nutrition, because other lifestyle factors, including alcohol consumption, sedentary time, and smoking are also interacting with those three and are often patterned together with the three. Methods -How valid is the FFQ used in this study? -It seems that FFQ data were collected a couple of years before the sleep and PA data, although the authors acknowledged the limitation, it is still very hard to interpret the results as dose- response, especially the dose is quite subtle. I am just curious about the author’s thoughts on the validity and rationale behind the minimum variations of lifestyle factors on the outcome while the lifestyle factors might have potential changed minimally with time as well. Discussion -The authors mentioned holistic approach of lifestyle intervention for policy and practice, maybe there are already empirical evidence regarding the effectiveness of this holistic approach, given that it is not entirely new in health promotion field.	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 07 Oct 2024 Reviewer's report: Stamatakis et al conducted a very innovative analysis unraveling the triangulation of combined effect of sleep, physical activity, and nutrition, and their association with all-cause mortality. The authors have already addressed the comments from previous reviewers which I also share. In addition, I have few more comments. Title What does the minimum and optimal variations imply here? Background -What is the rationale of focusing on sleep, PA, and nutrition, because other lifestyle factors, including alcohol consumption, sedentary time, and smoking are also interacting with those three and are often patterned together with the three. Methods -How valid is the FFQ used in this study? -It seems that FFQ data were collected a couple of years before the sleep and PA data, although the authors acknowledged the limitation, it is still very hard to interpret the results as dose- response, especially the dose is quite subtle. I am just curious about the author’s thoughts on the validity and rationale behind the minimum variations of lifestyle factors on the outcome while the lifestyle factors might have potential changed minimally with time as well. Discussion -The authors mentioned holistic approach of lifestyle intervention for policy and practice, maybe there are already empirical evidence regarding the effectiveness of this holistic approach, given that it is not entirely new in health promotion field.	BMC	12916_2024_3833_ReviewerReport_V1_R2.pdf	{ "criticism": 2, "example": 0, "importance_and_relevance": 2, "materials_and_methods": 5, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 3, "suggestion_and_solution": 1, "total": 9 }	{ "criticism": 0.2222222222222222, "example": 0, "importance_and_relevance": 0.2222222222222222, "materials_and_methods": 0.5555555555555556, "praise": 0.1111111111111111, "presentation_and_reporting": 0, "results_and_discussion": 0.3333333333333333, "suggestion_and_solution": 0.1111111111111111 }	1.555556	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in\nrelation to all-cause mortality risk\nVersion: 1 Date: 07 Oct 2024\nReviewer's report:\nStamatakis et al conducted a very innovative analysis unraveling the triangulation of combined\neffect of sleep, physical activity, and nutrition, and their association with all-cause mortality.\nThe authors have already addressed the comments from previous reviewers which I also share.\nIn addition, I have few more comments.\nTitle\nWhat does the minimum and optimal variations imply here?\nBackground\n-What is the rationale of focusing on sleep, PA, and nutrition, because other lifestyle factors,\nincluding alcohol consumption, sedentary time, and smoking are also interacting with those\nthree and are often patterned together with the three.\nMethods\n-How valid is the FFQ used in this study?\n-It seems that FFQ data were collected a couple of years before the sleep and PA data, although\nthe authors acknowledged the limitation, it is still very hard to interpret the results as dose-\nresponse, especially the dose is quite subtle. I am just curious about the author’s thoughts on the\nvalidity and rationale behind the minimum variations of lifestyle factors on the outcome while\nthe lifestyle factors might have potential changed minimally with time as well.\nDiscussion\n-The authors mentioned holistic approach of lifestyle intervention for policy and practice, maybe\nthere are already empirical evidence regarding the effectiveness of this holistic approach, given\nthat it is not entirely new in health promotion field.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03833-x	Reviewed - bmc_medicine	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 15 Oct 2024 Reviewer's report:	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 1 Date: 15 Oct 2024 Reviewer's report:	BMC	12916_2024_3833_ReviewerReport_V1_R4.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in\nrelation to all-cause mortality risk\nVersion: 1 Date: 15 Oct 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03833-x	Reviewed - bmc_medicine	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 2 Date: 17 Nov 2024 Reviewer's report: The authors have addressed all the comments. I have no further comments.	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 2 Date: 17 Nov 2024 Reviewer's report: The authors have addressed all the comments. I have no further comments.	BMC	12916_2024_3833_ReviewerReport_V2_R2.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0.5, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in\nrelation to all-cause mortality risk\nVersion: 2 Date: 17 Nov 2024\nReviewer's report:\nThe authors have addressed all the comments. I have no further comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-024-03833-x	Reviewed - bmc_medicine	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 2 Date: 27 Nov 2024 Reviewer's report:	Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk Version: 2 Date: 27 Nov 2024 Reviewer's report:	BMC	12916_2024_3833_ReviewerReport_V2_R4.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Minimum and optimal combined variations in sleep, physical activity, and nutrition in\nrelation to all-cause mortality risk\nVersion: 2 Date: 27 Nov 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 27 Jul 2024 Reviewer: gemma Parramon Reviewer's report:	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 27 Jul 2024 Reviewer: gemma Parramon Reviewer's report:	BMC	12916_2025_3927_ReviewerReport_V0_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 0 Date: 27 Jul 2024\nReviewer: gemma Parramon\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 19 Sep 2024 Reviewer's report: - It is unclear who is the intended audience - researchers or clinicians. The authors switch between describing mechanisms and factors that clinicians cannot routinely assess in every single long covid patient. It is also not practical to patients to complete the many questionnaires recommended across many social and biological systems. - Authors provide mainly recommendations for inventories that are normed for adults and not children. Authors should clarify up front in the paper that the recommendations are specific to adults. -Likewise, if the intended audience are researchers, then some of the very abbreviated instruments the authors suggested is not very informative to capture the domain. Moreover, I find it is too simplistic (and professionally inappropriate) to screen for certain areas with mainly questionnaires. For example, brain fog is a non-specific cognitive description and many patients experience it as slow speed of processing, mental fogginess, attention problems, concentration issues, word finding difficulty, and/or forgetfulness. Providing the patient a test of attention or attention symptom screeners is not sufficiently comprehensive to capture multiple cognitive domains that may be represented by "brain fog". -Page 10 "To deal with chronic and systemic disease conditions such as post-COVID-19 condition, a multi-professional approach is necessary, bringing together the progress of biomedical research in identifying and understanding pathophysiological changes in post- COVID-19 condition (2,14) with thorough psychosocial evaluation, enabling a holistic explanatory model and leading to multimodal treatment approaches (5,15). " multiprofessional may be better captured by "interdisciplinary" -Authors need to clarify who is in the consensus group who determined these recommendations, and how do they come into agreement to finalize guidelines (e.g., majority vote?) They also do not specify the expertise of the participant members who made these guidelines (e.g., was there a neuropsychologist given they very briefly mentioned brain fog?) -Given the extensive research on the clinical features of long covid now, domains and subgroups should be scientifically driven (e.g., if they are recommending select outcome measures, then these should reflect what are more commonly seen in long covid). However, this is not written into their introduction or methods, which raises concerns that the consensus for measures is not scientifically grounded. - Authors noted "The goal was to recommend psychosocial and psychobiological core domains and instruments for post-COVID-19 condition research and provide brief, feasible examples for clinical practice (core set)." - Authors transition from describing brain fog and cognitive difficulties to functional disorders which can feel stigmatizing. Moreover, they did not adequate describe how cognitive symptoms of brain fog can impact or be affected by anxiety, low mood and ADHD. - Specifically, the recommended tools for anxiety and mood were very brief. The authors did not discuss cognitive symptoms in the context of anxiety/low mood or other physical symptoms (pain, GI issues, fatigue). PROMIS are good outcome measures and focus on cognitive aspects of anxiety and depression rather than physical features. -pension claim, ongoing disability, health service utilization are all areas with no formal measurements.	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 19 Sep 2024 Reviewer's report: - It is unclear who is the intended audience - researchers or clinicians. The authors switch between describing mechanisms and factors that clinicians cannot routinely assess in every single long covid patient. It is also not practical to patients to complete the many questionnaires recommended across many social and biological systems. - Authors provide mainly recommendations for inventories that are normed for adults and not children. Authors should clarify up front in the paper that the recommendations are specific to adults. -Likewise, if the intended audience are researchers, then some of the very abbreviated instruments the authors suggested is not very informative to capture the domain. Moreover, I find it is too simplistic (and professionally inappropriate) to screen for certain areas with mainly questionnaires. For example, brain fog is a non-specific cognitive description and many patients experience it as slow speed of processing, mental fogginess, attention problems, concentration issues, word finding difficulty, and/or forgetfulness. Providing the patient a test of attention or attention symptom screeners is not sufficiently comprehensive to capture multiple cognitive domains that may be represented by "brain fog". -Page 10 "To deal with chronic and systemic disease conditions such as post-COVID-19 condition, a multi-professional approach is necessary, bringing together the progress of biomedical research in identifying and understanding pathophysiological changes in post- COVID-19 condition (2,14) with thorough psychosocial evaluation, enabling a holistic explanatory model and leading to multimodal treatment approaches (5,15). " multiprofessional may be better captured by "interdisciplinary" -Authors need to clarify who is in the consensus group who determined these recommendations, and how do they come into agreement to finalize guidelines (e.g., majority vote?) They also do not specify the expertise of the participant members who made these guidelines (e.g., was there a neuropsychologist given they very briefly mentioned brain fog?) -Given the extensive research on the clinical features of long covid now, domains and subgroups should be scientifically driven (e.g., if they are recommending select outcome measures, then these should reflect what are more commonly seen in long covid). However, this is not written into their introduction or methods, which raises concerns that the consensus for measures is not scientifically grounded. - Authors noted "The goal was to recommend psychosocial and psychobiological core domains and instruments for post-COVID-19 condition research and provide brief, feasible examples for clinical practice (core set)." - Authors transition from describing brain fog and cognitive difficulties to functional disorders which can feel stigmatizing. Moreover, they did not adequate describe how cognitive symptoms of brain fog can impact or be affected by anxiety, low mood and ADHD. - Specifically, the recommended tools for anxiety and mood were very brief. The authors did not discuss cognitive symptoms in the context of anxiety/low mood or other physical symptoms (pain, GI issues, fatigue). PROMIS are good outcome measures and focus on cognitive aspects of anxiety and depression rather than physical features. -pension claim, ongoing disability, health service utilization are all areas with no formal measurements.	BMC	12916_2025_3927_ReviewerReport_V0_R2.pdf	{ "criticism": 9, "example": 1, "importance_and_relevance": 2, "materials_and_methods": 14, "praise": 1, "presentation_and_reporting": 5, "results_and_discussion": 2, "suggestion_and_solution": 3, "total": 21 }	{ "criticism": 0.42857142857142855, "example": 0.047619047619047616, "importance_and_relevance": 0.09523809523809523, "materials_and_methods": 0.6666666666666666, "praise": 0.047619047619047616, "presentation_and_reporting": 0.23809523809523808, "results_and_discussion": 0.09523809523809523, "suggestion_and_solution": 0.14285714285714285 }	1.761905	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 0 Date: 19 Sep 2024\nReviewer's report:\n- It is unclear who is the intended audience - researchers or clinicians. The authors switch\nbetween describing mechanisms and factors that clinicians cannot routinely assess in every\nsingle long covid patient. It is also not practical to patients to complete the many questionnaires\nrecommended across many social and biological systems.\n- Authors provide mainly recommendations for inventories that are normed for adults and not\nchildren. Authors should clarify up front in the paper that the recommendations are specific to\nadults.\n-Likewise, if the intended audience are researchers, then some of the very abbreviated\ninstruments the authors suggested is not very informative to capture the domain. Moreover, I\nfind it is too simplistic (and professionally inappropriate) to screen for certain areas with mainly\nquestionnaires. For example, brain fog is a non-specific cognitive description and many patients\nexperience it as slow speed of processing, mental fogginess, attention problems, concentration\nissues, word finding difficulty, and/or forgetfulness. Providing the patient a test of attention\nor attention symptom screeners is not sufficiently comprehensive to capture multiple cognitive\ndomains that may be represented by \"brain fog\".\n-Page 10 \"To deal with chronic and systemic disease conditions such as post-COVID-19\ncondition, a multi-professional approach is necessary, bringing together the progress of\nbiomedical research in identifying and understanding pathophysiological changes in post-\nCOVID-19 condition (2,14) with thorough psychosocial evaluation, enabling a holistic\nexplanatory model and leading to multimodal treatment approaches (5,15). \" multiprofessional\nmay be better captured by \"interdisciplinary\"\n-Authors need to clarify who is in the consensus group who determined these recommendations,\nand how do they come into agreement to finalize guidelines (e.g., majority vote?) They also do\nnot specify the expertise of the participant members who made these guidelines (e.g., was there\na neuropsychologist given they very briefly mentioned brain fog?)\n-Given the extensive research on the clinical features of long covid now, domains and subgroups\nshould be scientifically driven (e.g., if they are recommending select outcome measures, then\nthese should reflect what are more commonly seen in long covid). However, this is not written\ninto their introduction or methods, which raises concerns that the consensus for measures is not\nscientifically grounded.\n- Authors noted \"The goal was to recommend psychosocial and psychobiological core domains\nand instruments for post-COVID-19 condition research and provide brief, feasible examples for\nclinical practice (core set).\"\n- Authors transition from describing brain fog and cognitive difficulties to functional disorders\nwhich can feel stigmatizing. Moreover, they did not adequate describe how cognitive symptoms\nof brain fog can impact or be affected by anxiety, low mood and ADHD.\n- Specifically, the recommended tools for anxiety and mood were very brief. The authors did not\ndiscuss cognitive symptoms in the context of anxiety/low mood or other physical symptoms\n(pain, GI issues, fatigue). PROMIS are good outcome measures and focus on cognitive aspects\nof anxiety and depression rather than physical features.\n-pension claim, ongoing disability, health service utilization are all areas with no formal\nmeasurements.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 27 Sep 2024 Reviewer's report:	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 0 Date: 27 Sep 2024 Reviewer's report:	BMC	12916_2025_3927_ReviewerReport_V0_R3.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 0 Date: 27 Sep 2024\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 06 Dec 2024 Reviewer: gemma Parramon Reviewer's report: Dear Dr Salzmann, I am writing to express my sincere gratitude for the revisions and clarifications you have made to the article. After reviewing the updated version, I find all the changes and explanations to be thoroughly addressed. Your efforts to enhance the clarity and precision of the work are greatly appreciated, and I am confident that these improvements will significantly contribute to the overall quality of the article. Thank you once again for your dedication and attention to detail. Please let me know if there is anything further required on my part. Best regards, Gemma Parramon Puig	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 06 Dec 2024 Reviewer: gemma Parramon Reviewer's report: Dear Dr Salzmann, I am writing to express my sincere gratitude for the revisions and clarifications you have made to the article. After reviewing the updated version, I find all the changes and explanations to be thoroughly addressed. Your efforts to enhance the clarity and precision of the work are greatly appreciated, and I am confident that these improvements will significantly contribute to the overall quality of the article. Thank you once again for your dedication and attention to detail. Please let me know if there is anything further required on my part. Best regards, Gemma Parramon Puig	BMC	12916_2025_3927_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 0, "praise": 3, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 6 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.16666666666666666, "materials_and_methods": 0, "praise": 0.5, "presentation_and_reporting": 0.16666666666666666, "results_and_discussion": 0, "suggestion_and_solution": 0.16666666666666666 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 1 Date: 06 Dec 2024\nReviewer: gemma Parramon\nReviewer's report:\nDear Dr Salzmann,\nI am writing to express my sincere gratitude for the revisions and clarifications you have made\nto the article. After reviewing the updated version, I find all the changes and explanations to\nbe thoroughly addressed.\nYour efforts to enhance the clarity and precision of the work are greatly appreciated, and I\nam confident that these improvements will significantly contribute to the overall quality of the\narticle.\nThank you once again for your dedication and attention to detail. Please let me know if there\nis anything further required on my part.\nBest regards,\nGemma Parramon Puig", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 11 Dec 2024 Reviewer's report: Thank you for thoroughly considering and responding to my feedback. It is clear the authors spent significant time revising and rethinking aspects of the paper. I think it is now clearer and more targeted and more clinically useful. While I think there are still some areas that are not completely clear I think the paper is still a helpful step to share knowledge about COVID-19 and to start to get clinicians and researchers more on the same page in terms of which domains to be assessing and which measures to consider.	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 11 Dec 2024 Reviewer's report: Thank you for thoroughly considering and responding to my feedback. It is clear the authors spent significant time revising and rethinking aspects of the paper. I think it is now clearer and more targeted and more clinically useful. While I think there are still some areas that are not completely clear I think the paper is still a helpful step to share knowledge about COVID-19 and to start to get clinicians and researchers more on the same page in terms of which domains to be assessing and which measures to consider.	BMC	12916_2025_3927_ReviewerReport_V1_R3.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 2, "materials_and_methods": 2, "praise": 3, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 1, "total": 4 }	{ "criticism": 0.25, "example": 0, "importance_and_relevance": 0.5, "materials_and_methods": 0.5, "praise": 0.75, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0.25 }	2.25	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 1 Date: 11 Dec 2024\nReviewer's report:\nThank you for thoroughly considering and responding to my feedback. It is clear the authors\nspent significant time revising and rethinking aspects of the paper. I think it is now clearer and\nmore targeted and more clinically useful. While I think there are still some areas that are not\ncompletely clear I think the paper is still a helpful step to share knowledge about COVID-19\nand to start to get clinicians and researchers more on the same page in terms of which domains\nto be assessing and which measures to consider.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 11 Dec 2024 Reviewer's report: The manuscript, Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use, outlines recommendations for core outcome domains and measures for clinical research and practice. In the revision, the authors do a nice job clarifying their consensus approach and providing a “core” set of outcome measures now, which is somewhat better than the extensive list of measures before in the original submission. However, I still find the paper extremely lengthy with some areas redundant and some measures questionable as a “clinical outcome”. I find the authors approach to broaden the target audience to both clinicians and researchers (rather choosing a clinical audience or research audience and abbreviating their paper), makes the paper even harder to read as it is unclear which measures are more practically useful for a clinical visit vs a research study design. For example, I would not expect a general clinician (e.g., primary care) to provide a SCID to screen a person for psychopathology, and rather a GAD or something similar may be more feasible. Yet, a PHQ-4 with just 4 inventory items do not strike as having strong discriminant or diagnostic sensitivity for a research design. In brief, the paper appears to share so many measures its not clear which ones are clinically practical vs comprehensive enough for research use, as the nature of abbreviated clinical appointments makes the selection of inventories different than that of a study design. Overall, I find the authors need to significantly tighten their paper while at the same time be more direct at which tools are they suggesting for a clinical outcome vs research outcome. They should also consider narrowing down their variables as some are not actually patient outcomes I would practically expect a clinician to track as part of clinical surveillance given the patient load they have to manage (e.g, suggestions to monitor/measure healthcare utilization). Other specific comments: - Abstract: Consider changing sentence structure to “...the European Network (EURONET- SOMA) developed psychosocial core outcome domains and assessments regarding post- COVID-19 condition in efforts to improve diagnostic, treatment, and healthcare for patients with persistent somatic symptoms “ - Introduction: “Commonly reported symptoms include fatigue, observed in approximately 28% of cases, and neurocognitive issues such as memory difficulties, dizziness and brain fog, affecting around 28% of patients.” - Needs citation - In the section “Psychopathological status and mental comorbidities “, authors need to be clear that screeners for anxiety and mood should focus on inventories separate from somatic symptoms that may overlap with physical symptoms of postcovid conditions -Under PTSD section, “However, PTSD may also be relevant for ICU caregivers who worked under extraordinary circumstances during the pandemic” – this seems irrelevant. The authors are writing about patient outcomes not their family outcomes. Again, I suggest authors review all their variables and measures and be selective at what are actually clinical outcomes related to the patient and clinical features. - Under PTSD section, PTSD can also manifest in individuals with COVID conditions who also witness family/friends with COVID complications. - Also under “Psychopathological status and mental comorbidities”, authors note these structured interviews like SCID and DIPS require expertise and training….but MINI and PRIME MD also requires training. - Under “Neurocognitive symptoms”, like noted in my last review, I disagree with including functional cognitive disorders under this section. Authors should consider that many different functional disorders like functional neurologic, functional pain, functional GI and so on also can manifest in post covid conditions. If they would like to note this, they should have a section on screening for functional disorders broadly rather than only emphasize cognitive symptoms may reflect a functional disorder. -Overall, I question if all domains covered in this paper are pertinent to clinical outcomes (e.g., healthcare costs and utilization). Providers who sees patients for a limited appointment likely do not have time to provide all these screeners + some frankly some measures that may be interesting as a research measure but are questionably a clinical outcome measure. The mixture of measures that are geared towards CLINICAL OUTCOME for clinical surveillance vs research tracking makes these recommendations less effective, useful and clear. - The section “Affective Components” – some of this reads redundant to the Psychopathological Status section. Eg. PANS is another structured interview that could have been noted above with SCID. -Risk factors section(s) – The authors should really clarify what the paper is for. If they are providing suggestions on clinical outcome measures (i.e., measures to identify change in health, quality of life, functional change); OR , variables of interest for COVID-related research. -ACES and early child adversities can also fit under Psychopathology section.	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 1 Date: 11 Dec 2024 Reviewer's report: The manuscript, Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use, outlines recommendations for core outcome domains and measures for clinical research and practice. In the revision, the authors do a nice job clarifying their consensus approach and providing a “core” set of outcome measures now, which is somewhat better than the extensive list of measures before in the original submission. However, I still find the paper extremely lengthy with some areas redundant and some measures questionable as a “clinical outcome”. I find the authors approach to broaden the target audience to both clinicians and researchers (rather choosing a clinical audience or research audience and abbreviating their paper), makes the paper even harder to read as it is unclear which measures are more practically useful for a clinical visit vs a research study design. For example, I would not expect a general clinician (e.g., primary care) to provide a SCID to screen a person for psychopathology, and rather a GAD or something similar may be more feasible. Yet, a PHQ-4 with just 4 inventory items do not strike as having strong discriminant or diagnostic sensitivity for a research design. In brief, the paper appears to share so many measures its not clear which ones are clinically practical vs comprehensive enough for research use, as the nature of abbreviated clinical appointments makes the selection of inventories different than that of a study design. Overall, I find the authors need to significantly tighten their paper while at the same time be more direct at which tools are they suggesting for a clinical outcome vs research outcome. They should also consider narrowing down their variables as some are not actually patient outcomes I would practically expect a clinician to track as part of clinical surveillance given the patient load they have to manage (e.g, suggestions to monitor/measure healthcare utilization). Other specific comments: - Abstract: Consider changing sentence structure to “...the European Network (EURONET- SOMA) developed psychosocial core outcome domains and assessments regarding post- COVID-19 condition in efforts to improve diagnostic, treatment, and healthcare for patients with persistent somatic symptoms “ - Introduction: “Commonly reported symptoms include fatigue, observed in approximately 28% of cases, and neurocognitive issues such as memory difficulties, dizziness and brain fog, affecting around 28% of patients.” - Needs citation - In the section “Psychopathological status and mental comorbidities “, authors need to be clear that screeners for anxiety and mood should focus on inventories separate from somatic symptoms that may overlap with physical symptoms of postcovid conditions -Under PTSD section, “However, PTSD may also be relevant for ICU caregivers who worked under extraordinary circumstances during the pandemic” – this seems irrelevant. The authors are writing about patient outcomes not their family outcomes. Again, I suggest authors review all their variables and measures and be selective at what are actually clinical outcomes related to the patient and clinical features. - Under PTSD section, PTSD can also manifest in individuals with COVID conditions who also witness family/friends with COVID complications. - Also under “Psychopathological status and mental comorbidities”, authors note these structured interviews like SCID and DIPS require expertise and training….but MINI and PRIME MD also requires training. - Under “Neurocognitive symptoms”, like noted in my last review, I disagree with including functional cognitive disorders under this section. Authors should consider that many different functional disorders like functional neurologic, functional pain, functional GI and so on also can manifest in post covid conditions. If they would like to note this, they should have a section on screening for functional disorders broadly rather than only emphasize cognitive symptoms may reflect a functional disorder. -Overall, I question if all domains covered in this paper are pertinent to clinical outcomes (e.g., healthcare costs and utilization). Providers who sees patients for a limited appointment likely do not have time to provide all these screeners + some frankly some measures that may be interesting as a research measure but are questionably a clinical outcome measure. The mixture of measures that are geared towards CLINICAL OUTCOME for clinical surveillance vs research tracking makes these recommendations less effective, useful and clear. - The section “Affective Components” – some of this reads redundant to the Psychopathological Status section. Eg. PANS is another structured interview that could have been noted above with SCID. -Risk factors section(s) – The authors should really clarify what the paper is for. If they are providing suggestions on clinical outcome measures (i.e., measures to identify change in health, quality of life, functional change); OR , variables of interest for COVID-related research. -ACES and early child adversities can also fit under Psychopathology section.	BMC	12916_2025_3927_ReviewerReport_V1_R2.pdf	{ "criticism": 7, "example": 1, "importance_and_relevance": 5, "materials_and_methods": 16, "praise": 1, "presentation_and_reporting": 3, "results_and_discussion": 5, "suggestion_and_solution": 11, "total": 26 }	{ "criticism": 0.2692307692307692, "example": 0.038461538461538464, "importance_and_relevance": 0.19230769230769232, "materials_and_methods": 0.6153846153846154, "praise": 0.038461538461538464, "presentation_and_reporting": 0.11538461538461539, "results_and_discussion": 0.19230769230769232, "suggestion_and_solution": 0.4230769230769231 }	1.884615	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 1 Date: 11 Dec 2024\nReviewer's report:\nThe manuscript, Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition:\nThe EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and\nResearch Use, outlines recommendations for core outcome domains and measures for clinical\nresearch and practice. In the revision, the authors do a nice job clarifying their consensus\napproach and providing a “core” set of outcome measures now, which is somewhat better than\nthe extensive list of measures before in the original submission. However, I still find the paper\nextremely lengthy with some areas redundant and some measures questionable as a “clinical\noutcome”. I find the authors approach to broaden the target audience to both clinicians and\nresearchers (rather choosing a clinical audience or research audience and abbreviating their\npaper), makes the paper even harder to read as it is unclear which measures are more practically\nuseful for a clinical visit vs a research study design. For example, I would not expect a general\nclinician (e.g., primary care) to provide a SCID to screen a person for psychopathology, and\nrather a GAD or something similar may be more feasible. Yet, a PHQ-4 with just 4 inventory\nitems do not strike as having strong discriminant or diagnostic sensitivity for a research design. In\nbrief, the paper appears to share so many measures its not clear which ones are clinically practical\nvs comprehensive enough for research use, as the nature of abbreviated clinical appointments\nmakes the selection of inventories different than that of a study design. Overall, I find the authors\nneed to significantly tighten their paper while at the same time be more direct at which tools are\nthey suggesting for a clinical outcome vs research outcome. They should also consider narrowing\ndown their variables as some are not actually patient outcomes I would practically expect a\nclinician to track as part of clinical surveillance given the patient load they have to manage (e.g,\nsuggestions to monitor/measure healthcare utilization).\nOther specific comments:\n- Abstract: Consider changing sentence structure to “...the European Network (EURONET-\nSOMA) developed psychosocial core outcome domains and assessments regarding post-\nCOVID-19 condition in efforts to improve diagnostic, treatment, and healthcare for patients with\npersistent somatic symptoms “\n- Introduction: “Commonly reported symptoms include fatigue, observed in approximately\n28% of cases, and neurocognitive issues such as memory difficulties, dizziness and brain fog,\naffecting around 28% of patients.” - Needs citation\n- In the section “Psychopathological status and mental comorbidities “, authors need to be clear\nthat screeners for anxiety and mood should focus on inventories separate from somatic symptoms\nthat may overlap with physical symptoms of postcovid conditions\n-Under PTSD section, “However, PTSD may also be relevant for ICU caregivers who worked\nunder extraordinary circumstances during the pandemic” – this seems irrelevant. The authors\nare writing about patient outcomes not their family outcomes. Again, I suggest authors review\nall their variables and measures and be selective at what are actually clinical outcomes related\nto the patient and clinical features.\n- Under PTSD section, PTSD can also manifest in individuals with COVID conditions who also\nwitness family/friends with COVID complications.\n- Also under “Psychopathological status and mental comorbidities”, authors note these\nstructured interviews like SCID and DIPS require expertise and training….but MINI and PRIME\nMD also requires training.\n- Under “Neurocognitive symptoms”, like noted in my last review, I disagree with including\nfunctional cognitive disorders under this section. Authors should consider that many different\nfunctional disorders like functional neurologic, functional pain, functional GI and so on also can\nmanifest in post covid conditions. If they would like to note this, they should have a section on\nscreening for functional disorders broadly rather than only emphasize cognitive symptoms may\nreflect a functional disorder.\n-Overall, I question if all domains covered in this paper are pertinent to clinical outcomes (e.g.,\nhealthcare costs and utilization). Providers who sees patients for a limited appointment likely\ndo not have time to provide all these screeners + some frankly some measures that may be\ninteresting as a research measure but are questionably a clinical outcome measure. The mixture\nof measures that are geared towards CLINICAL OUTCOME for clinical surveillance vs research\ntracking makes these recommendations less effective, useful and clear.\n- The section “Affective Components” – some of this reads redundant to the Psychopathological\nStatus section. Eg. PANS is another structured interview that could have been noted above with\nSCID.\n-Risk factors section(s) – The authors should really clarify what the paper is for. If they are\nproviding suggestions on clinical outcome measures (i.e., measures to identify change in health,\nquality of life, functional change); OR , variables of interest for COVID-related research.\n-ACES and early child adversities can also fit under Psychopathology section.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03927-0	Reviewed - bmc_medicine	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 2 Date: 17 Jan 2025 Reviewer's report: Thank you for the opportunity to review the revised manuscript. I believe the authors addressed my concerns as best as they can and have no further comments	Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The EURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research Use Version: 2 Date: 17 Jan 2025 Reviewer's report: Thank you for the opportunity to review the revised manuscript. I believe the authors addressed my concerns as best as they can and have no further comments	BMC	12916_2025_3927_ReviewerReport_V2_R2.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0.5, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 0.5, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Assessment of Psychosocial Aspects in Adults in post-COVID-19 condition: The\nEURONET-SOMA Recommendations on Core Outcome Domains for Clinical and Research\nUse\nVersion: 2 Date: 17 Jan 2025\nReviewer's report:\nThank you for the opportunity to review the revised manuscript. I believe the authors addressed\nmy concerns as best as they can and have no further comments", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 28 Sep 2024 Reviewer: Joanna Didkowska Reviewer's report: I found the paper extremely interesting and necessary. The authors have demonstrated excellent statistical skills and have done a gigantic job. However, I have a few questions for the Authors: Wouldn't the obtained estimate be more accurate if using pack-years of smoking? I don't understand the idea of additionally adjusting for fruit intake, vegetable intake, red meat intake, and processed meat intake, due to self-reporting of values of these variables - the risk of forgetting or intentionally indicating higher/lower values. Figure 4 (Smoking-attributable fractions for current and past smoking by age group and sex in Australia) remains incomprehensible to me and is not described in detail (perhaps redundant?). The figure shows that current smoking status is more important in the younger cohort (45-74), while past smoking is more important in the older cohort, which is intuitive, but perhaps worth highlighting?	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 28 Sep 2024 Reviewer: Joanna Didkowska Reviewer's report: I found the paper extremely interesting and necessary. The authors have demonstrated excellent statistical skills and have done a gigantic job. However, I have a few questions for the Authors: Wouldn't the obtained estimate be more accurate if using pack-years of smoking? I don't understand the idea of additionally adjusting for fruit intake, vegetable intake, red meat intake, and processed meat intake, due to self-reporting of values of these variables - the risk of forgetting or intentionally indicating higher/lower values. Figure 4 (Smoking-attributable fractions for current and past smoking by age group and sex in Australia) remains incomprehensible to me and is not described in detail (perhaps redundant?). The figure shows that current smoking status is more important in the younger cohort (45-74), while past smoking is more important in the older cohort, which is intuitive, but perhaps worth highlighting?	BMC	12916_2025_3883_ReviewerReport_V0_R3.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 1, "materials_and_methods": 4, "praise": 2, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 2, "total": 6 }	{ "criticism": 0.3333333333333333, "example": 0.16666666666666666, "importance_and_relevance": 0.16666666666666666, "materials_and_methods": 0.6666666666666666, "praise": 0.3333333333333333, "presentation_and_reporting": 0.16666666666666666, "results_and_discussion": 0, "suggestion_and_solution": 0.3333333333333333 }	2.166667	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 0 Date: 28 Sep 2024\nReviewer: Joanna Didkowska\nReviewer's report:\nI found the paper extremely interesting and necessary. The authors have demonstrated excellent\nstatistical skills and have done a gigantic job.\nHowever, I have a few questions for the Authors:\nWouldn't the obtained estimate be more accurate if using pack-years of smoking?\nI don't understand the idea of additionally adjusting for fruit intake, vegetable intake, red meat\nintake, and processed meat intake, due to self-reporting of values of these variables - the risk of\nforgetting or intentionally indicating higher/lower values.\nFigure 4 (Smoking-attributable fractions for current and past smoking by age group and sex in\nAustralia) remains incomprehensible to me and is not described in detail (perhaps redundant?).\nThe figure shows that current smoking status is more important in the younger cohort (45-74),\nwhile past smoking is more important in the older cohort, which is intuitive, but perhaps worth\nhighlighting?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 29 Sep 2024 Reviewer's report: The authors estimated tobacco smoking attributable mortality in Australia. The topic is of importance. The manuscript is well-written. I only have some comments below: Methods: Smoking status was from a 3-year-follow-up survey, has smoking status changed over time? How could this affect the estimates? Do the authors assume that the smoking prevalence remains unchanged in recent years? Smoking prevalence in the 2000s is likely much higher than the recent one. Results: In this study, 8% were current smokers and 34% were former smokers. Were these prevalence rates similar to the national statistics in Australia? Results: Do the authors consider a median follow-up of 9.32 years long enough to capture mortality? Please discuss. Results: What does “15 alcoholic drinks/week” mean? Do you mean 15 units? Please add a description of it. Results: The cut points of BMI “15-19.9” ”30-50” look confusing to me. I’d like to know why the authors chose not to use cut points representing overweight and obese.	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 29 Sep 2024 Reviewer's report: The authors estimated tobacco smoking attributable mortality in Australia. The topic is of importance. The manuscript is well-written. I only have some comments below: Methods: Smoking status was from a 3-year-follow-up survey, has smoking status changed over time? How could this affect the estimates? Do the authors assume that the smoking prevalence remains unchanged in recent years? Smoking prevalence in the 2000s is likely much higher than the recent one. Results: In this study, 8% were current smokers and 34% were former smokers. Were these prevalence rates similar to the national statistics in Australia? Results: Do the authors consider a median follow-up of 9.32 years long enough to capture mortality? Please discuss. Results: What does “15 alcoholic drinks/week” mean? Do you mean 15 units? Please add a description of it. Results: The cut points of BMI “15-19.9” ”30-50” look confusing to me. I’d like to know why the authors chose not to use cut points representing overweight and obese.	BMC	12916_2025_3883_ReviewerReport_V0_R1.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 6, "praise": 2, "presentation_and_reporting": 4, "results_and_discussion": 6, "suggestion_and_solution": 2, "total": 16 }	{ "criticism": 0.0625, "example": 0, "importance_and_relevance": 0.0625, "materials_and_methods": 0.375, "praise": 0.125, "presentation_and_reporting": 0.25, "results_and_discussion": 0.375, "suggestion_and_solution": 0.125 }	1.375	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 0 Date: 29 Sep 2024\nReviewer's report:\nThe authors estimated tobacco smoking attributable mortality in Australia. The topic is of\nimportance. The manuscript is well-written. I only have some comments below:\nMethods: Smoking status was from a 3-year-follow-up survey, has smoking status changed over\ntime? How could this affect the estimates? Do the authors assume that the smoking prevalence\nremains unchanged in recent years? Smoking prevalence in the 2000s is likely much higher than\nthe recent one.\nResults: In this study, 8% were current smokers and 34% were former smokers. Were these\nprevalence rates similar to the national statistics in Australia?\nResults: Do the authors consider a median follow-up of 9.32 years long enough to capture\nmortality? Please discuss.\nResults: What does “15 alcoholic drinks/week” mean? Do you mean 15 units? Please add a\ndescription of it.\nResults: The cut points of BMI “15-19.9” ”30-50” look confusing to me. I’d like to know why\nthe authors chose not to use cut points representing overweight and obese.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 30 Sep 2024 Reviewer: Philippe Autier Reviewer's report: The paper of G Joshy and colleagues is about the risk of various conditions and of death associated with tobacco smoking in a large cohort in Australia. The study is highly relevant because it assesses risks in a country that has done much on tobacco control, and where the prevalence of smoking has much decreased. Nonetheless the health impact of smoking is still dramatic. I have no special comment to do on the method, which meets usual requirements of this type of study. The statistical analysis is fine. Study limitations acknowledged. The Discussion should stress that the study left out prevalent cases of patients with diseases that could have been caused by smoking during years preceding inclusion in the cohort (eg, CVD). Therefore attributable fractions should be considered as lower figure estimates.	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 30 Sep 2024 Reviewer: Philippe Autier Reviewer's report: The paper of G Joshy and colleagues is about the risk of various conditions and of death associated with tobacco smoking in a large cohort in Australia. The study is highly relevant because it assesses risks in a country that has done much on tobacco control, and where the prevalence of smoking has much decreased. Nonetheless the health impact of smoking is still dramatic. I have no special comment to do on the method, which meets usual requirements of this type of study. The statistical analysis is fine. Study limitations acknowledged. The Discussion should stress that the study left out prevalent cases of patients with diseases that could have been caused by smoking during years preceding inclusion in the cohort (eg, CVD). Therefore attributable fractions should be considered as lower figure estimates.	BMC	12916_2025_3883_ReviewerReport_V0_R2.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 6, "praise": 3, "presentation_and_reporting": 0, "results_and_discussion": 2, "suggestion_and_solution": 2, "total": 8 }	{ "criticism": 0.125, "example": 0, "importance_and_relevance": 0.125, "materials_and_methods": 0.75, "praise": 0.375, "presentation_and_reporting": 0, "results_and_discussion": 0.25, "suggestion_and_solution": 0.25 }	1.875	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 0 Date: 30 Sep 2024\nReviewer: Philippe Autier\nReviewer's report:\nThe paper of G Joshy and colleagues is about the risk of various conditions and of death\nassociated with tobacco smoking in a large cohort in Australia. The study is highly relevant\nbecause it assesses risks in a country that has done much on tobacco control, and where the\nprevalence of smoking has much decreased. Nonetheless the health impact of smoking is still\ndramatic.\nI have no special comment to do on the method, which meets usual requirements of this type of\nstudy. The statistical analysis is fine. Study limitations acknowledged.\nThe Discussion should stress that the study left out prevalent cases of patients with diseases that\ncould have been caused by smoking during years preceding inclusion in the cohort (eg, CVD).\nTherefore attributable fractions should be considered as lower figure estimates.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 04 Oct 2024 Reviewer's report: Thank you for inviting me to review the manuscript titled “Relationship of Tobacco Smoking to Cause-Specific Mortality: Contemporary Estimates from Australia.” The paper is well-written and thoroughly addresses a significant public health issue. I have a few comments that need to be addressed. Abstract: Lines 42-43: The authors stated that the follow-up period ended in November 2017. However, the methods section references death data from the NSW Registry of Births, Deaths and Marriages (January 1, 2006, to March 31, 2019) and the Australian Bureau of Statistics (ABS) (January 1, 2006, to November 30, 2017). The NSW Cancer Registry is linked to the NSW Registry of Births, Deaths and Marriages and the AIHW to obtain vital status information. It is not clear to me why the authors chose not to use cause-specific data from the NSW Cancer Registry (Mar 2019) and instead opted for the ABS mortality data (Nov 2017). If the ABS data was only used to determine vital status, what was the purpose of mentioning the NSW Cancer Registry death data? It appears that the authors used National Death Index data as well, as mentioned in lines 119-120. Please ensure clarity and consistency between your abstract and method section. Methods: Line 106: It is unclear which socio-demographic factors and health behaviours were collected. Please specify them in brackets, for example, demographic factors (income, education, etc.) Lines 126-128: A standard pack contains 20 cigarettes. Please explain the rationale behind selecting these specific cut-offs (#14, 15-24, and #25 cigarettes/day). Statistical methods: Lines 169-173: Please use more precise terminology than saying models were adjusted for x, y, and z. It is better to state that Model 1 included x, y, and z, while Model 2 incorporated additional confounding variables or covariates. In Model 2, the authors included covariates that do not confound the association between smoking and mortality, as they act as mediators in the causal pathway. For instance, what is the rationale for adjusting for private health insurance and all the variables listed in Table S4 (such as dietary intake, aspirin, PSA testing, hormonal factors, etc)? They are not confounders. A similar issue arises in the sensitivity analysis (lines 193-194) with adjustments for BMI and physical activity. Smoking affects BMI and BMI affects mortality; therefore, BMI is a mediator, and physical activity is a mediator-outcome confounder. The authors should provide a causal diagram (directed acyclic graph) to identify confounding variables and mediators. Comparing models with and without adjustments for mediators is a standard practice in traditional epidemiology and should be avoided. Adjusting for mediators can introduce bias. Discussion: Please relocate the strengths and limitations of your study (lines 328-353) to follow immediately after the first paragraph (lines 273-277).	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 0 Date: 04 Oct 2024 Reviewer's report: Thank you for inviting me to review the manuscript titled “Relationship of Tobacco Smoking to Cause-Specific Mortality: Contemporary Estimates from Australia.” The paper is well-written and thoroughly addresses a significant public health issue. I have a few comments that need to be addressed. Abstract: Lines 42-43: The authors stated that the follow-up period ended in November 2017. However, the methods section references death data from the NSW Registry of Births, Deaths and Marriages (January 1, 2006, to March 31, 2019) and the Australian Bureau of Statistics (ABS) (January 1, 2006, to November 30, 2017). The NSW Cancer Registry is linked to the NSW Registry of Births, Deaths and Marriages and the AIHW to obtain vital status information. It is not clear to me why the authors chose not to use cause-specific data from the NSW Cancer Registry (Mar 2019) and instead opted for the ABS mortality data (Nov 2017). If the ABS data was only used to determine vital status, what was the purpose of mentioning the NSW Cancer Registry death data? It appears that the authors used National Death Index data as well, as mentioned in lines 119-120. Please ensure clarity and consistency between your abstract and method section. Methods: Line 106: It is unclear which socio-demographic factors and health behaviours were collected. Please specify them in brackets, for example, demographic factors (income, education, etc.) Lines 126-128: A standard pack contains 20 cigarettes. Please explain the rationale behind selecting these specific cut-offs (#14, 15-24, and #25 cigarettes/day). Statistical methods: Lines 169-173: Please use more precise terminology than saying models were adjusted for x, y, and z. It is better to state that Model 1 included x, y, and z, while Model 2 incorporated additional confounding variables or covariates. In Model 2, the authors included covariates that do not confound the association between smoking and mortality, as they act as mediators in the causal pathway. For instance, what is the rationale for adjusting for private health insurance and all the variables listed in Table S4 (such as dietary intake, aspirin, PSA testing, hormonal factors, etc)? They are not confounders. A similar issue arises in the sensitivity analysis (lines 193-194) with adjustments for BMI and physical activity. Smoking affects BMI and BMI affects mortality; therefore, BMI is a mediator, and physical activity is a mediator-outcome confounder. The authors should provide a causal diagram (directed acyclic graph) to identify confounding variables and mediators. Comparing models with and without adjustments for mediators is a standard practice in traditional epidemiology and should be avoided. Adjusting for mediators can introduce bias. Discussion: Please relocate the strengths and limitations of your study (lines 328-353) to follow immediately after the first paragraph (lines 273-277).	BMC	12916_2025_3883_ReviewerReport_V0_R4.pdf	{ "criticism": 3, "example": 7, "importance_and_relevance": 1, "materials_and_methods": 17, "praise": 1, "presentation_and_reporting": 8, "results_and_discussion": 1, "suggestion_and_solution": 9, "total": 24 }	{ "criticism": 0.125, "example": 0.2916666666666667, "importance_and_relevance": 0.041666666666666664, "materials_and_methods": 0.7083333333333334, "praise": 0.041666666666666664, "presentation_and_reporting": 0.3333333333333333, "results_and_discussion": 0.041666666666666664, "suggestion_and_solution": 0.375 }	1.958333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 0 Date: 04 Oct 2024\nReviewer's report:\nThank you for inviting me to review the manuscript titled “Relationship of Tobacco Smoking to\nCause-Specific Mortality: Contemporary Estimates from Australia.” The paper is well-written\nand thoroughly addresses a significant public health issue.\nI have a few comments that need to be addressed.\nAbstract:\nLines 42-43: The authors stated that the follow-up period ended in November 2017. However,\nthe methods section references death data from the NSW Registry of Births, Deaths and\nMarriages (January 1, 2006, to March 31, 2019) and the Australian Bureau of Statistics (ABS)\n(January 1, 2006, to November 30, 2017).\nThe NSW Cancer Registry is linked to the NSW Registry of Births, Deaths and Marriages and\nthe AIHW to obtain vital status information. It is not clear to me why the authors chose not to\nuse cause-specific data from the NSW Cancer Registry (Mar 2019) and instead opted for the\nABS mortality data (Nov 2017). If the ABS data was only used to determine vital status, what\nwas the purpose of mentioning the NSW Cancer Registry death data?\nIt appears that the authors used National Death Index data as well, as mentioned in lines 119-120.\nPlease ensure clarity and consistency between your abstract and method section.\nMethods:\nLine 106: It is unclear which socio-demographic factors and health behaviours were collected.\nPlease specify them in brackets, for example, demographic factors (income, education, etc.)\nLines 126-128: A standard pack contains 20 cigarettes. Please explain the rationale behind\nselecting these specific cut-offs (#14, 15-24, and #25 cigarettes/day).\nStatistical methods:\nLines 169-173: Please use more precise terminology than saying models were adjusted for x, y,\nand z. It is better to state that Model 1 included x, y, and z, while Model 2 incorporated additional\nconfounding variables or covariates.\nIn Model 2, the authors included covariates that do not confound the association between\nsmoking and mortality, as they act as mediators in the causal pathway. For instance, what is the\nrationale for adjusting for private health insurance and all the variables listed in Table S4 (such\nas dietary intake, aspirin, PSA testing, hormonal factors, etc)? They are not confounders.\nA similar issue arises in the sensitivity analysis (lines 193-194) with adjustments for BMI and\nphysical activity. Smoking affects BMI and BMI affects mortality; therefore, BMI is a mediator,\nand physical activity is a mediator-outcome confounder.\nThe authors should provide a causal diagram (directed acyclic graph) to identify confounding\nvariables and mediators. Comparing models with and without adjustments for mediators is a\nstandard practice in traditional epidemiology and should be avoided. Adjusting for mediators\ncan introduce bias.\nDiscussion:\nPlease relocate the strengths and limitations of your study (lines 328-353) to follow immediately\nafter the first paragraph (lines 273-277).", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 1 Date: 30 Nov 2024 Reviewer's report: The authors answered my comments appropriately. I have no further questions.	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 1 Date: 30 Nov 2024 Reviewer's report: The authors answered my comments appropriately. I have no further questions.	BMC	12916_2025_3883_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.5, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 1 Date: 30 Nov 2024\nReviewer's report:\nThe authors answered my comments appropriately. I have no further questions.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03883-9	Reviewed - bmc_medicine	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 1 Date: 01 Dec 2024 Reviewer: Philippe Autier Reviewer's report: Authors have provided satisfactory answers to my comments.	Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates from Australia Version: 1 Date: 01 Dec 2024 Reviewer: Philippe Autier Reviewer's report: Authors have provided satisfactory answers to my comments.	BMC	12916_2025_3883_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Relationship of tobacco smoking to cause-specific mortality: Contemporary estimates\nfrom Australia\nVersion: 1 Date: 01 Dec 2024\nReviewer: Philippe Autier\nReviewer's report:\nAuthors have provided satisfactory answers to my comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 03 Oct 2024 Reviewer's report: Thank you for the opportunity to review the manuscript titled "Long-term outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) without traditional modifiable cardiovascular risk factors: findings from the OPT-CAD cohort." In this article, the authors explore the long-term outcomes and identify independent prognostic factors associated with adverse clinical outcomes in patients with ACS undergoing PCI without traditional modifiable cardiovascular risk factors (CVRFs). As a result, ACS patients without CVRFs undergoing PCI had a similar risk of recurrent cardiovascular events compared to those with one or more CVRFs at 5 years. My evaluation is that the paper is publishable with major scientific revisions. 1. What does NACE represent as a Secondary Endpoint? This is not mentioned in the manuscript or the supplemental materials. Please provide a clear explanation of the abbreviation and its definition. 2. There are too many tables in comparison to the study content. What is the purpose of comparing patient backgrounds with and without MACCE? 3. If the authors are performing the comparison between "with MACCE" and "without MACCE," this should be clearly explained in the Methods section. The sudden introduction of these new groups makes the manuscript difficult for the reader to follow. 4. In the Limitations section, the authors mention the lack of information on lipid-lowering drugs prior to hospitalization. However, dyslipidemia is defined in the study as including the "use of lipid-lowering drugs." Shouldn't this inconsistency be addressed? 5. The sudden appearance of Definitions I and II in the manuscript should be better explained within the main body rather than relegated to the supplemental materials. 6. When presenting results, it is important to include actual values alongside your findings. Given the number of tables in this study, it is inconvenient for the reader to have to constantly refer back to them. Please consider including key numbers directly in the text. 7. Regarding the multivariate Cox regression analysis, the authors mention results for two factors. Was the analysis conducted only on these two factors, or were other factors included, with only these two being significant? Please clarify. 8. Thrombus lesion is identified as a significant factor influencing the results, but its definition is not provided. This is an important element, and its definition should be clearly explained in the Methods section. 9. The mention of clonal hematopoiesis of indeterminate potential (CHIP) in the Discussion seems like a significant leap based on the study results. It would be better to reconsider the relevance of this point. 10. The authors mentioned the low usage rate of ACE-i/ARB, but it is a reasonable decision not to prescribe these agents in cases without hypertension or reduced left ventricular ejection fraction, as they are not essential for secondary prevention after ACS. This point might also warrant revision.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 03 Oct 2024 Reviewer's report: Thank you for the opportunity to review the manuscript titled "Long-term outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) without traditional modifiable cardiovascular risk factors: findings from the OPT-CAD cohort." In this article, the authors explore the long-term outcomes and identify independent prognostic factors associated with adverse clinical outcomes in patients with ACS undergoing PCI without traditional modifiable cardiovascular risk factors (CVRFs). As a result, ACS patients without CVRFs undergoing PCI had a similar risk of recurrent cardiovascular events compared to those with one or more CVRFs at 5 years. My evaluation is that the paper is publishable with major scientific revisions. 1. What does NACE represent as a Secondary Endpoint? This is not mentioned in the manuscript or the supplemental materials. Please provide a clear explanation of the abbreviation and its definition. 2. There are too many tables in comparison to the study content. What is the purpose of comparing patient backgrounds with and without MACCE? 3. If the authors are performing the comparison between "with MACCE" and "without MACCE," this should be clearly explained in the Methods section. The sudden introduction of these new groups makes the manuscript difficult for the reader to follow. 4. In the Limitations section, the authors mention the lack of information on lipid-lowering drugs prior to hospitalization. However, dyslipidemia is defined in the study as including the "use of lipid-lowering drugs." Shouldn't this inconsistency be addressed? 5. The sudden appearance of Definitions I and II in the manuscript should be better explained within the main body rather than relegated to the supplemental materials. 6. When presenting results, it is important to include actual values alongside your findings. Given the number of tables in this study, it is inconvenient for the reader to have to constantly refer back to them. Please consider including key numbers directly in the text. 7. Regarding the multivariate Cox regression analysis, the authors mention results for two factors. Was the analysis conducted only on these two factors, or were other factors included, with only these two being significant? Please clarify. 8. Thrombus lesion is identified as a significant factor influencing the results, but its definition is not provided. This is an important element, and its definition should be clearly explained in the Methods section. 9. The mention of clonal hematopoiesis of indeterminate potential (CHIP) in the Discussion seems like a significant leap based on the study results. It would be better to reconsider the relevance of this point. 10. The authors mentioned the low usage rate of ACE-i/ARB, but it is a reasonable decision not to prescribe these agents in cases without hypertension or reduced left ventricular ejection fraction, as they are not essential for secondary prevention after ACS. This point might also warrant revision.	BMC	12916_2025_3933_ReviewerReport_V0_R1.pdf	{ "criticism": 6, "example": 1, "importance_and_relevance": 2, "materials_and_methods": 8, "praise": 2, "presentation_and_reporting": 9, "results_and_discussion": 8, "suggestion_and_solution": 9, "total": 37 }	{ "criticism": 0.16216216216216217, "example": 0.02702702702702703, "importance_and_relevance": 0.05405405405405406, "materials_and_methods": 0.21621621621621623, "praise": 0.05405405405405406, "presentation_and_reporting": 0.24324324324324326, "results_and_discussion": 0.21621621621621623, "suggestion_and_solution": 0.24324324324324326 }	1.216216	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 0 Date: 03 Oct 2024\nReviewer's report:\nThank you for the opportunity to review the manuscript titled \"Long-term outcomes in patients\nwith acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI)\nwithout traditional modifiable cardiovascular risk factors: findings from the OPT-CAD cohort.\"\nIn this article, the authors explore the long-term outcomes and identify independent prognostic\nfactors associated with adverse clinical outcomes in patients with ACS undergoing PCI without\ntraditional modifiable cardiovascular risk factors (CVRFs). As a result, ACS patients without\nCVRFs undergoing PCI had a similar risk of recurrent cardiovascular events compared to those\nwith one or more CVRFs at 5 years. My evaluation is that the paper is publishable with major\nscientific revisions.\n1. What does NACE represent as a Secondary Endpoint? This is not mentioned in the manuscript\nor the supplemental materials. Please provide a clear explanation of the abbreviation and its\ndefinition.\n2. There are too many tables in comparison to the study content. What is the purpose of\ncomparing patient backgrounds with and without MACCE?\n3. If the authors are performing the comparison between \"with MACCE\" and \"without\nMACCE,\" this should be clearly explained in the Methods section. The sudden introduction of\nthese new groups makes the manuscript difficult for the reader to follow.\n4. In the Limitations section, the authors mention the lack of information on lipid-lowering drugs\nprior to hospitalization. However, dyslipidemia is defined in the study as including the \"use of\nlipid-lowering drugs.\" Shouldn't this inconsistency be addressed?\n5. The sudden appearance of Definitions I and II in the manuscript should be better explained\nwithin the main body rather than relegated to the supplemental materials.\n6. When presenting results, it is important to include actual values alongside your findings.\nGiven the number of tables in this study, it is inconvenient for the reader to have to constantly\nrefer back to them. Please consider including key numbers directly in the text.\n7. Regarding the multivariate Cox regression analysis, the authors mention results for two\nfactors. Was the analysis conducted only on these two factors, or were other factors included,\nwith only these two being significant? Please clarify.\n8. Thrombus lesion is identified as a significant factor influencing the results, but its definition\nis not provided. This is an important element, and its definition should be clearly explained in\nthe Methods section.\n9. The mention of clonal hematopoiesis of indeterminate potential (CHIP) in the Discussion\nseems like a significant leap based on the study results. It would be better to reconsider the\nrelevance of this point.\n10. The authors mentioned the low usage rate of ACE-i/ARB, but it is a reasonable decision\nnot to prescribe these agents in cases without hypertension or reduced left ventricular ejection\nfraction, as they are not essential for secondary prevention after ACS. This point might also\nwarrant revision.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 07 Nov 2024 Reviewer's report: I think this is an important study, as it clarifies the differences in outcomes following intervention between patients without cardiovascular risk factors (CVRFs) and those with them. I have a few questions for the authors: 1. For patients with CVRFs, there is a higher prevalence of issues such as hypertension, diabetes, and smoking. However, as shown in Table 1, there does not appear to be a higher incidence of renal dysfunction or decreased cardiac output compared to patients without CVRFs. Could you provide some insight into the possible reasons for this? 2. There seems to be no significant difference in total cholesterol and LDL-C levels between patients with and without CVRFs. Could you explain why this might be the case? 3. This study included approximately 40% of patients with STEMI, yet the vascular complexity only indicates around 2% occlusion and 10% thrombus lesions. This seems somewhat inconsistent. Could you elaborate on this? 4. Medication therapy is also crucial for these patients without CVRFs, and understanding which medications impact their prognosis seems particularly important. For this group, I feel that providing a subgroup analysis on medication effects and outcomes could increase reader interest.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 07 Nov 2024 Reviewer's report: I think this is an important study, as it clarifies the differences in outcomes following intervention between patients without cardiovascular risk factors (CVRFs) and those with them. I have a few questions for the authors: 1. For patients with CVRFs, there is a higher prevalence of issues such as hypertension, diabetes, and smoking. However, as shown in Table 1, there does not appear to be a higher incidence of renal dysfunction or decreased cardiac output compared to patients without CVRFs. Could you provide some insight into the possible reasons for this? 2. There seems to be no significant difference in total cholesterol and LDL-C levels between patients with and without CVRFs. Could you explain why this might be the case? 3. This study included approximately 40% of patients with STEMI, yet the vascular complexity only indicates around 2% occlusion and 10% thrombus lesions. This seems somewhat inconsistent. Could you elaborate on this? 4. Medication therapy is also crucial for these patients without CVRFs, and understanding which medications impact their prognosis seems particularly important. For this group, I feel that providing a subgroup analysis on medication effects and outcomes could increase reader interest.	BMC	12916_2025_3933_ReviewerReport_V0_R3.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 3, "materials_and_methods": 4, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 1, "suggestion_and_solution": 4, "total": 15 }	{ "criticism": 0.13333333333333333, "example": 0.06666666666666667, "importance_and_relevance": 0.2, "materials_and_methods": 0.26666666666666666, "praise": 0.06666666666666667, "presentation_and_reporting": 0, "results_and_discussion": 0.06666666666666667, "suggestion_and_solution": 0.26666666666666666 }	1.066667	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 0 Date: 07 Nov 2024\nReviewer's report:\nI think this is an important study, as it clarifies the differences in outcomes following intervention\nbetween patients without cardiovascular risk factors (CVRFs) and those with them. I have a few\nquestions for the authors:\n1. For patients with CVRFs, there is a higher prevalence of issues such as hypertension, diabetes,\nand smoking. However, as shown in Table 1, there does not appear to be a higher incidence of\nrenal dysfunction or decreased cardiac output compared to patients without CVRFs. Could you\nprovide some insight into the possible reasons for this?\n2. There seems to be no significant difference in total cholesterol and LDL-C levels between\npatients with and without CVRFs. Could you explain why this might be the case?\n3. This study included approximately 40% of patients with STEMI, yet the vascular complexity\nonly indicates around 2% occlusion and 10% thrombus lesions. This seems somewhat\ninconsistent. Could you elaborate on this?\n4. Medication therapy is also crucial for these patients without CVRFs, and understanding which\nmedications impact their prognosis seems particularly important. For this group, I feel that\nproviding a subgroup analysis on medication effects and outcomes could increase reader interest.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 16 Nov 2024 Reviewer's report: The authors should be congratulated for this interesting and well-conducted study. The study investigators assessed the long-term outcomes of patients without traditional modifiable cardiovascular risk factors (CVRF) and undergoing PCI for ACS, using data from the OPT- CAD registry. They found no differences in the rates of MACCE between CVRFs-absent and CVRFs-present patients over five years, with age and thrombus lesions identified as independent predictors of adverse outcomes in CVRFs-absent individuals. The findings highlight the need for improved risk assessment models and targeted interventions for this unique patient subgroup. Few comments/edits to improve the current manuscript: Introduction - I recommend using the term SMuRF (standard modifiable risk factors), in line with recently published studies. - A large number of papers from different registries across the world addressing the same research question has been published over past few years. Authors should clarify in the intro section how the present study is different as well as its added value. Methods: - Definitions on how SMuRF were defined should be reported in the main manuscript text. - The cutoff for SBP and DBP in patients with CKD or diabetes should be 130 mmHg and 80 mmHg, respectively. - When were the BP measurements collected? On presentation to the ED/cath lab or in clinic? - Were patients with missing data on risk factors excluded? Please clarify exclusion criteria and report rate of missing data. - Please report the list of adjustment variables in the main manuscript text. Were results adjusted according to the different institutions where patients were treated? I would recommend performing a multivariable analysis using a mixed model with institutions as a random-effects model and patient baseline characteristics as a fixed-effects model. - Define NACE - Define ACS as inclusion criteria (cardiac biomarkers?) - Include a statement regarding study approval, informed consent, and other ethical considerations. - I recommend excluding patients with unstable angina, or at least performing a sensitivity analysis excluding patients with unstable angina. Results: - Any data on in-hospital complications and events? - Figure 2, KM curve, although no differences in MACCE on the long-term, can you provide sensitivity analysis at 2 and 3 years and explain the difference in MACCE rates between the two groups. Discussion: - Authors should discuss and compare their findings in comparison to the recently published papers on the same topic. Conclusions: - The term ‘recurrent’ is misleading. The authors did not perform any analysis for recurrent events as far as we know from the main manuscript text.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 0 Date: 16 Nov 2024 Reviewer's report: The authors should be congratulated for this interesting and well-conducted study. The study investigators assessed the long-term outcomes of patients without traditional modifiable cardiovascular risk factors (CVRF) and undergoing PCI for ACS, using data from the OPT- CAD registry. They found no differences in the rates of MACCE between CVRFs-absent and CVRFs-present patients over five years, with age and thrombus lesions identified as independent predictors of adverse outcomes in CVRFs-absent individuals. The findings highlight the need for improved risk assessment models and targeted interventions for this unique patient subgroup. Few comments/edits to improve the current manuscript: Introduction - I recommend using the term SMuRF (standard modifiable risk factors), in line with recently published studies. - A large number of papers from different registries across the world addressing the same research question has been published over past few years. Authors should clarify in the intro section how the present study is different as well as its added value. Methods: - Definitions on how SMuRF were defined should be reported in the main manuscript text. - The cutoff for SBP and DBP in patients with CKD or diabetes should be 130 mmHg and 80 mmHg, respectively. - When were the BP measurements collected? On presentation to the ED/cath lab or in clinic? - Were patients with missing data on risk factors excluded? Please clarify exclusion criteria and report rate of missing data. - Please report the list of adjustment variables in the main manuscript text. Were results adjusted according to the different institutions where patients were treated? I would recommend performing a multivariable analysis using a mixed model with institutions as a random-effects model and patient baseline characteristics as a fixed-effects model. - Define NACE - Define ACS as inclusion criteria (cardiac biomarkers?) - Include a statement regarding study approval, informed consent, and other ethical considerations. - I recommend excluding patients with unstable angina, or at least performing a sensitivity analysis excluding patients with unstable angina. Results: - Any data on in-hospital complications and events? - Figure 2, KM curve, although no differences in MACCE on the long-term, can you provide sensitivity analysis at 2 and 3 years and explain the difference in MACCE rates between the two groups. Discussion: - Authors should discuss and compare their findings in comparison to the recently published papers on the same topic. Conclusions: - The term ‘recurrent’ is misleading. The authors did not perform any analysis for recurrent events as far as we know from the main manuscript text.	BMC	12916_2025_3933_ReviewerReport_V0_R2.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 2, "materials_and_methods": 16, "praise": 1, "presentation_and_reporting": 8, "results_and_discussion": 7, "suggestion_and_solution": 13, "total": 24 }	{ "criticism": 0.08333333333333333, "example": 0.041666666666666664, "importance_and_relevance": 0.08333333333333333, "materials_and_methods": 0.6666666666666666, "praise": 0.041666666666666664, "presentation_and_reporting": 0.3333333333333333, "results_and_discussion": 0.2916666666666667, "suggestion_and_solution": 0.5416666666666666 }	2.083333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 0 Date: 16 Nov 2024\nReviewer's report:\nThe authors should be congratulated for this interesting and well-conducted study. The\nstudy investigators assessed the long-term outcomes of patients without traditional modifiable\ncardiovascular risk factors (CVRF) and undergoing PCI for ACS, using data from the OPT-\nCAD registry. They found no differences in the rates of MACCE between CVRFs-absent and\nCVRFs-present patients over five years, with age and thrombus lesions identified as independent\npredictors of adverse outcomes in CVRFs-absent individuals. The findings highlight the need\nfor improved risk assessment models and targeted interventions for this unique patient subgroup.\nFew comments/edits to improve the current manuscript:\nIntroduction\n- I recommend using the term SMuRF (standard modifiable risk factors), in line with recently\npublished studies.\n- A large number of papers from different registries across the world addressing the same\nresearch question has been published over past few years. Authors should clarify in the intro\nsection how the present study is different as well as its added value.\nMethods:\n- Definitions on how SMuRF were defined should be reported in the main manuscript text.\n- The cutoff for SBP and DBP in patients with CKD or diabetes should be 130 mmHg and 80\nmmHg, respectively.\n- When were the BP measurements collected? On presentation to the ED/cath lab or in clinic?\n- Were patients with missing data on risk factors excluded? Please clarify exclusion criteria and\nreport rate of missing data.\n- Please report the list of adjustment variables in the main manuscript text. Were results\nadjusted according to the different institutions where patients were treated? I would recommend\nperforming a multivariable analysis using a mixed model with institutions as a random-effects\nmodel and patient baseline characteristics as a fixed-effects model.\n- Define NACE\n- Define ACS as inclusion criteria (cardiac biomarkers?)\n- Include a statement regarding study approval, informed consent, and other ethical\nconsiderations.\n- I recommend excluding patients with unstable angina, or at least performing a sensitivity\nanalysis excluding patients with unstable angina.\nResults:\n- Any data on in-hospital complications and events?\n- Figure 2, KM curve, although no differences in MACCE on the long-term, can you provide\nsensitivity analysis at 2 and 3 years and explain the difference in MACCE rates between the\ntwo groups.\nDiscussion:\n- Authors should discuss and compare their findings in comparison to the recently published\npapers on the same topic.\nConclusions:\n- The term ‘recurrent’ is misleading. The authors did not perform any analysis for recurrent\nevents as far as we know from the main manuscript text.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 11 Dec 2024 Reviewer's report: The authors successfully answered all of my comments.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 11 Dec 2024 Reviewer's report: The authors successfully answered all of my comments.	BMC	12916_2025_3933_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 1 Date: 11 Dec 2024\nReviewer's report:\nThe authors successfully answered all of my comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 13 Dec 2024 Reviewer's report: I think the current version of the article has been revised very well, and I have no additional suggestions.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 13 Dec 2024 Reviewer's report: I think the current version of the article has been revised very well, and I have no additional suggestions.	BMC	12916_2025_3933_ReviewerReport_V1_R3.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	2	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 1 Date: 13 Dec 2024\nReviewer's report:\nI think the current version of the article has been revised very well, and I have no additional\nsuggestions.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03933-2	Reviewed - bmc_medicine	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 02 Jan 2025 Reviewer's report: We have reviewed the revised manuscript. The authors' responses to the points raised by me and other reviewers were appropriate. All comments are taken seriously and are well written. I believe the manuscript is acceptable.	Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort Version: 1 Date: 02 Jan 2025 Reviewer's report: We have reviewed the revised manuscript. The authors' responses to the points raised by me and other reviewers were appropriate. All comments are taken seriously and are well written. I believe the manuscript is acceptable.	BMC	12916_2025_3933_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 3, "presentation_and_reporting": 1, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 4 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0.75, "presentation_and_reporting": 0.25, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous\ncoronary intervention without standard modifiable cardiovascular risk factors: findings from the\nOPT-CAD cohort\nVersion: 1 Date: 02 Jan 2025\nReviewer's report:\nWe have reviewed the revised manuscript. The authors' responses to the points raised by me\nand other reviewers were appropriate. All comments are taken seriously and are well written.\nI believe the manuscript is acceptable.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 03 Sep 2024 Reviewer's report: I have reviewed the manuscript you provided. Below is a constructive critique with three areas for improvement and a positive comment on the work. Positive Comments The article presents an innovative and well-grounded approach to assessing nutritional and inflammatory risk in patients with non-small cell lung cancer (NSCLC) undergoing video- assisted lobectomy. The introduction of the Systemic Nutrition-Inflammation Index (SNII) as a predictive tool for perioperative management is particularly valuable. The study’s structure is solid, and the validation of the SNII in independent cohorts strengthens the robustness of the findings. The use of multivariable analyses and the focus on specific subgroups add depth to the study, suggesting that the SNII could be a useful tool in clinical practice. Areas for Improvement Clarity in the Presentation of Statistical Results: Although the results are well-founded, certain sections, such as Table 3, might be confusing for readers due to the complexity of the multivariable analyses. Simplifying the presentation or providing additional explanations on the interpretation of the adjusted models (Models 1, 2, and 3) would make it easier for readers to understand how each model contributes to the overall analysis. Discussion on the Generalization of SNII: The article mentions the need to validate the SNII in additional clinical settings, but it could expand on the limitations of its applicability in different populations and cancer types. A more detailed discussion on how variations in population characteristics or surgical protocols might impact the efficacy of the SNII and what additional steps could be taken to adapt or validate the index in these scenarios would be beneficial. Integration of Psychosocial Factors and Comorbidities: While the article effectively addresses nutritional and inflammatory aspects, it does not go into detail on other important factors that could influence perioperative outcomes, such as the patients’ psychosocial status or the presence of additional comorbidities. Including a discussion on how these factors might interact with the SNII would enhance the clinical relevance of the study. Overall, the article is a valuable contribution to the field of thoracic oncology and has great potential to improve the perioperative management of NSCLC patients. With some minor improvements in clarity and discussion, the manuscript would be even more ready for publication.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 03 Sep 2024 Reviewer's report: I have reviewed the manuscript you provided. Below is a constructive critique with three areas for improvement and a positive comment on the work. Positive Comments The article presents an innovative and well-grounded approach to assessing nutritional and inflammatory risk in patients with non-small cell lung cancer (NSCLC) undergoing video- assisted lobectomy. The introduction of the Systemic Nutrition-Inflammation Index (SNII) as a predictive tool for perioperative management is particularly valuable. The study’s structure is solid, and the validation of the SNII in independent cohorts strengthens the robustness of the findings. The use of multivariable analyses and the focus on specific subgroups add depth to the study, suggesting that the SNII could be a useful tool in clinical practice. Areas for Improvement Clarity in the Presentation of Statistical Results: Although the results are well-founded, certain sections, such as Table 3, might be confusing for readers due to the complexity of the multivariable analyses. Simplifying the presentation or providing additional explanations on the interpretation of the adjusted models (Models 1, 2, and 3) would make it easier for readers to understand how each model contributes to the overall analysis. Discussion on the Generalization of SNII: The article mentions the need to validate the SNII in additional clinical settings, but it could expand on the limitations of its applicability in different populations and cancer types. A more detailed discussion on how variations in population characteristics or surgical protocols might impact the efficacy of the SNII and what additional steps could be taken to adapt or validate the index in these scenarios would be beneficial. Integration of Psychosocial Factors and Comorbidities: While the article effectively addresses nutritional and inflammatory aspects, it does not go into detail on other important factors that could influence perioperative outcomes, such as the patients’ psychosocial status or the presence of additional comorbidities. Including a discussion on how these factors might interact with the SNII would enhance the clinical relevance of the study. Overall, the article is a valuable contribution to the field of thoracic oncology and has great potential to improve the perioperative management of NSCLC patients. With some minor improvements in clarity and discussion, the manuscript would be even more ready for publication.	BMC	12916_2025_3925_ReviewerReport_V0_R3.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 6, "materials_and_methods": 10, "praise": 8, "presentation_and_reporting": 2, "results_and_discussion": 6, "suggestion_and_solution": 6, "total": 14 }	{ "criticism": 0.07142857142857142, "example": 0, "importance_and_relevance": 0.42857142857142855, "materials_and_methods": 0.7142857142857143, "praise": 0.5714285714285714, "presentation_and_reporting": 0.14285714285714285, "results_and_discussion": 0.42857142857142855, "suggestion_and_solution": 0.42857142857142855 }	2.785714	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 0 Date: 03 Sep 2024\nReviewer's report:\nI have reviewed the manuscript you provided. Below is a constructive critique with three areas\nfor improvement and a positive comment on the work.\nPositive Comments\nThe article presents an innovative and well-grounded approach to assessing nutritional and\ninflammatory risk in patients with non-small cell lung cancer (NSCLC) undergoing video-\nassisted lobectomy. The introduction of the Systemic Nutrition-Inflammation Index (SNII) as a\npredictive tool for perioperative management is particularly valuable. The study’s structure is\nsolid, and the validation of the SNII in independent cohorts strengthens the robustness of the\nfindings. The use of multivariable analyses and the focus on specific subgroups add depth to the\nstudy, suggesting that the SNII could be a useful tool in clinical practice.\nAreas for Improvement\nClarity in the Presentation of Statistical Results:\nAlthough the results are well-founded, certain sections, such as Table 3, might be confusing\nfor readers due to the complexity of the multivariable analyses. Simplifying the presentation\nor providing additional explanations on the interpretation of the adjusted models (Models 1, 2,\nand 3) would make it easier for readers to understand how each model contributes to the overall\nanalysis.\nDiscussion on the Generalization of SNII:\nThe article mentions the need to validate the SNII in additional clinical settings, but it could\nexpand on the limitations of its applicability in different populations and cancer types. A more\ndetailed discussion on how variations in population characteristics or surgical protocols might\nimpact the efficacy of the SNII and what additional steps could be taken to adapt or validate the\nindex in these scenarios would be beneficial.\nIntegration of Psychosocial Factors and Comorbidities:\nWhile the article effectively addresses nutritional and inflammatory aspects, it does not go\ninto detail on other important factors that could influence perioperative outcomes, such as the\npatients’ psychosocial status or the presence of additional comorbidities. Including a discussion\non how these factors might interact with the SNII would enhance the clinical relevance of the\nstudy.\nOverall, the article is a valuable contribution to the field of thoracic oncology and has\ngreat potential to improve the perioperative management of NSCLC patients. With some\nminor improvements in clarity and discussion, the manuscript would be even more ready for\npublication.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 09 Sep 2024 Reviewer: Taro Okayama Reviewer's report: The authors developed a new nutritional and inflammatory status index, the SNII, and investigated its validity in non-small cell lung cancer patients undergoing VATS thoracoscopic lobectomy. As the authors stated in the “Background”, many studies have shown the impact of pre-treatment nutritional and inflammatory status on long-term prognosis but with less emphasis on short-term perioperative outcomes. The authors should state more why they developed the new index in more detail. Minor comments (1) The authors should give the sufficient rationale why a new single tertile indicator had to be developed this time. The shortcomings of current nutritional and inflammatory assessments described in Supplement 1 in predicting perioperative outcomes should be stated too. (2) In the "Nutrition/inflammation risk assessment" section of Materials and Methods, the authors simply state "Based on the predictive performance of these indicators for postoperative endpoints in the development cohort (Table 1), we established a new index, the SNII, defined as total cholesterol × total lymphocytes / total monocytes". The authors should state here the reason why SNII is selected among many possible candidates including other composite biochemical indicators.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 09 Sep 2024 Reviewer: Taro Okayama Reviewer's report: The authors developed a new nutritional and inflammatory status index, the SNII, and investigated its validity in non-small cell lung cancer patients undergoing VATS thoracoscopic lobectomy. As the authors stated in the “Background”, many studies have shown the impact of pre-treatment nutritional and inflammatory status on long-term prognosis but with less emphasis on short-term perioperative outcomes. The authors should state more why they developed the new index in more detail. Minor comments (1) The authors should give the sufficient rationale why a new single tertile indicator had to be developed this time. The shortcomings of current nutritional and inflammatory assessments described in Supplement 1 in predicting perioperative outcomes should be stated too. (2) In the "Nutrition/inflammation risk assessment" section of Materials and Methods, the authors simply state "Based on the predictive performance of these indicators for postoperative endpoints in the development cohort (Table 1), we established a new index, the SNII, defined as total cholesterol × total lymphocytes / total monocytes". The authors should state here the reason why SNII is selected among many possible candidates including other composite biochemical indicators.	BMC	12916_2025_3925_ReviewerReport_V0_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 5, "praise": 0, "presentation_and_reporting": 2, "results_and_discussion": 0, "suggestion_and_solution": 4, "total": 7 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.14285714285714285, "materials_and_methods": 0.7142857142857143, "praise": 0, "presentation_and_reporting": 0.2857142857142857, "results_and_discussion": 0, "suggestion_and_solution": 0.5714285714285714 }	1.714286	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 0 Date: 09 Sep 2024\nReviewer: Taro Okayama\nReviewer's report:\nThe authors developed a new nutritional and inflammatory status index, the SNII, and\ninvestigated its validity in non-small cell lung cancer patients undergoing VATS thoracoscopic\nlobectomy. As the authors stated in the “Background”, many studies have shown the impact of\npre-treatment nutritional and inflammatory status on long-term prognosis but with less emphasis\non short-term perioperative outcomes. The authors should state more why they developed the\nnew index in more detail.\nMinor comments\n(1) The authors should give the sufficient rationale why a new single tertile indicator had to\nbe developed this time. The shortcomings of current nutritional and inflammatory assessments\ndescribed in Supplement 1 in predicting perioperative outcomes should be stated too.\n(2) In the \"Nutrition/inflammation risk assessment\" section of Materials and Methods, the\nauthors simply state \"Based on the predictive performance of these indicators for postoperative\nendpoints in the development cohort (Table 1), we established a new index, the SNII, defined as\ntotal cholesterol × total lymphocytes / total monocytes\". The authors should state here the reason\nwhy SNII is selected among many possible candidates including other composite biochemical\nindicators.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 23 Sep 2024 Reviewer's report: Peiyu Wang et al developed and validated the SNII as a tool for identifying systemic nutrition and inflammation risk, which can enhance perioperative managements in NSCLC patients. This study is very informative and uses appropriate statistics. But I think that there are several concerns. Major comments 1) The value of SNII is unclear. Currently, there are a lot of biomarkers of nutrition and inflammation that have sufficient clinical significance, like the supplementary Table 1. In fact, table 1 showed that Total cholesterol, COUNT, LMR, and SIRI had mild predictive capability for postoperative complication (AUC: 0.43 to 0.58, p: <0.01). However, newly developed SNII had low predictive capability (AUC: 0.39, p: <0.001). What is the value of SNII for predicting postoperative complications, compared with other useful biomarkers of nutrition and inflammation? You have to indicate the more clinical advantages of SNII than other biomarkers, for example, predictive capability for all specific or severe complications, re-admission rate, or survival. 2) The methodology for the determination of SNII is unclear. Methodology for the determination of SNII is unclear, which means arbitrary. Why did you use Total cholesterol and LMR only for SNII? Why without COUNT and SIRI? What is this methodology? The detailed methodology to determine domains (Total cholesterol, LMR, etc.) and to develop a formula for SNII must be completely clear in the methods section. Minor comment 3) Inappropriate statement In the method section, you stated, "Based on the predictive performance of these indicators for postoperative endpoints in the development cohort (Table 1), we established a new index, the SNII, defined as total cholesterol × total lymphocytes / total monocytes. The SNII classification system, with tertiles of patient values as cutoffs, categorized nutrition/inflammation risk into low (>23.14), moderate (15.62-23.14), and high (<15.62). The predictive efficacy of the SNII classification system for perioperative endpoints was validated in the external cohort." This statement must be in the results section because these are obvious results. You have to write the methodology of cutoff definition, group definition, determination of domains, and development of a formula for SNII. You must not write results.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 0 Date: 23 Sep 2024 Reviewer's report: Peiyu Wang et al developed and validated the SNII as a tool for identifying systemic nutrition and inflammation risk, which can enhance perioperative managements in NSCLC patients. This study is very informative and uses appropriate statistics. But I think that there are several concerns. Major comments 1) The value of SNII is unclear. Currently, there are a lot of biomarkers of nutrition and inflammation that have sufficient clinical significance, like the supplementary Table 1. In fact, table 1 showed that Total cholesterol, COUNT, LMR, and SIRI had mild predictive capability for postoperative complication (AUC: 0.43 to 0.58, p: <0.01). However, newly developed SNII had low predictive capability (AUC: 0.39, p: <0.001). What is the value of SNII for predicting postoperative complications, compared with other useful biomarkers of nutrition and inflammation? You have to indicate the more clinical advantages of SNII than other biomarkers, for example, predictive capability for all specific or severe complications, re-admission rate, or survival. 2) The methodology for the determination of SNII is unclear. Methodology for the determination of SNII is unclear, which means arbitrary. Why did you use Total cholesterol and LMR only for SNII? Why without COUNT and SIRI? What is this methodology? The detailed methodology to determine domains (Total cholesterol, LMR, etc.) and to develop a formula for SNII must be completely clear in the methods section. Minor comment 3) Inappropriate statement In the method section, you stated, "Based on the predictive performance of these indicators for postoperative endpoints in the development cohort (Table 1), we established a new index, the SNII, defined as total cholesterol × total lymphocytes / total monocytes. The SNII classification system, with tertiles of patient values as cutoffs, categorized nutrition/inflammation risk into low (>23.14), moderate (15.62-23.14), and high (<15.62). The predictive efficacy of the SNII classification system for perioperative endpoints was validated in the external cohort." This statement must be in the results section because these are obvious results. You have to write the methodology of cutoff definition, group definition, determination of domains, and development of a formula for SNII. You must not write results.	BMC	12916_2025_3925_ReviewerReport_V0_R1.pdf	{ "criticism": 6, "example": 1, "importance_and_relevance": 2, "materials_and_methods": 17, "praise": 1, "presentation_and_reporting": 6, "results_and_discussion": 2, "suggestion_and_solution": 5, "total": 22 }	{ "criticism": 0.2727272727272727, "example": 0.045454545454545456, "importance_and_relevance": 0.09090909090909091, "materials_and_methods": 0.7727272727272727, "praise": 0.045454545454545456, "presentation_and_reporting": 0.2727272727272727, "results_and_discussion": 0.09090909090909091, "suggestion_and_solution": 0.22727272727272727 }	1.818182	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 0 Date: 23 Sep 2024\nReviewer's report:\nPeiyu Wang et al developed and validated the SNII as a tool for identifying systemic nutrition\nand inflammation risk, which can enhance perioperative managements in NSCLC patients.\nThis study is very informative and uses appropriate statistics.\nBut I think that there are several concerns.\nMajor comments\n1) The value of SNII is unclear.\nCurrently, there are a lot of biomarkers of nutrition and inflammation that have sufficient clinical\nsignificance, like the supplementary Table 1.\nIn fact, table 1 showed that Total cholesterol, COUNT, LMR, and SIRI had mild predictive\ncapability for postoperative complication (AUC: 0.43 to 0.58, p: <0.01).\nHowever, newly developed SNII had low predictive capability (AUC: 0.39, p: <0.001).\nWhat is the value of SNII for predicting postoperative complications, compared with other useful\nbiomarkers of nutrition and inflammation?\nYou have to indicate the more clinical advantages of SNII than other biomarkers, for example,\npredictive capability for all specific or severe complications, re-admission rate, or survival.\n2) The methodology for the determination of SNII is unclear.\nMethodology for the determination of SNII is unclear, which means arbitrary.\nWhy did you use Total cholesterol and LMR only for SNII? Why without COUNT and SIRI?\nWhat is this methodology?\nThe detailed methodology to determine domains (Total cholesterol, LMR, etc.) and to develop\na formula for SNII must be completely clear in the methods section.\nMinor comment\n3) Inappropriate statement\nIn the method section, you stated, \"Based on the predictive performance of these indicators for\npostoperative endpoints in the development cohort (Table 1), we established a new index, the\nSNII, defined as total cholesterol × total lymphocytes / total monocytes. The SNII classification\nsystem, with tertiles of patient values as cutoffs, categorized nutrition/inflammation risk into\nlow (>23.14), moderate (15.62-23.14), and high (<15.62). The predictive efficacy of the SNII\nclassification system for perioperative endpoints was validated in the external cohort.\"\nThis statement must be in the results section because these are obvious results.\nYou have to write the methodology of cutoff definition, group definition, determination of\ndomains, and development of a formula for SNII. You must not write results.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 24 Dec 2024 Reviewer: Taro Okayama Reviewer's report: Dear Authors, In this revision, the authors have responded well to the previous critique. This is a markedly improved manuscript which merits publication. Thank you for all your efforts.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 24 Dec 2024 Reviewer: Taro Okayama Reviewer's report: Dear Authors, In this revision, the authors have responded well to the previous critique. This is a markedly improved manuscript which merits publication. Thank you for all your efforts.	BMC	12916_2025_3925_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 1, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 3 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.3333333333333333, "praise": 0.6666666666666666, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 1 Date: 24 Dec 2024\nReviewer: Taro Okayama\nReviewer's report:\nDear Authors,\nIn this revision, the authors have responded well to the previous critique. This is a markedly\nimproved manuscript which merits publication. Thank you for all your efforts.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 13 Jan 2025 Reviewer's report: The revised manuscript demonstrates significant improvements and successfully addresses the previous feedback. The study is well-structured, and the methodology, results, and discussion are clearly presented. The addition of subgroup analyses and the emphasis on the clinical applicability of SNII are valuable contributions that enhance the manuscript’s impact. Before final submission, a few minor edits are recommended: Ensure consistent use of decimals across numerical data, such as SNII values and percentages. Reintroduce abbreviations like SNII and CCI when they first appear in new sections for clarity. Review table and figure titles to ensure they are clear and descriptive enough to stand alone. Address minor typographical edits, including punctuation in the discussion section. Verify that references follow the journal’s required format, particularly DOI links and author names. These minor adjustments will help polish the manuscript further. Overall, the study is of high quality and a valuable contribution to the field.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 13 Jan 2025 Reviewer's report: The revised manuscript demonstrates significant improvements and successfully addresses the previous feedback. The study is well-structured, and the methodology, results, and discussion are clearly presented. The addition of subgroup analyses and the emphasis on the clinical applicability of SNII are valuable contributions that enhance the manuscript’s impact. Before final submission, a few minor edits are recommended: Ensure consistent use of decimals across numerical data, such as SNII values and percentages. Reintroduce abbreviations like SNII and CCI when they first appear in new sections for clarity. Review table and figure titles to ensure they are clear and descriptive enough to stand alone. Address minor typographical edits, including punctuation in the discussion section. Verify that references follow the journal’s required format, particularly DOI links and author names. These minor adjustments will help polish the manuscript further. Overall, the study is of high quality and a valuable contribution to the field.	BMC	12916_2025_3925_ReviewerReport_V1_R3.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 2, "materials_and_methods": 4, "praise": 6, "presentation_and_reporting": 6, "results_and_discussion": 2, "suggestion_and_solution": 5, "total": 10 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.2, "materials_and_methods": 0.4, "praise": 0.6, "presentation_and_reporting": 0.6, "results_and_discussion": 0.2, "suggestion_and_solution": 0.5 }	2.5	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 1 Date: 13 Jan 2025\nReviewer's report:\nThe revised manuscript demonstrates significant improvements and successfully addresses the\nprevious feedback. The study is well-structured, and the methodology, results, and discussion\nare clearly presented. The addition of subgroup analyses and the emphasis on the clinical\napplicability of SNII are valuable contributions that enhance the manuscript’s impact.\nBefore final submission, a few minor edits are recommended:\nEnsure consistent use of decimals across numerical data, such as SNII values and percentages.\nReintroduce abbreviations like SNII and CCI when they first appear in new sections for clarity.\nReview table and figure titles to ensure they are clear and descriptive enough to stand alone.\nAddress minor typographical edits, including punctuation in the discussion section.\nVerify that references follow the journal’s required format, particularly DOI links and author\nnames.\nThese minor adjustments will help polish the manuscript further. Overall, the study is of high\nquality and a valuable contribution to the field.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03925-2	Reviewed - bmc_medicine	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 15 Jan 2025 Reviewer's report: The author's work was perfect. This manuscript was more improved as valuable for medical science and clinical practice. I have no additional comments.	Title: Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer Version: 1 Date: 15 Jan 2025 Reviewer's report: The author's work was perfect. This manuscript was more improved as valuable for medical science and clinical practice. I have no additional comments.	BMC	12916_2025_3925_ReviewerReport_V1_R1.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 1, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 3 }	{ "criticism": 0.3333333333333333, "example": 0, "importance_and_relevance": 0.3333333333333333, "materials_and_methods": 0.3333333333333333, "praise": 0.6666666666666666, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.666667	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Development and validation of the systemic nutrition/inflammation index for improving\nperioperative management of non-small cell lung cancer\nVersion: 1 Date: 15 Jan 2025\nReviewer's report:\nThe author's work was perfect.\nThis manuscript was more improved as valuable for medical science and clinical practice.\nI have no additional comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03851-3	Reviewed - bmc_medicine	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 0 Date: 20 Jul 2024 Reviewer's report: This national cohort study investigates the impact of antidepressants on cognitive decline in dementia patients, including the risks of severe dementia, fractures, and death. Analyzing data from 18,740 patients in the Swedish Registry for Cognitive/Dementia Disorders (SveDem), the study found that 22.8% of patients used antidepressants, with SSRIs being the most common. Antidepressant use, particularly SSRIs, was linked to faster cognitive decline and higher risks of severe dementia, fractures, and mortality. The study highlights a dose-response relationship, suggesting higher doses of SSRIs correlate with increased adverse outcomes. It remains unclear if these effects stem from antidepressants or underlying psychiatric conditions. However, there are several concerns in this study. There are 79705 patients in the database; however, We found there is only 18740 patients were included in the final analysis. The authors should discuss generalability or representativeness. We found that around 30% of patients have an MMSE score of 25 or more. Is it possible to include patients with mild cognitive impairment or those with pseudodementia? Is there any study validation study for the accuracy of clinical diagnosis? This study may be biased by therapeutic indication. Antidepressants were prescribed not only for depression but also for anxiety and other behavioral syndromes associated with dementia. Therefore, the subgroup analysis for patients without depression may not fully eliminate the possibility of confounding by indication. I believe the authors have discussed these issues in the limitations section. However, the conclusions in the main text should be more conservative. The methods for evaluating modifying effects should be rigorously tested statistically and detailed in the statistical analysis section. In the results section, it remains unclear whether only sex and the use of anxiolytics exhibited significant modification effects. Could the authors please clarify these points? Regarding the analysis, when using non-use as a reference, cognitive decline appeared more pronounced with citalopram than with sertraline. However, when using sertraline as the reference, citalopram seemed less likely to induce cognitive decline. Could the authors explain this discrepancy?	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 0 Date: 20 Jul 2024 Reviewer's report: This national cohort study investigates the impact of antidepressants on cognitive decline in dementia patients, including the risks of severe dementia, fractures, and death. Analyzing data from 18,740 patients in the Swedish Registry for Cognitive/Dementia Disorders (SveDem), the study found that 22.8% of patients used antidepressants, with SSRIs being the most common. Antidepressant use, particularly SSRIs, was linked to faster cognitive decline and higher risks of severe dementia, fractures, and mortality. The study highlights a dose-response relationship, suggesting higher doses of SSRIs correlate with increased adverse outcomes. It remains unclear if these effects stem from antidepressants or underlying psychiatric conditions. However, there are several concerns in this study. There are 79705 patients in the database; however, We found there is only 18740 patients were included in the final analysis. The authors should discuss generalability or representativeness. We found that around 30% of patients have an MMSE score of 25 or more. Is it possible to include patients with mild cognitive impairment or those with pseudodementia? Is there any study validation study for the accuracy of clinical diagnosis? This study may be biased by therapeutic indication. Antidepressants were prescribed not only for depression but also for anxiety and other behavioral syndromes associated with dementia. Therefore, the subgroup analysis for patients without depression may not fully eliminate the possibility of confounding by indication. I believe the authors have discussed these issues in the limitations section. However, the conclusions in the main text should be more conservative. The methods for evaluating modifying effects should be rigorously tested statistically and detailed in the statistical analysis section. In the results section, it remains unclear whether only sex and the use of anxiolytics exhibited significant modification effects. Could the authors please clarify these points? Regarding the analysis, when using non-use as a reference, cognitive decline appeared more pronounced with citalopram than with sertraline. However, when using sertraline as the reference, citalopram seemed less likely to induce cognitive decline. Could the authors explain this discrepancy?	BMC	12916_2025_3851_ReviewerReport_V0_R1.pdf	{ "criticism": 3, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 10, "praise": 1, "presentation_and_reporting": 3, "results_and_discussion": 5, "suggestion_and_solution": 4, "total": 22 }	{ "criticism": 0.13636363636363635, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0.45454545454545453, "praise": 0.045454545454545456, "presentation_and_reporting": 0.13636363636363635, "results_and_discussion": 0.22727272727272727, "suggestion_and_solution": 0.18181818181818182 }	1.181818	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study\nVersion: 0 Date: 20 Jul 2024\nReviewer's report:\nThis national cohort study investigates the impact of antidepressants on cognitive decline in\ndementia patients, including the risks of severe dementia, fractures, and death. Analyzing data\nfrom 18,740 patients in the Swedish Registry for Cognitive/Dementia Disorders (SveDem), the\nstudy found that 22.8% of patients used antidepressants, with SSRIs being the most common.\nAntidepressant use, particularly SSRIs, was linked to faster cognitive decline and higher risks\nof severe dementia, fractures, and mortality. The study highlights a dose-response relationship,\nsuggesting higher doses of SSRIs correlate with increased adverse outcomes. It remains unclear\nif these effects stem from antidepressants or underlying psychiatric conditions.\nHowever, there are several concerns in this study.\nThere are 79705 patients in the database; however, We found there is only 18740 patients were\nincluded in the final analysis. The authors should discuss generalability or representativeness.\nWe found that around 30% of patients have an MMSE score of 25 or more. Is it possible to\ninclude patients with mild cognitive impairment or those with pseudodementia? Is there any\nstudy validation study for the accuracy of clinical diagnosis?\nThis study may be biased by therapeutic indication. Antidepressants were prescribed not only\nfor depression but also for anxiety and other behavioral syndromes associated with dementia.\nTherefore, the subgroup analysis for patients without depression may not fully eliminate the\npossibility of confounding by indication. I believe the authors have discussed these issues in the\nlimitations section. However, the conclusions in the main text should be more conservative.\nThe methods for evaluating modifying effects should be rigorously tested statistically and\ndetailed in the statistical analysis section. In the results section, it remains unclear whether only\nsex and the use of anxiolytics exhibited significant modification effects. Could the authors please\nclarify these points?\nRegarding the analysis, when using non-use as a reference, cognitive decline appeared more\npronounced with citalopram than with sertraline. However, when using sertraline as the\nreference, citalopram seemed less likely to induce cognitive decline. Could the authors explain\nthis discrepancy?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03851-3	Reviewed - bmc_medicine	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 0 Date: 20 Aug 2024 Reviewer's report: I have provided my comments in the uploaded document.	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 0 Date: 20 Aug 2024 Reviewer's report: I have provided my comments in the uploaded document.	BMC	12916_2025_3851_ReviewerReport_V0_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study\nVersion: 0 Date: 20 Aug 2024\nReviewer's report:\nI have provided my comments in the uploaded document.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03851-3	Reviewed - bmc_medicine	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 1 Date: 15 Oct 2024 Reviewer's report: The authors have addressed all my concerns; I have no further comments.	Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study Version: 1 Date: 15 Oct 2024 Reviewer's report: The authors have addressed all my concerns; I have no further comments.	BMC	12916_2025_3851_ReviewerReport_V1_R1.pdf	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 1, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Antidepressant use and cognitive decline in patients with dementia: a national cohort study\nVersion: 1 Date: 15 Oct 2024\nReviewer's report:\nThe authors have addressed all my concerns; I have no further comments.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03928-z	Reviewed - bmc_medicine	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 0 Date: 18 Nov 2024 Reviewer: Nathaniel Hendrix Reviewer's report: Thanks for the opportunity to review this interesting and highly relevant manuscript on RSV prevention strategies in Canada. My overall impression is that it’s clearly-written and represents a well-executed analysis. I especially like the depth of analysis represented in Figure 3 and in the analysis of waning effectiveness. The focus on heterogeneity within Canada is also commendable. Below are a few suggestions that I hope you might consider to further improve the manuscript. - Abstract: This is a very thorough analysis, and it’s difficult to include all its findings in the abstract. Still, I think it would be helpful to include some cost-effectiveness ratios with uncertainty measures in the results section of the abstract. To make room, you might consider dropping or abbreviating your discussion of Abrysvo-nirsevimab combination therapy, which raises a lot of questions without having the space to answer them. - Methods: I’m not clear on whether there are any regional differences in outcomes of hospitalization. Whether because of limited medical resources or because of treatment delays attributable to the medical evacuation, it seems plausible that outcomes may vary even with hospitalization. Would it be possible to include these differences (if any) in the analysis? - Methods: Does the one-year time horizon really allow for inclusion of the full impacts of mortality? An infant’s death causes a lot of lost years of life, while recovering from RSV has minimal if any impact on quality of life after recovery. I think a lifetime time horizon is potentially feasible and worth considering for this reason, although I recognize that there are trade-offs. - Methods: In cases where nirsevimab uptake/availability is sub-optimal, do you assume 100% uptake/availability of Abrysvo? - Out of curiosity, why wasn’t Yukon Territory included? It’s more populous than the other northern regions and seems to have many of the same challenges.	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 0 Date: 18 Nov 2024 Reviewer: Nathaniel Hendrix Reviewer's report: Thanks for the opportunity to review this interesting and highly relevant manuscript on RSV prevention strategies in Canada. My overall impression is that it’s clearly-written and represents a well-executed analysis. I especially like the depth of analysis represented in Figure 3 and in the analysis of waning effectiveness. The focus on heterogeneity within Canada is also commendable. Below are a few suggestions that I hope you might consider to further improve the manuscript. - Abstract: This is a very thorough analysis, and it’s difficult to include all its findings in the abstract. Still, I think it would be helpful to include some cost-effectiveness ratios with uncertainty measures in the results section of the abstract. To make room, you might consider dropping or abbreviating your discussion of Abrysvo-nirsevimab combination therapy, which raises a lot of questions without having the space to answer them. - Methods: I’m not clear on whether there are any regional differences in outcomes of hospitalization. Whether because of limited medical resources or because of treatment delays attributable to the medical evacuation, it seems plausible that outcomes may vary even with hospitalization. Would it be possible to include these differences (if any) in the analysis? - Methods: Does the one-year time horizon really allow for inclusion of the full impacts of mortality? An infant’s death causes a lot of lost years of life, while recovering from RSV has minimal if any impact on quality of life after recovery. I think a lifetime time horizon is potentially feasible and worth considering for this reason, although I recognize that there are trade-offs. - Methods: In cases where nirsevimab uptake/availability is sub-optimal, do you assume 100% uptake/availability of Abrysvo? - Out of curiosity, why wasn’t Yukon Territory included? It’s more populous than the other northern regions and seems to have many of the same challenges.	BMC	12916_2025_3928_ReviewerReport_V0_R1.pdf	{ "criticism": 3, "example": 1, "importance_and_relevance": 2, "materials_and_methods": 9, "praise": 5, "presentation_and_reporting": 2, "results_and_discussion": 3, "suggestion_and_solution": 5, "total": 17 }	{ "criticism": 0.17647058823529413, "example": 0.058823529411764705, "importance_and_relevance": 0.11764705882352941, "materials_and_methods": 0.5294117647058824, "praise": 0.29411764705882354, "presentation_and_reporting": 0.11764705882352941, "results_and_discussion": 0.17647058823529413, "suggestion_and_solution": 0.29411764705882354 }	1.764706	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing\nRespiratory Syncytial Virus Disease in Infants Across Canada\nVersion: 0 Date: 18 Nov 2024\nReviewer: Nathaniel Hendrix\nReviewer's report:\nThanks for the opportunity to review this interesting and highly relevant manuscript on RSV\nprevention strategies in Canada. My overall impression is that it’s clearly-written and represents\na well-executed analysis. I especially like the depth of analysis represented in Figure 3 and\nin the analysis of waning effectiveness. The focus on heterogeneity within Canada is also\ncommendable. Below are a few suggestions that I hope you might consider to further improve\nthe manuscript.\n- Abstract: This is a very thorough analysis, and it’s difficult to include all its findings in\nthe abstract. Still, I think it would be helpful to include some cost-effectiveness ratios with\nuncertainty measures in the results section of the abstract. To make room, you might consider\ndropping or abbreviating your discussion of Abrysvo-nirsevimab combination therapy, which\nraises a lot of questions without having the space to answer them.\n- Methods: I’m not clear on whether there are any regional differences in outcomes of\nhospitalization. Whether because of limited medical resources or because of treatment delays\nattributable to the medical evacuation, it seems plausible that outcomes may vary even with\nhospitalization. Would it be possible to include these differences (if any) in the analysis?\n- Methods: Does the one-year time horizon really allow for inclusion of the full impacts of\nmortality? An infant’s death causes a lot of lost years of life, while recovering from RSV\nhas minimal if any impact on quality of life after recovery. I think a lifetime time horizon is\npotentially feasible and worth considering for this reason, although I recognize that there are\ntrade-offs.\n- Methods: In cases where nirsevimab uptake/availability is sub-optimal, do you assume 100%\nuptake/availability of Abrysvo?\n- Out of curiosity, why wasn’t Yukon Territory included? It’s more populous than the other\nnorthern regions and seems to have many of the same challenges.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03928-z	Reviewed - bmc_medicine	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 0 Date: 25 Nov 2024 Reviewer's report: Thank you for the opportunity to revise the manuscript draft entitled "Cost-effectiveness of Nirsevimab and Abrysvo for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada." I reviewed this manuscript with great interest and provided below my suggestions for revision. Overall, the manuscript was difficult to follow as its analysis included heterogeneous patient population across different regions in Canada and for multiple treatment strategies. The model included three (3) comparators, nine (9) strategies, and four (4) regions. This seems overly ambitious for a decision tree model with numerous implied assumptions. While I applaud the efforts to expand RSV prevention, I would like suggest limiting the scope of work and adding more methodological rigor. --Comments-- 1. Please provide justification for limiting the analysis to a 12-month time horizon when RSV is the primary cause of LRTI in children under five and vaccines can confer immunity for more than 12 months. This might be related to the author's consideration to efficacy waning based on half-life of nirsevimab, palivizumab, and Abrysvo. Some treatments are concentration dependent while others are not. For vaccines, many are designed to elicit long-lasting immune response. What are the justifications for this assumption? Also, please note that the vaccine efficacy varies over different populations. Please see Tables 8-12 in Abrysvo's package insert. 2. Not just vaccine efficacy, all model inputs should be specific to different regions and populations of interests included in this analysis. Importantly, please provide information on how efficacy and update of nirsevimab, abrysvo, and palivizumab varies across different regions and patient groups (e.g., high-risk) and when used in a combination (e.g.,abrysvo+nirsevimab). If inputs are assumed to be the same in different populations and regions, please provide justification. 3. On a related note, please provide comparative effectiveness data on abrysvo, nirsevimab versus palivizumab in general infant population and high-risk infants. The study argues that abrysvo and nirsevimab can expand prevention efforts in high-risk infants and beyond. This implies that they are perfect substitutes for each other. Is that a true reflection of clinical practice? 4. I believe Abrysvo needs be referred as a maternal RSV vaccine as some journals may prohibit the use of branded names. Please check. 5. Please provide information on whether % of high-risk patients can vary by region in Canada. This could explain different hospitalization rates and is an important consideration for the analysis by region. 6. In Table 1, please use the same strategy as the reference case to avoid confusion. South had NIRS HR as the reference case and Northwest Territories NIR HR + MR. It would also be helpful to show a breakdown of the total cost; it would be helpful to see if the cost of vaccines offset the cost of hospitalizations and other healthcare resource utilization. Importantly, it is not a conventional practice to report the total cost or QALY per 1000 patients. It does not affect the ICER calculation but can give a misleading sense of the total cost. Please provide an average cost per patient, not 1,000 patients. Also, if the authors choose to present the numbers per patient, instead of 1,000 patients, the delta QALY can be extremely close to zero. The difference can be so small that the study's conclusion can change in both magnitude and direction by a small change in a model input. Please provide justifications for how such a small difference can be robust in sensitivity analysis. Please add abbreviations in all the tables and figures. 8. The authors borrowed the drug costs from the US for nirsevimab and Abrysvo. Was it WAC, AWP, or something else? Also, please provide justification for this assumption. We all know that drug prices are much cheaper in Canada. How are the prices of other vaccines compare between Canada and the US?	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 0 Date: 25 Nov 2024 Reviewer's report: Thank you for the opportunity to revise the manuscript draft entitled "Cost-effectiveness of Nirsevimab and Abrysvo for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada." I reviewed this manuscript with great interest and provided below my suggestions for revision. Overall, the manuscript was difficult to follow as its analysis included heterogeneous patient population across different regions in Canada and for multiple treatment strategies. The model included three (3) comparators, nine (9) strategies, and four (4) regions. This seems overly ambitious for a decision tree model with numerous implied assumptions. While I applaud the efforts to expand RSV prevention, I would like suggest limiting the scope of work and adding more methodological rigor. --Comments-- 1. Please provide justification for limiting the analysis to a 12-month time horizon when RSV is the primary cause of LRTI in children under five and vaccines can confer immunity for more than 12 months. This might be related to the author's consideration to efficacy waning based on half-life of nirsevimab, palivizumab, and Abrysvo. Some treatments are concentration dependent while others are not. For vaccines, many are designed to elicit long-lasting immune response. What are the justifications for this assumption? Also, please note that the vaccine efficacy varies over different populations. Please see Tables 8-12 in Abrysvo's package insert. 2. Not just vaccine efficacy, all model inputs should be specific to different regions and populations of interests included in this analysis. Importantly, please provide information on how efficacy and update of nirsevimab, abrysvo, and palivizumab varies across different regions and patient groups (e.g., high-risk) and when used in a combination (e.g.,abrysvo+nirsevimab). If inputs are assumed to be the same in different populations and regions, please provide justification. 3. On a related note, please provide comparative effectiveness data on abrysvo, nirsevimab versus palivizumab in general infant population and high-risk infants. The study argues that abrysvo and nirsevimab can expand prevention efforts in high-risk infants and beyond. This implies that they are perfect substitutes for each other. Is that a true reflection of clinical practice? 4. I believe Abrysvo needs be referred as a maternal RSV vaccine as some journals may prohibit the use of branded names. Please check. 5. Please provide information on whether % of high-risk patients can vary by region in Canada. This could explain different hospitalization rates and is an important consideration for the analysis by region. 6. In Table 1, please use the same strategy as the reference case to avoid confusion. South had NIRS HR as the reference case and Northwest Territories NIR HR + MR. It would also be helpful to show a breakdown of the total cost; it would be helpful to see if the cost of vaccines offset the cost of hospitalizations and other healthcare resource utilization. Importantly, it is not a conventional practice to report the total cost or QALY per 1000 patients. It does not affect the ICER calculation but can give a misleading sense of the total cost. Please provide an average cost per patient, not 1,000 patients. Also, if the authors choose to present the numbers per patient, instead of 1,000 patients, the delta QALY can be extremely close to zero. The difference can be so small that the study's conclusion can change in both magnitude and direction by a small change in a model input. Please provide justifications for how such a small difference can be robust in sensitivity analysis. Please add abbreviations in all the tables and figures. 8. The authors borrowed the drug costs from the US for nirsevimab and Abrysvo. Was it WAC, AWP, or something else? Also, please provide justification for this assumption. We all know that drug prices are much cheaper in Canada. How are the prices of other vaccines compare between Canada and the US?	BMC	12916_2025_3928_ReviewerReport_V0_R2.pdf	{ "criticism": 2, "example": 1, "importance_and_relevance": 3, "materials_and_methods": 21, "praise": 2, "presentation_and_reporting": 15, "results_and_discussion": 5, "suggestion_and_solution": 18, "total": 46 }	{ "criticism": 0.043478260869565216, "example": 0.021739130434782608, "importance_and_relevance": 0.06521739130434782, "materials_and_methods": 0.45652173913043476, "praise": 0.043478260869565216, "presentation_and_reporting": 0.32608695652173914, "results_and_discussion": 0.10869565217391304, "suggestion_and_solution": 0.391304347826087 }	1.456522	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing\nRespiratory Syncytial Virus Disease in Infants Across Canada\nVersion: 0 Date: 25 Nov 2024\nReviewer's report:\nThank you for the opportunity to revise the manuscript draft entitled \"Cost-effectiveness of\nNirsevimab and Abrysvo for Preventing Respiratory Syncytial Virus Disease in Infants Across\nCanada.\" I reviewed this manuscript with great interest and provided below my suggestions for\nrevision. Overall, the manuscript was difficult to follow as its analysis included heterogeneous\npatient population across different regions in Canada and for multiple treatment strategies. The\nmodel included three (3) comparators, nine (9) strategies, and four (4) regions. This seems overly\nambitious for a decision tree model with numerous implied assumptions.\nWhile I applaud the efforts to expand RSV prevention, I would like suggest limiting the scope\nof work and adding more methodological rigor.\n--Comments--\n1. Please provide justification for limiting the analysis to a 12-month time horizon when RSV\nis the primary cause of LRTI in children under five and vaccines can confer immunity for more\nthan 12 months.\nThis might be related to the author's consideration to efficacy waning based on half-life of\nnirsevimab, palivizumab, and Abrysvo. Some treatments are concentration dependent while\nothers are not. For vaccines, many are designed to elicit long-lasting immune response. What\nare the justifications for this assumption? Also, please note that the vaccine efficacy varies over\ndifferent populations. Please see Tables 8-12 in Abrysvo's package insert.\n2. Not just vaccine efficacy, all model inputs should be specific to different regions and\npopulations of interests included in this analysis. Importantly, please provide information on\nhow efficacy and update of nirsevimab, abrysvo, and palivizumab varies across different regions\nand patient groups (e.g., high-risk) and when used in a combination (e.g.,abrysvo+nirsevimab).\nIf inputs are assumed to be the same in different populations and regions, please provide\njustification.\n3. On a related note, please provide comparative effectiveness data on abrysvo, nirsevimab\nversus palivizumab in general infant population and high-risk infants. The study argues that\nabrysvo and nirsevimab can expand prevention efforts in high-risk infants and beyond. This\nimplies that they are perfect substitutes for each other. Is that a true reflection of clinical practice?\n4. I believe Abrysvo needs be referred as a maternal RSV vaccine as some journals may prohibit\nthe use of branded names. Please check.\n5. Please provide information on whether % of high-risk patients can vary by region in Canada.\nThis could explain different hospitalization rates and is an important consideration for the\nanalysis by region.\n6. In Table 1, please use the same strategy as the reference case to avoid confusion. South had\nNIRS HR as the reference case and Northwest Territories NIR HR + MR.\nIt would also be helpful to show a breakdown of the total cost; it would be helpful to see if the\ncost of vaccines offset the cost of hospitalizations and other healthcare resource utilization.\nImportantly, it is not a conventional practice to report the total cost or QALY per 1000 patients.\nIt does not affect the ICER calculation but can give a misleading sense of the total cost. Please\nprovide an average cost per patient, not 1,000 patients.\nAlso, if the authors choose to present the numbers per patient, instead of 1,000 patients, the delta\nQALY can be extremely close to zero. The difference can be so small that the study's conclusion\ncan change in both magnitude and direction by a small change in a model input. Please provide\njustifications for how such a small difference can be robust in sensitivity analysis.\nPlease add abbreviations in all the tables and figures.\n8. The authors borrowed the drug costs from the US for nirsevimab and Abrysvo. Was it WAC,\nAWP, or something else? Also, please provide justification for this assumption. We all know\nthat drug prices are much cheaper in Canada. How are the prices of other vaccines compare\nbetween Canada and the US?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03928-z	Reviewed - bmc_medicine	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 1 Date: 16 Jan 2025 Reviewer's report: Thank you for address my comments. The revised manuscript looks great. One last item that I hope authors and the editor can address is the presentation of ICER and QALYs. I am still perplexed that the authors chose to present costs and QALYs for 1000 infants. In all the other economic studies, ICERS, costs and QALYs are presented per person or per patient. Presenting costs and QALYs per 1000 infants is equivalent to multiplying the same size by 1000 to make a p-value appear more statistically significant. This does not seme to be a good research practice. In fact, this seems misleading and manipulative.	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 1 Date: 16 Jan 2025 Reviewer's report: Thank you for address my comments. The revised manuscript looks great. One last item that I hope authors and the editor can address is the presentation of ICER and QALYs. I am still perplexed that the authors chose to present costs and QALYs for 1000 infants. In all the other economic studies, ICERS, costs and QALYs are presented per person or per patient. Presenting costs and QALYs per 1000 infants is equivalent to multiplying the same size by 1000 to make a p-value appear more statistically significant. This does not seme to be a good research practice. In fact, this seems misleading and manipulative.	BMC	12916_2025_3928_ReviewerReport_V1_R2.pdf	{ "criticism": 3, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 2, "praise": 1, "presentation_and_reporting": 1, "results_and_discussion": 1, "suggestion_and_solution": 0, "total": 8 }	{ "criticism": 0.375, "example": 0, "importance_and_relevance": 0.125, "materials_and_methods": 0.25, "praise": 0.125, "presentation_and_reporting": 0.125, "results_and_discussion": 0.125, "suggestion_and_solution": 0 }	1.125	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing\nRespiratory Syncytial Virus Disease in Infants Across Canada\nVersion: 1 Date: 16 Jan 2025\nReviewer's report:\nThank you for address my comments. The revised manuscript looks great.\nOne last item that I hope authors and the editor can address is the presentation of ICER and\nQALYs. I am still perplexed that the authors chose to present costs and QALYs for 1000 infants.\nIn all the other economic studies, ICERS, costs and QALYs are presented per person or per\npatient.\nPresenting costs and QALYs per 1000 infants is equivalent to multiplying the same size by\n1000 to make a p-value appear more statistically significant. This does not seme to be a good\nresearch practice. In fact, this seems misleading and manipulative.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03928-z	Reviewed - bmc_medicine	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 1 Date: 22 Jan 2025 Reviewer: Nathaniel Hendrix Reviewer's report: Excellent work on the updates. This is fascinating work and you've executed it well! I'm happy to recommend publication.	Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing Respiratory Syncytial Virus Disease in Infants Across Canada Version: 1 Date: 22 Jan 2025 Reviewer: Nathaniel Hendrix Reviewer's report: Excellent work on the updates. This is fascinating work and you've executed it well! I'm happy to recommend publication.	BMC	12916_2025_3928_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 1, "materials_and_methods": 0, "praise": 3, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 3 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0.3333333333333333, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1.333333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Cost-Effectiveness of Nirsevimab and Maternal RSVpreF Vaccination for Preventing\nRespiratory Syncytial Virus Disease in Infants Across Canada\nVersion: 1 Date: 22 Jan 2025\nReviewer: Nathaniel Hendrix\nReviewer's report:\nExcellent work on the updates. This is fascinating work and you've executed it well! I'm happy\nto recommend publication.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03947-w	Reviewed - bmc_medicine	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 22 Oct 2024 Reviewer: Catherine Leclercq Reviewer's report: The paper deals with an important nutrition issue at global level i.e. the high consumption of Highly Processed Foods which has been put in relation with the increased level of non communicable diseases. The paper illustrates the results of a study in a low income country in its nutrition transition phase. The methodology used to answer the research question is appropriate and the results are clearly described. However, the paper needs to be significantly revised to increase its scientific rigor. 1) More rigor is needed in the choice of papers/studies which are cited, in the way they are cited and in the interpretation given to their results. a) The paper would benefit from introducing first the issue of processed foods and then that of Ultra Processed Foods, based on systematic reviews or documents from International organizations rather than to single studies. One possibility could be to make reference to the “FAO Guidelines on the collection of information on food processing through food consumption surveys” p.2, paragraphs 2 and 3 https://openknowledge.fao.org/server/api/core/bitstreams/ e9ce3172-8eb5-4f40-a494-dd5c9b39edd3/content b) More specific papers should be cited. Thus, the very first paper cited is titled “The role of trade in pacific food security and nutrition.”which does not appear appropriate to be quoted to support the following statement: “In the Pacific Island region, non-communicable diseases (NCDs) account for 70-75% of deaths and are considered an epidemic.”. More recent data in terms of death and more specific data on premature death are made available by WHO (https://www.who.int/westernpacific/news/item/17-10-2024-despite-health-gains-- urgent-action-needed-to-meet-health-related-sustainable-development-goals-in-the-western- pacific-region ) c) Many citations appear to be secondary citations (indirect references) without being reported as such. Authors may wish to mention the original author and year followed by “as cited in” before the reference of the paper listed in the bibliography. For example the definition of Ultra-processed foods (“UPF are manufactured products that consist of natural food substances, additives, and industrially produced ingredients”) is quoted from the paper “Nutritional Quality of Pre-Packaged Foods in China under Various Nutrient Profile Models” and not to original papers written ro define UPFs. d) Some statements appear to over interpretate the results of the study but also of studies reported in the bibliography. This could easily be tacked by editing the wording. - Thus, the last sentence of the abstract reads ““This study identified that UPFs are ……, and that efforts to reduce UPF consumption would also reduce intake of harmful nutrients such as sodium, fat, and sugar, crucial to reducing the diet related burden of disease” could read “UPF appear to be a large contributor to energy,sodium, fat, and sugar intake in adults in the central division of Fiji. A reduction of UPF consumption in Fiji might lead to a reduction of intake these nutrients and, thus, to the the diet related burden of disease.” Indeed it is likely but can not take for granted that UPF would be subtsituted by foods with a lower fat, sugar and sodium content. - 2) Authors may wish to further implement the “limitations” section of the paper with a further issue. : a) 24 h recalls do not allow to capture discretionary use of salt (cooking salt used at household level and table salt) but only salt present in processed foods. This potentially leads to a significant under estimate of total salt intake. The proportion of UPF to total salt intake may therefore be significantly overestimated. The proportion of discretionary salt may vary between population groups depending on the frequency of eating out and of household coking. As a consequence, the difference in proportion of sodium from UPF between groups may in part derive a a lower/ higher frequence of home cooking. 3) Minor issues a) In line 78 it is not clear what was certified by senior researchers (the translation?) and based on which methodology. b) All over the paper and tables, as appropriate, authors may wish to substitute “minimally processed” by “unprocessed or minimally processed” as defined in the background section c) Line 251, could the authors specify which aspect of “quality” of UPFs increased in the Pacific ? Is it their food safety? d) Line 279. Authors may wish to mention some traditional foods which could be used in food aid e) Authors may wish to make clear at the very beginning of the method section that the reference 8 is to a previous paper written on the same study f) The title of Table 1 may mention that the table is related to the “assignment to NOVA groups” g) Table 2 lacks the unit of measurements h) Authors use the term “salt” and “sodium” indifferently. One of the two shoul be chosen or else they should be defined.	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 22 Oct 2024 Reviewer: Catherine Leclercq Reviewer's report: The paper deals with an important nutrition issue at global level i.e. the high consumption of Highly Processed Foods which has been put in relation with the increased level of non communicable diseases. The paper illustrates the results of a study in a low income country in its nutrition transition phase. The methodology used to answer the research question is appropriate and the results are clearly described. However, the paper needs to be significantly revised to increase its scientific rigor. 1) More rigor is needed in the choice of papers/studies which are cited, in the way they are cited and in the interpretation given to their results. a) The paper would benefit from introducing first the issue of processed foods and then that of Ultra Processed Foods, based on systematic reviews or documents from International organizations rather than to single studies. One possibility could be to make reference to the “FAO Guidelines on the collection of information on food processing through food consumption surveys” p.2, paragraphs 2 and 3 https://openknowledge.fao.org/server/api/core/bitstreams/ e9ce3172-8eb5-4f40-a494-dd5c9b39edd3/content b) More specific papers should be cited. Thus, the very first paper cited is titled “The role of trade in pacific food security and nutrition.”which does not appear appropriate to be quoted to support the following statement: “In the Pacific Island region, non-communicable diseases (NCDs) account for 70-75% of deaths and are considered an epidemic.”. More recent data in terms of death and more specific data on premature death are made available by WHO (https://www.who.int/westernpacific/news/item/17-10-2024-despite-health-gains-- urgent-action-needed-to-meet-health-related-sustainable-development-goals-in-the-western- pacific-region ) c) Many citations appear to be secondary citations (indirect references) without being reported as such. Authors may wish to mention the original author and year followed by “as cited in” before the reference of the paper listed in the bibliography. For example the definition of Ultra-processed foods (“UPF are manufactured products that consist of natural food substances, additives, and industrially produced ingredients”) is quoted from the paper “Nutritional Quality of Pre-Packaged Foods in China under Various Nutrient Profile Models” and not to original papers written ro define UPFs. d) Some statements appear to over interpretate the results of the study but also of studies reported in the bibliography. This could easily be tacked by editing the wording. - Thus, the last sentence of the abstract reads ““This study identified that UPFs are ……, and that efforts to reduce UPF consumption would also reduce intake of harmful nutrients such as sodium, fat, and sugar, crucial to reducing the diet related burden of disease” could read “UPF appear to be a large contributor to energy,sodium, fat, and sugar intake in adults in the central division of Fiji. A reduction of UPF consumption in Fiji might lead to a reduction of intake these nutrients and, thus, to the the diet related burden of disease.” Indeed it is likely but can not take for granted that UPF would be subtsituted by foods with a lower fat, sugar and sodium content. - 2) Authors may wish to further implement the “limitations” section of the paper with a further issue. : a) 24 h recalls do not allow to capture discretionary use of salt (cooking salt used at household level and table salt) but only salt present in processed foods. This potentially leads to a significant under estimate of total salt intake. The proportion of UPF to total salt intake may therefore be significantly overestimated. The proportion of discretionary salt may vary between population groups depending on the frequency of eating out and of household coking. As a consequence, the difference in proportion of sodium from UPF between groups may in part derive a a lower/ higher frequence of home cooking. 3) Minor issues a) In line 78 it is not clear what was certified by senior researchers (the translation?) and based on which methodology. b) All over the paper and tables, as appropriate, authors may wish to substitute “minimally processed” by “unprocessed or minimally processed” as defined in the background section c) Line 251, could the authors specify which aspect of “quality” of UPFs increased in the Pacific ? Is it their food safety? d) Line 279. Authors may wish to mention some traditional foods which could be used in food aid e) Authors may wish to make clear at the very beginning of the method section that the reference 8 is to a previous paper written on the same study f) The title of Table 1 may mention that the table is related to the “assignment to NOVA groups” g) Table 2 lacks the unit of measurements h) Authors use the term “salt” and “sodium” indifferently. One of the two shoul be chosen or else they should be defined.	BMC	12916_2025_3947_ReviewerReport_V0_R2.pdf	{ "criticism": 3, "example": 5, "importance_and_relevance": 1, "materials_and_methods": 12, "praise": 2, "presentation_and_reporting": 12, "results_and_discussion": 3, "suggestion_and_solution": 10, "total": 29 }	{ "criticism": 0.10344827586206896, "example": 0.1724137931034483, "importance_and_relevance": 0.034482758620689655, "materials_and_methods": 0.41379310344827586, "praise": 0.06896551724137931, "presentation_and_reporting": 0.41379310344827586, "results_and_discussion": 0.10344827586206896, "suggestion_and_solution": 0.3448275862068966 }	1.655172	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Ultra-Processed Food Consumption in the Central Division of Fiji\nVersion: 0 Date: 22 Oct 2024\nReviewer: Catherine Leclercq\nReviewer's report:\nThe paper deals with an important nutrition issue at global level i.e. the high consumption\nof Highly Processed Foods which has been put in relation with the increased level of non\ncommunicable diseases. The paper illustrates the results of a study in a low income country in\nits nutrition transition phase.\nThe methodology used to answer the research question is appropriate and the results are clearly\ndescribed. However, the paper needs to be significantly revised to increase its scientific rigor.\n1) More rigor is needed in the choice of papers/studies which are cited, in the way they are cited\nand in the interpretation given to their results.\na) The paper would benefit from introducing first the issue of processed foods and then\nthat of Ultra Processed Foods, based on systematic reviews or documents from International\norganizations rather than to single studies. One possibility could be to make reference to the\n“FAO Guidelines on the collection of information on food processing through food consumption\nsurveys” p.2, paragraphs 2 and 3 https://openknowledge.fao.org/server/api/core/bitstreams/\ne9ce3172-8eb5-4f40-a494-dd5c9b39edd3/content\nb) More specific papers should be cited. Thus, the very first paper cited is titled “The role\nof trade in pacific food security and nutrition.”which does not appear appropriate to be\nquoted to support the following statement: “In the Pacific Island region, non-communicable\ndiseases (NCDs) account for 70-75% of deaths and are considered an epidemic.”. More\nrecent data in terms of death and more specific data on premature death are made available\nby WHO (https://www.who.int/westernpacific/news/item/17-10-2024-despite-health-gains--\nurgent-action-needed-to-meet-health-related-sustainable-development-goals-in-the-western-\npacific-region )\nc) Many citations appear to be secondary citations (indirect references) without being reported\nas such. Authors may wish to mention the original author and year followed by “as cited\nin” before the reference of the paper listed in the bibliography. For example the definition of\nUltra-processed foods (“UPF are manufactured products that consist of natural food substances,\nadditives, and industrially produced ingredients”) is quoted from the paper “Nutritional Quality\nof Pre-Packaged Foods in China under Various Nutrient Profile Models” and not to original\npapers written ro define UPFs.\nd) Some statements appear to over interpretate the results of the study but also of studies reported\nin the bibliography. This could easily be tacked by editing the wording.\n- Thus, the last sentence of the abstract reads ““This study identified that UPFs are ……, and\nthat efforts to reduce UPF consumption would also reduce intake of harmful nutrients such as\nsodium, fat, and sugar, crucial to reducing the diet related burden of disease” could read “UPF\nappear to be a large contributor to energy,sodium, fat, and sugar intake in adults in the central\ndivision of Fiji. A reduction of UPF consumption in Fiji might lead to a reduction of intake these\nnutrients and, thus, to the the diet related burden of disease.” Indeed it is likely but can not take\nfor granted that UPF would be subtsituted by foods with a lower fat, sugar and sodium content.\n-\n2) Authors may wish to further implement the “limitations” section of the paper with a further\nissue. :\na) 24 h recalls do not allow to capture discretionary use of salt (cooking salt used at household\nlevel and table salt) but only salt present in processed foods. This potentially leads to a significant\nunder estimate of total salt intake. The proportion of UPF to total salt intake may therefore be\nsignificantly overestimated. The proportion of discretionary salt may vary between population\ngroups depending on the frequency of eating out and of household coking. As a consequence,\nthe difference in proportion of sodium from UPF between groups may in part derive a a lower/\nhigher frequence of home cooking.\n3) Minor issues\na) In line 78 it is not clear what was certified by senior researchers (the translation?) and based\non which methodology.\nb) All over the paper and tables, as appropriate, authors may wish to substitute “minimally\nprocessed” by “unprocessed or minimally processed” as defined in the background section\nc) Line 251, could the authors specify which aspect of “quality” of UPFs increased in the\nPacific ? Is it their food safety?\nd) Line 279. Authors may wish to mention some traditional foods which could be used in food aid\ne) Authors may wish to make clear at the very beginning of the method section that the reference\n8 is to a previous paper written on the same study\nf) The title of Table 1 may mention that the table is related to the “assignment to NOVA groups”\ng) Table 2 lacks the unit of measurements\nh) Authors use the term “salt” and “sodium” indifferently. One of the two shoul be chosen or\nelse they should be defined.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03947-w	Reviewed - bmc_medicine	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 31 Oct 2024 Reviewer: Edwina Wambogo Reviewer's report:	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 31 Oct 2024 Reviewer: Edwina Wambogo Reviewer's report:	BMC	12916_2025_3947_ReviewerReport_V0_R3.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 1 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Ultra-Processed Food Consumption in the Central Division of Fiji\nVersion: 0 Date: 31 Oct 2024\nReviewer: Edwina Wambogo\nReviewer's report:", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03947-w	Reviewed - bmc_medicine	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 04 Nov 2024 Reviewer: Paul Eze Eme Reviewer's report: This is an interesting well-written paper. Just a couple of issues to be considered: 1. The authors reported that a household listing was conducted from Oct to Dec 2021 but how the sample size was calculated from the household listing was not provided. Who was the target member of the household that was intended to participate? I think the authors can provided in this paper the inclusion and exclusion criteria of the selection of households and participants (members of the households) 2. Participants’ anthropometrics were collected- of what use is this information to this paper? 3. How was Table 3 developed? Why do food groups for each category add up to 100? What message is intended to be transmitted using Table 3? 4. I suggest the authors should add to this paper “what is already know on this topic’ and What this study adds’. 5. The title of Table 2 can be misleading- ‘Ultra-processed foods contribution to energy and nutrient intake …..’ In my opinion, the title can be changed to mention only the nutrients determined which are fats and sodium and not generalise. The level of significance should be added to Table 2 and 3. The term ‘convenience foods’ as found in Table 3 must be defined. Also, I would be interested to know: i. what percentage of the 24-hour dietary recall assessment of the subjects are minimally processed, processed and ultra processed. ii. Why was the classification in this paper limited to 3 groups and not 4 groups as per NOVA classification? iii. What considerations were made to minimise the bias or errors since the level of processing from the food composition data from the United Kingdom, New Zealand and Intake24 could be significantly different from what is obtainable in Fiji? iv. How was traditional Fiji foods with no nutrient composition information in the databases used assessed?	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 0 Date: 04 Nov 2024 Reviewer: Paul Eze Eme Reviewer's report: This is an interesting well-written paper. Just a couple of issues to be considered: 1. The authors reported that a household listing was conducted from Oct to Dec 2021 but how the sample size was calculated from the household listing was not provided. Who was the target member of the household that was intended to participate? I think the authors can provided in this paper the inclusion and exclusion criteria of the selection of households and participants (members of the households) 2. Participants’ anthropometrics were collected- of what use is this information to this paper? 3. How was Table 3 developed? Why do food groups for each category add up to 100? What message is intended to be transmitted using Table 3? 4. I suggest the authors should add to this paper “what is already know on this topic’ and What this study adds’. 5. The title of Table 2 can be misleading- ‘Ultra-processed foods contribution to energy and nutrient intake …..’ In my opinion, the title can be changed to mention only the nutrients determined which are fats and sodium and not generalise. The level of significance should be added to Table 2 and 3. The term ‘convenience foods’ as found in Table 3 must be defined. Also, I would be interested to know: i. what percentage of the 24-hour dietary recall assessment of the subjects are minimally processed, processed and ultra processed. ii. Why was the classification in this paper limited to 3 groups and not 4 groups as per NOVA classification? iii. What considerations were made to minimise the bias or errors since the level of processing from the food composition data from the United Kingdom, New Zealand and Intake24 could be significantly different from what is obtainable in Fiji? iv. How was traditional Fiji foods with no nutrient composition information in the databases used assessed?	BMC	12916_2025_3947_ReviewerReport_V0_R1.pdf	{ "criticism": 1, "example": 2, "importance_and_relevance": 1, "materials_and_methods": 10, "praise": 1, "presentation_and_reporting": 5, "results_and_discussion": 0, "suggestion_and_solution": 7, "total": 23 }	{ "criticism": 0.043478260869565216, "example": 0.08695652173913043, "importance_and_relevance": 0.043478260869565216, "materials_and_methods": 0.43478260869565216, "praise": 0.043478260869565216, "presentation_and_reporting": 0.21739130434782608, "results_and_discussion": 0, "suggestion_and_solution": 0.30434782608695654 }	1.173913	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Ultra-Processed Food Consumption in the Central Division of Fiji\nVersion: 0 Date: 04 Nov 2024\nReviewer: Paul Eze Eme\nReviewer's report:\nThis is an interesting well-written paper. Just a couple of issues to be considered:\n1. The authors reported that a household listing was conducted from Oct to Dec 2021 but how\nthe sample size was calculated from the household listing was not provided. Who was the target\nmember of the household that was intended to participate? I think the authors can provided in\nthis paper the inclusion and exclusion criteria of the selection of households and participants\n(members of the households)\n2. Participants’ anthropometrics were collected- of what use is this information to this paper?\n3. How was Table 3 developed? Why do food groups for each category add up to 100? What\nmessage is intended to be transmitted using Table 3?\n4. I suggest the authors should add to this paper “what is already know on this topic’ and What\nthis study adds’.\n5. The title of Table 2 can be misleading- ‘Ultra-processed foods contribution to energy and\nnutrient intake …..’ In my opinion, the title can be changed to mention only the nutrients\ndetermined which are fats and sodium and not generalise. The level of significance should be\nadded to Table 2 and 3. The term ‘convenience foods’ as found in Table 3 must be defined.\nAlso, I would be interested to know:\ni. what percentage of the 24-hour dietary recall assessment of the subjects are minimally\nprocessed, processed and ultra processed.\nii. Why was the classification in this paper limited to 3 groups and not 4 groups as per NOVA\nclassification?\niii. What considerations were made to minimise the bias or errors since the level of processing\nfrom the food composition data from the United Kingdom, New Zealand and Intake24 could be\nsignificantly different from what is obtainable in Fiji?\niv. How was traditional Fiji foods with no nutrient composition information in the databases\nused assessed?", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03947-w	Reviewed - bmc_medicine	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 1 Date: 13 Dec 2024 Reviewer: Paul Eze Eme Reviewer's report: The paper has been well revised and significantly improved. Kudos to the authors for doing the wonderful job.	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 1 Date: 13 Dec 2024 Reviewer: Paul Eze Eme Reviewer's report: The paper has been well revised and significantly improved. Kudos to the authors for doing the wonderful job.	BMC	12916_2025_3947_ReviewerReport_V1_R1.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 2, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 2 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	1	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Ultra-Processed Food Consumption in the Central Division of Fiji\nVersion: 1 Date: 13 Dec 2024\nReviewer: Paul Eze Eme\nReviewer's report:\nThe paper has been well revised and significantly improved. Kudos to the authors for doing the\nwonderful job.", "role": "assistant" } ]	2,025
Review for 10.1186/s12916-025-03947-w	Reviewed - bmc_medicine	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 1 Date: 01 Jan 2025 Reviewer: Catherine Leclercq Reviewer's report: In the revised version of the manuscript, the authors have dealt with all the issues that I had raised in my referee report and made corrections/integrations based on the suggestions they received. I noted they also dealt with the issues raised by referees 2 and 3. I congratulate the authors for the quality of this revised paper.	Title: Ultra-Processed Food Consumption in the Central Division of Fiji Version: 1 Date: 01 Jan 2025 Reviewer: Catherine Leclercq Reviewer's report: In the revised version of the manuscript, the authors have dealt with all the issues that I had raised in my referee report and made corrections/integrations based on the suggestions they received. I noted they also dealt with the issues raised by referees 2 and 3. I congratulate the authors for the quality of this revised paper.	BMC	12916_2025_3947_ReviewerReport_V1_R2.pdf	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 1, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0, "total": 3 }	{ "criticism": 0, "example": 0, "importance_and_relevance": 0, "materials_and_methods": 0, "praise": 0.3333333333333333, "presentation_and_reporting": 0, "results_and_discussion": 0, "suggestion_and_solution": 0 }	0.333333	[ { "content": "Please review this paper.", "role": "user" }, { "content": "Title: Ultra-Processed Food Consumption in the Central Division of Fiji\nVersion: 1 Date: 01 Jan 2025\nReviewer: Catherine Leclercq\nReviewer's report:\nIn the revised version of the manuscript, the authors have dealt with all the issues that I had\nraised in my referee report and made corrections/integrations based on the suggestions they\nreceived. I noted they also dealt with the issues raised by referees 2 and 3. I congratulate the\nauthors for the quality of this revised paper.", "role": "assistant" } ]	2,025

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