Title: Epidemiology of breast cancer in Cyprus: a population based case control study
|
|
- Frederick Flynn
- 6 years ago
- Views:
Transcription
1 Author's response to reviews Title: Epidemiology of breast cancer in Cyprus: a population based case control study Authors: Andreas Hadjisavvas (ahsavvas@cing.ac.cy) Maria A Loizidou (loizidou@cing.ac.cy) Nicos Middleton (nicos.middleton@cut.ac.cy) Thalia Michael (thalia@cing.ac.cy) Rena Papachristoforou (rena@cing.ac.cy) Eleni Kakouri (eleni.kakouri@bococ.org.cy) Maria Daniel (maria.daniel@bococ.org.cy) Panayiotis Papadopoulos (panicos.papadopoulos@bococ.org.cy) Simon Malas (malas@logos.net.cy) Yiola Marcou (yiola.marcou@bococ.org.cy) Kyriacos Kyriacou (kyriacos@cing.ac.cy) Version: 2 Date: 30 March 2010 Author's response to reviews: see over
2 29 March 2010 Jason Kerr Assistant Editor BMC Cancer THE CYPRUS INSTITUTE OF NEUROLOGY & GENETICS Dr Kyriacos Kyriacou, PhD Head, Electron Microscopy/Molecular Pathology Department P.O. Box Nicosia, Cyprus Tel.: (+357) (+357) Fax: (+357) Website: Dear Editor, Re: Epidemiology of breast cancer in Cyprus: a population based case control study Revised title: A study of breast cancer risk factors in Cyprus: a population-based case control study I am pleased to accept your offer to resubmit a revised version of the above article. Please note that following one of the reviewers suggestion we have now changed the title of the paper to A study of breast cancer risk factors in Cyprus: a population-based case control study to better reflect the scope of the submitted work. We have also requested statistical advice from a biostatistician whose name has of course been added to the paper as a contributing author (Dr Nicos Middleton). The data have now been re-analyzed using more appropriate methods including multivariable logistic regression. While breast cancer is the leading cancer among Cypriot women, to date, there has not been any epidemiological investigation into the strength of associations between recognized person-based risk factors and breast cancer in our population. While there is no doubt that locally this study has important public health implications, we also believe that describing the underlying distribution of some recognized risk (or protective) factors for breast cancer in a less-well studied population, will also be of interest to the international community. For instance, 1 in 4 Cypriot women have never breast-fed while as many as 80% have at least two children and a comparable proportion has never used hormone replacement therapy. More interestingly, previous published work by our group has shown that the Cypriot population exhibits some unique genetic features as revealed by the identification of novel mutations in the BRCA1 and BRCA2 genes. Thus, the current study will function as a baseline of future efforts from our group, into combining person-based data with the molecular/genetic data to study gene-environment interactions. We have explained the background and scope of this work in the Background section of the manuscript. We have now addressed all of the important issues and recommendations raised by the reviewers. All authors have seen and approved the revised draft. Finally, I would like to thank the reviewer s for their constructive comments and suggestions and below please find our point by point responses (in the highlighted sections) in the order that were raised by the two referees.
3 Referee 1: Bachok Norsa Adah Overall: this article does not add more knowledge on breast cancer. It has value for local interest only unless researchers put in new variables pertaining to local habits. Eg frequency consumption of olive oil in diet, Mediterranean lifestyle etc. While we certainly agree with the reviewer about the novel contribution in studying the contribution of dietary factors on a Mediterranean island, detailed data on dietary habits of these women were unfortunately not available. Nevertheless, the main focus in this population-based case-control study of breast cancer risk factors in Cyprus was mainly to assess the strength of association with some of the internationally established risk factors for breast cancer such as family history and reproductive status. Indeed this is the first such study in our population. Major Compulsory Revisions: Title is neither complete nor reflecting content. When epidemiology word is put up, I am expecting the article about the distribution of breast cancer according to person, time and place. It will be better to put up a study of risk factors of breast cancer in Cyprus. As already mentioned above, the word epidemiology has been removed from the title of the article, which has now been modified to read A study of breast cancer risk factors in Cyprus: a populationbased case-control study. Method is not well described nor detail. Inclusion & exclusion criteria of case & control are not clear. What is meant by healthy control? No breast cancer only or no diabetes, hypertension etc? We have now expanded the Methods, Study Participants and Data collection section of the article to adequately describe the study design as well as the inclusion/exclusion criteria of the participants, both cases and controls. In more detail, cases were all histologically-confirmed breast cancer cases, diagnosed between 1999 and 2005 who were recruited from the main cancer treatment hospitals in Cyprus. Controls were selected from the pool of women who participated in the National programme for breast cancer mammography screening, and were negative for breast cancer. How age is matched? Looking at table 1 age is not properly matched for example those <45, cases are almost twice in number than controls. It was repetitively mentioned population based study but how the researcher get the participants from the population are not clearly mentioned. Specifically, regarding the issue of age matching: we have now explained in the Methods, Study Participants and Data collection sections of the article, that the controls have NOT been matched to the age-distribution of cases as it was falsely implied in the previous version of the paper. This of course explains why the age-distribution of cases and controls differed in Table 1 in the old manuscript. This table has now been removed and no reference of age-matching appears in the revised text. Of course, due to the narrow age span of women invited for screening (ages 50-69) younger and older women were underrepresented, thus all analyses were adjusted for the confounding effect of age. Definition of operative terms such as cigarette smokers. Does it mean current smokers only or include previous smokers. The same with exercise, OCP, HRT etc. HRT category is not 2
4 comprehensive. HRT use <6month is not mentioned at all. In the same section (Methods, Study Participants and Data collection), we have now given further explanations about the risk factors investigated. Regarding smoking, we have now included past smokers as a separate category while in terms of HRT, we now display associations across duration of use in the following categorisation: never, <6months, 6-60months and >60 months. Only information on current exercise status was available. Socio-economic status is not explored. Unlike Britain where socio-economic classification is commonly operationalised on the basis of occupation, there are no similar socio-economic classification systems in Cyprus. In the absence of such socio-economic indicators, educational status is commonly used as a proxy. We have also explained this in the article (Discussion). Statistical analysis. Not adequate using only univariate logistic regression. Should continue to multivariate so that confounders can be controlled. Also interaction & multicollinearity can be checked. The proper statistical analysis is conditional multiple logistic regression. Based on the misunderstanding that this was a matched case-control study (see above), the reviewer suggests the use of conditional logistic regression. However, we have now clarified that since no matching was employed between cases and controls, simple logistic regression is the appropriate method of analysis of these data. Of course, we agree with the reviewer about the importance of controlling for confounders in a multivariable approach (as well as testing for effect modification), thus, the data have now been re-analysed. As a result, three new tables are presented in the revised manuscript. The first Table presents the socio-demographic characteristics of the study participants along with a χ 2 test for differences between cases and controls. Table 2 first investigates the interrelationships between variables with a high degree of collinearity (i.e. pregnancy, number of children and breastfeeding) and finally, Table 3 presents odds ratios by participants characteristics before and after adjusting for the effect of all other risk factors estimates in multivariable logistic models. This is detailed both in the Methods, Data analysis section of the article as well as in the Results section where each of these tables is presented and discussed appropriately. Conclusion is not supported by data. The present conclusion can be put in the discussion. Following the reviewer s suggestion, the former conclusion has now been re-written. Minor Essential Revisions: Results Sociodemographic background of the participants are not included Table 1 (previously Table 2) presents the distribution of socio-demographic characteristics and potential risk factors among the participants in absolute numbers and relative frequencies, separately for cases and controls. Table 1&2 there are mean & median age of both groups but there is no p value. I am interested to know whether there is significant difference or not. We are expecting there is no significant difference in the mean age since matching is used. 3
5 There was no difference in mean age between cases and controls (p-value of t-test=0.22). Nevertheless, since this was not an age-matched case-control study (see above), there were some differences in the age distribution among cases and controls, mainly driven by the underrepresentation of controls in the younger and older age-groups. After restricting to ages 45-65, p- value for differences in the age-structure of cases and controls becomes P-values were included in Table 1 and this was explained in a footnote. Pg 7 paragraph 2, 2nd line ~50% should be the exact value Table 2, Sum of all variables are not equal to the total number of participants stated in the table headings. All descriptive statistics should have frequency with %. All decimal numbers should be consistent through out the article eg table 2 the p values range between 1 to 4 decimal numbers. All three issues have been dealt with i.e. (a) we present exact estimates (as well as confidence intervals) in the text, (b) we now present both frequencies and relative frequencies for all participant characteristics in Table 1 (previously labeled table 2) and (c) we ensured that all estimates consistently display 2 decimal points. Categorization of breastfeeding may need revision since the ORs are not consistent. Reference group may need reversion. I do not agree with the categorization of reproductive status. Why include breast feeding? There will be multi-collinearity with breast feeding variable. If the authors want to show interaction between variables, can check using multiple logistic regression. We agree with the reviewer that our previous categorisation of reproductive status was not adequate since it does not allow for the synergy between breastfeeding and pregnancy to be examined. We have now estimated the protective effect of pregnancy and the added effect of breastfeeding over the effect of pregnancy in a logistic regression model that included the main effect of pregnancy and an interaction term between pregnancy and breastfeeding (to capture the combined effect of the two variables) but no separate main effect for breastfeeding (since only women who have had a child breastfed). As it was found that the effect of breastfeeding was more protective rather than pregnancy alone (even if number of pregnancies is considered), only breastfeeding was considered in multivariable models. These findings are presented in the newly added Table 2 as well as discussed in the Results section. Discussion is a repetitive of results. There is too few discussion, comparison & contrast and similarity with other studies. 1st paragraph should be combined in the background Many statements do not have supported references eg. pg10 1st & 2nd sentences. No mention of limitation of study Following the reviewer s advice, we have now restructured the Discussion section of the manuscript, discussed our findings in the context of the international literature, moved the first paragraph to the Background section, as well as mentioned the limitations of the study in the Discussion section. 4
6 Referee 2: Sunita Saxena The manuscript entitled Epidemiology of breast cancer in Cyprus: a population based case control study is based upon the adequate sample size. However there are areas of major concerns, especially to the analytical methods adopted in the analysis of data and the presentation of results. The other area of concern is the imprecise postulation of the research question addressed. The authors say that the present study main aim was to compare established and recognized breast cancer risk factor, in Cypriot women with and without breast cancer. Lastly it has been concluded that their study provides the first scientific evidence for more targeted campaigns of prevention and early diagnosis, in the studied population. But even after large n the results are not well presented that is the primary requirement for any epidemiological investigation. It was pleasing to note that the reviewer recognised the large sample size as an obvious strength of our study. As we mention in the article, due to the small population of the island, cases represented 50% of all breast cancer cases diagnosed during the 7-year period Power calculations indicate that the sample size in the study would have 90% power to detect a magnitude of association at the odds ratio scale of 1.5 at 5% statistical significance for an exposure that occurs among 10% of the controls. We have now addressed their main concern which mainly refers to the analysis and presentation of the data. As we also mentioned above the data have now been reanalysed using multivariable logistic regression (see Methods, Data analysis). We have also framed our research question more clearly. Major Compulsory Revisions: Abstract # The first paragraph states that there are no data as yet available about the risk factors and breast cancer in the Cypriot female population. But then they say that the aim of the present study was to compare the established and recognized breast cancer risk factors, in Cypriot women with and without breast cancer. There is a lack of well defined research question in the study. If the aim is to compare then the methodology adopted cannot specifically address this issue. Background # The same issue of imprecise research question in the abstract also applies to the background section of the manuscript. The main aim of the study was (a) to describe the underlying distribution of some recognized breast cancer risk factors among the Cypriot population (hence the choice of a population-based control group) and (b) to assess the strength of the associations with breast cancer risk in a Cypriot population. Methods # Please state more specifically how the matching was performed. Individual/frequency matched. # There is a need for mentioning the criterion laid down for considering the age group 40-70, for completeness? # What it is meant by controls participating in the study was stratified. It needs to be written for the clear understanding of the readers? The controls have been stated to have been stratified to be representative of the island population. In such a scenario, these are not expected to be appropriate to serve as controls in a case control study. # The criterions lay down for selection of selection has not been explicitly stated. 5
7 We have now explained in more detail the design of the study as well as the selection criteria for the participants in the Methods, Study Participants and Data collection sections of the article. Specifically, we have clarified that this was NOT an age-matched case-control study (as it might have been wrongly implied in the earlier draft). That is why simple logistic regression adjusting for possible confounding effect of age (rather than conditional logistic regression) was employed for the analysis of the data. The controls were women who participated in the National screening programme; to a large extent the same population that would also give rise to cases. All women aged (identified from population lists) are invited to participate in the National screening programme. Due to the narrow age span of women invited for screening (ages 50-69) younger and older women were underrepresented. Nevertheless, between the ages of 50-65, the observed age distribution roughly reflected the age-distribution structure of the female population. Data analysis and Methods # The study design is case control with age matched. Then why Mc-Nemars test was not performed. The Case Control Study design should accompany the Matched Analysis. Presently, the degrees of freedom and P value in relation to the #2, are not being provided, which should be provided irrespective of the unmatched or matched analysis is performed. # The fundamental issues of Multicollineraity, Confounding and Interaction assessment was possibly not performed as the results are based only on the univariate logistic regression analysis. These are the fundamental issues of such epidemiological studies that help in estimating the true estimate of the real effect. # What was the value of the non parametric Kendall s Tau-b, statistics for the covariates under consideration? If the coefficient matrix, illustrated significant non parametric correlation, then how it was taken care during the analysis? # The depicted results are based only upon the univariate logistic regression analysis. Why multivariable analysis results are not presented? It is strongly recommended to please do the multivariable analysis and present their result. # Why conditional logistic regression analysis was not performed in spite of adopting the Case Control study design? # The results of univariate only cannot be considered for campaigns of prevention and early diagnosis, in the studied population. The univariate analysis only gives the direction for association and is an exploratory step prior to the multivariable model development. The multivariable analysis is definitive and is a standard regression approach for the epidemiological model development as they address the issue of Multicollineraity, Confounding and provide scope for the interaction assessment. # There is no mentioning of the statistical package considered for the data/statistical analysis As already mentioned above, χ 2 test and simple logistic regression was performed (rather than McNemar s and conditional logistic regression) because no individual matching was employed. Note that all model estimates presented in the revised version of the article (including associations with single risk factors) were adjusted for age. We, of course, agree with the reviewer about the importance of issues such as multicollinearity, confounding and interaction and acknowledge the weakness of the previous version of the manuscript to address these issues effectively. This has also been noted by the first reviewer. As also mentioned above, the data have now been re-analysed using multivariable logistic regression in STATA SE 9.0 and presented accordingly in a series of three Tables (see details in the Methods, Data Analysis section of the revised manuscript). As expected, pregnancy, number of children and breastfeeding (both status and duration) displayed a high degree of dependence (as indicated by Kenall s tau-b statistic). To avoid multi-collinearity, associations with these variables were firstly explored, in order to study their behaviour when adjusting for the 6
8 effect of each other and selected the variable with the strongest association, to be included in the final model. Table 2 presents the results of this part of the analysis. In more detail, the possible protective effect of pregnancy and the added effect of breastfeeding over the effect of pregnancy, was investigated in a logistic regression model that included the main effect of pregnancy and an interaction term between pregnancy and breastfeeding (to capture the combined effect of the two variables) but no separate main effect for breastfeeding (since only women who have had a child breastfed). Breastfeeding appeared to have a more protective effect (rather than pregnancy alone). Similarly, the strong univariable association observed with number of children diminished once breastfeeding was controlled for, in the analysis. In fact, the Odds Ratio for a one unit increase in the number of children was 0.92 (95%CI 0.80, 1.05) among women who did not breastfeed and 0.97 (95%CI 0.82, 1.15) among women who breastfed. The Mantel-Haenszel estimate controlling for breastfeeding was 0.94 (95% CI 0.85, 1.04) (test of homogeneity of ORs= =0.61), indicating no evidence of an association between breast cancer and number of children, irrespective of breastfeeding status. Thus, among these variables, breastfeeding was the only one further considered in multivariable models. These issues are covered in the Methods, Data Analysis section as well as presented accordingly in the Results section of the revised manuscript. Results # Table 2 presents data according to various risk factors as sub tables. However, the total of cases and even controls is different in different sub tables. In fact, for subtables on marital status, pregnancy, breast feeding, reproductive status, smoking and exercise, the total number of cases is 1111, 1112, 1179, 1143 and 1110 respectively, which is more than the cases enrolled. In fact all the sub tables seem to have different totals, the reason for which is not given. Similar discrepancies exist for control also. There were 88 women among cases stated to have had no pregnancy, but 103 women were given as not having any children. Were 15 women pregnant at the time of interview? Under this sub-table 1006 women cases were given as pregnant (at any time) but the details on age at first pregnancy is given for 996, but breast feeding details are given for 1112 cases. Reproductive status of 1179 is given with only 66 stated as never pregnant (against 88 given elsewhere). # The percentages for each level of the considered covariates are not provided. # The median is not accompanied with inter quartile range (IQR). # P value in table 2 for age not specified. # Associated statistics related to #2 not given in the result (value of the test statistic and significance), so the statement that there was statistically significant differences, between cases and controls in terms of level of education and marital status lacks the evidence. # There should be uniformity in stating and placing the reference category for the covariates under the consideration (for age at menarche written lastly whereas for others first). # Its OK that for the age at menarche the Odds Ratio value of 1.57 (for the category <11) is more than 1.27 (for the category 12-14), but if the trend is significant, then the P value for the trend must be mentioned in the text or at the footnote of the table with appropriate legend identification. # The statement some associations of reproductive factors with breast cancer------, pregnant %CI (0.50, 0.96) require to be interpreted specifically in relation to the considered dependent variable in the logistic regression analysis (breast cancer risk). # What was the rationale behind considering the threshold of 5 years for HRT. Needs to be addressed for proper understanding, partly addressed. # The interpretation for the variable smoking needs to be correctly interpreted in relation to the dependent variable in the logistic regression analysis (breast cancer risk). The precise way how the variable smoking was considered the analysis quantitatively has not been mentioned (mention regarding duration and intensity/number of pack years). 7
9 We have now re-structured the presentation of the results in three separate Tables and re-wrote the results accordingly. As such, we have now followed the reviewer s suggestions faithfully for correcting the previous inconsistencies. This includes the provision of percentages, reporting p- values for differences, and p-values for trend across ordered categorical variables, ensuring consistency in reference categories as well as consistency in reported numbers. For instance, the difference in number of women reporting not having had a pregnancy (N=155) and not having had a child (N=191) is due to the fact that 15 and 21 women in cases and controls respectively have reported having a pregnancy that did not result in birth. With regards to the reviewer s comments on smoking and HRT use (also noted by the first reviewer), we have now explained that no information for duration or intensity of smoking was available, in order to calculate pack-years. Regarding HRT use only a small percentage of women in our sample reported use for longer than 5 years. Nevertheless, we have now displayed associations across duration of use in the following categorisation: never, <6months, 6-60months and >60 months. Discussion # Discussion is based only upon the findings of the univariate logistic regression analysis. The authors need to do multivariable analysis and present the results and discuss them subsequently. # No result has been provided for the statement breast cancer risk was significantly greater in postmenopausal woman Vs pre menopausal women. We have now performed multivariable logistic analysis and presented/discussed our results accordingly. Lastly, while we have previously used age of diagnosis as a proxy for menopausal status, it was decided to remove it from the revised version of the manuscript. Thank you and the reviewers for their constructive comments and for giving us sufficient time to respond to their suggestions. I look forward to receiving your response. Yours sincerely, K. Kyriacou, PhD Senior Scientist 8
Title:Continuity of GP care is associated with lower use of complementary and alternative medical providers A population-based cross-sectional survey
Author's response to reviews Title:Continuity of GP care is associated with lower use of complementary and alternative medical providers A population-based cross-sectional survey Authors: Anne Helen Hansen
More informationTitle: Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study
Author s response to reviews Title: Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study Authors: Jin Young Nam (jynam@yuhs.ac) Juyoung Kim
More informationAn investigation of breast cancer risk factors in Cyprus: a case control study
RESEARCH ARTICLE Open Access An investigation of breast cancer risk factors in Cyprus: a case control study Andreas Hadjisavvas 1, Maria A Loizidou 1, Nicos Middleton 2, Thalia Michael 1, Rena Papachristoforou
More informationTitle: Insomnia and its correlates in a representative sample of the Greek population
Author's response to reviews Title: Insomnia and its correlates in a representative sample of the Greek population Authors: Thomas Paparrigopoulos (tpaparrig@med.uoa.gr) Chara Tzavara (htzavara@med.uoa.gr)
More informationUNIVERSITY OF CALIFORNIA, LOS ANGELES
UNIVERSITY OF CALIFORNIA, LOS ANGELES BERKELEY DAVIS IRVINE LOS ANGELES MERCED RIVERSIDE SAN DIEGO SAN FRANCISCO UCLA SANTA BARBARA SANTA CRUZ DEPARTMENT OF EPIDEMIOLOGY SCHOOL OF PUBLIC HEALTH CAMPUS
More informationPrevalence of asthma and allergies in children from the Greek- Cypriot and Turkish-Cypriot communities in Cyprus: a bicommunal cross-sectional study
Prevalence of asthma and allergies in children from the Greek- Cypriot and Turkish-Cypriot communities in Cyprus: a bicommunal cross-sectional study The Harvard community has made this article openly available.
More informationTitle: Socioeconomic conditions and number of pain sites in women
Author's response to reviews Title: Socioeconomic conditions and number of pain sites in women Authors: Finn E Skjeldestad (fisk@fhi.no) Toril Rannestad (Toril.Rannestad@hist.no) Version: 2 Date: 17 January
More informationMJ - Decision on Manuscript ID BMJ
MJ - Decision on Manuscript ID BMJ.2018.044966 Body: 12-Jul-2018 Dear Dr. Khandwala Manuscript ID BMJ.2018.044966 entitled "The Association of Paternal Age and Perinatal Outcomes between 2007 and 2016
More informationAuthor's response to reviews
Author's response to reviews Title: Gender differences in Greek centenarians. A cross-sectional nation-wide study, examining multiple socio-demographic and personality factors and health locus of control.
More informationAuthor's response to reviews
Author's response to reviews Title: Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination Authors: Grant
More informationAuthor's response to reviews
Author's response to reviews Title:Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study Authors:
More informationTitle: Identifying work ability promoting factors for home care aides and assistant nurses
Author's response to reviews Title: Identifying work ability promoting factors for home care aides and assistant nurses Authors: Agneta Larsson (agneta.larsson@ltu.se) Lena Karlqvist (lena.karlqvist@ltu.se)
More informationTitle: Home Exposure to Arabian Incense (Bakhour) and Asthma Symptoms in Children: A Community Survey in Two Regions in Oman
Author's response to reviews Title: Home Exposure to Arabian Incense (Bakhour) and Asthma Symptoms in Children: A Community Survey in Two Regions in Oman Authors: Omar A Al-Rawas (orawas@squ.edu.om) Abdullah
More informationTitle: Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study
Author's response to reviews Title: Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study Authors: Atsuko Sekita (atsekita@med.kyushu-u.ac.jp)
More informationPEER REVIEW HISTORY ARTICLE DETAILS TITLE (PROVISIONAL)
PEER REVIEW HISTORY BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (http://bmjopen.bmj.com/site/about/resources/checklist.pdf)
More informationTitle: The effect of Breast Cancer Awareness Month on Internet search activity - a comparison with awareness campaigns for lung and prostate cancer
Author's response to reviews Title: The effect of Breast Cancer Awareness Month on Internet search activity - a comparison with awareness campaigns for lung and prostate cancer Authors: Ronan W Glynn (ronanglynn@doctors.net.uk)
More informationTitle:Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet
Author's response to reviews Title:Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet Authors: Sara Sáez Almendros (sara.saez.almendros@gmail.com)
More informationTitle: Living alone and antidepressant medication use: a prospective study in a working-age population
Author's response to reviews Title: Living alone and antidepressant medication use: a prospective study in a working-age population Authors: Laura Pulkki-Råback (laura.pulkki-raback@helsinki.fi) Mika Kivimäki
More informationTitle: Body fatness and breast cancer risk in women of African ancestry
Author's response to reviews Title: Body fatness and breast cancer risk in women of African ancestry Authors: Elisa V Bandera (elisa.bandera@rutgers.edu) Urmila Chandran (chandrur@cinj.rutgers.edu) Gary
More information논문투고및투고후소통하기 : 영문교정작업, 실제논문투고하기, revision 답변달기, query form 작성하기
Apr 28, 2018 9:20-9:40 JGO Workshop 논문투고및투고후소통하기 : 영문교정작업, 실제논문투고하기, revision 답변달기, query form 작성하기 연세의대이정윤 좋은아이디어를얻기위하여, 타인으로부터유익한암시를받을때가있음. 새로운아이디어는두사람이상의지식및아이디어를함께모을때생겨나는경우가있음. 토론은잘못의발견에유익한방법임. 혼자독립하여동료와이야기를나누지않는연구자는틀린길을걸어가다많은시간을낭비하게되는경우가있음.
More informationAuthor's response to reviews
Author's response to reviews Title: Prevalence of psychological distress and mental disorders, and use of mental health services in the epidemiological catchment area of Montreal South-West Authors: Jean
More informationTitle:Modern contraceptive use among sexually active men in Uganda: Does discussion with a health worker matter?
Author's response to reviews Title:Modern contraceptive use among sexually active men in Uganda: Does discussion with a health worker matter? Authors: Allen Kabagenyi Ms. (allenka79@yahoo.com) Patricia
More informationTitle: Who does not participate in a follow-up postal study? A survey of infertile couples treated by in vitro fertilization
Author's response to reviews Title: Who does not participate in a follow-up postal study? A survey of infertile couples treated by in vitro fertilization Authors: Pénélope Troude (penelope.troude@inserm.fr)
More informationAuthor's response to reviews
Author's response to reviews Title: Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15-34 years - a Swedish population-based study using EQ-5D
More informationTitle: A Prospective Study of Dietary Selenium Intake and Risk of Type 2 Diabetes
Author's response to reviews Title: A Prospective Study of Dietary Selenium Intake and Risk of Type 2 Diabetes Authors: Saverio Stranges (S.Stranges@warwick.ac.uk) Sabina Sieri (Sabina.Sieri@istitutotumori.mi.it)
More informationTitle: A Central Storage Facility to Reduce Pesticide Suicides- A Feasibility Study from India
Author's response to reviews Title: A Central Storage Facility to Reduce Pesticide Suicides- A Feasibility Study from India Authors: Lakshmi Vijayakumar (lakshmi@vijayakumars.com) Jeyaseelan Lakshmanan
More informationTitle:Postpartum contraceptive use in Gondar town, Northwest Ethiopia: a community based cross-sectional study
Author's response to reviews Title:Postpartum contraceptive use in Gondar town, Northwest Ethiopia: a community based cross-sectional study Authors: Yeshewas Abera (yeshiab57@gmail.com) Zelalem Birhanu
More information8/10/2012. Education level and diabetes risk: The EPIC-InterAct study AIM. Background. Case-cohort design. Int J Epidemiol 2012 (in press)
Education level and diabetes risk: The EPIC-InterAct study 50 authors from European countries Int J Epidemiol 2012 (in press) Background Type 2 diabetes mellitus (T2DM) is one of the most common chronic
More informationAuthor's response to reviews
Author's response to reviews Title: Contribution of Interferon Gamma Release Assays testing to the Diagnosis of Latent Tuberculosis Infection in HIV-Infected Patients: A comparison of QuantiFERON Gold
More informationTitle: Use of food labels by adolescents to make healthier choices on snacks: a cross sectional study from Sri Lanka
Author s response to reviews Title: Use of food labels by adolescents to make healthier choices on snacks: a cross sectional study from Sri Lanka Authors: Ishanka Talagala (drmaheshkeerthi@gmail.com;drishanka@gmail.com)
More informationTitle: Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
Author's response to reviews Title: Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors? Authors: Kontie Moussa (kontie.moussa@med.lu.se)
More informationTitle: Validation of Metabolic Syndrome using medical records in the SUN cohort
Author's response to reviews Title: Validation of Metabolic Syndrome using medical records in the SUN cohort Authors: Maria-Teresa Barrio-Lopez (terebarriol@gmail.com) Maira Bes-Rastrollo (mbes@unav.es)
More informationMammographic density and risk of breast cancer by tumor characteristics: a casecontrol
Krishnan et al. BMC Cancer (2017) 17:859 DOI 10.1186/s12885-017-3871-7 RESEARCH ARTICLE Mammographic density and risk of breast cancer by tumor characteristics: a casecontrol study Open Access Kavitha
More informationTitle: Intention-to-treat and transparency of related practices in randomized, controlled trials of anti-infectives
Author s response to reviews Title: Intention-to-treat and transparency of related practices in randomized, controlled trials of anti-infectives Authors: Robert Beckett (rdbeckett@manchester.edu) Kathryn
More informationTitle: Exposure of bakery and pastry apprentices to airborne flour dust using PM2.5 and PM10 personal samplers
Author's response to reviews Title: Exposure of bakery and pastry apprentices to airborne flour dust using PM2.5 and PM10 personal samplers Authors: Estelle Mounier-Geyssant (estellemounier@yahoo.fr) Jean-Francois
More informationQuestion 1. Can EFSA explain how the small number of boys followed up may have affected the results?
NL questions and comments on the EFSA Scientific Opinion Risk for animal and human health related to the presence of dioxins and dioxin-like PCBs in feed and food, version of 14 June 2018, doi: 10.2903/j.efsa.2018.5333
More informationDear Dr. Villanueva,
22-12-2017 Dear Dr. Villanueva, We would like to thank you for your interest in our paper and the opportunity to resubmit our manuscript Living network meta-analysis for reducing research waste: an empirical
More informationTitle: Survival endpoints in colorectal cancer. The effect of second primary other cancer on disease free survival.
Author's response to reviews Title: Survival endpoints in colorectal cancer. The effect of second primary other cancer on disease free survival. Authors: Helgi Birgisson (helgi.birgisson@surgsci.uu.se)
More informationTitle: Increased incidence of traffic accidents in RhD-negative, Toxoplasma gondii-infected military drivers revealed by a prospective cohort study
Author's response to reviews Title: Increased incidence of traffic accidents in RhD-negative, Toxoplasma gondii-infected military drivers revealed by a prospective cohort study Authors: Jaroslav Flegr
More informationAuthor's response to reviews
Author's response to reviews Title: Gender and age differences among current smokers in a general population survey Authors: Ulrich John (ujohn@uni-greifswald.de) Monika Hanke (hanke@uni-greifswald.de)
More informationTitle: Validation of the Comprehensive Feeding Practices Questionnaire with parents of 10-to-12-year-olds
Author's response to reviews Title: Validation of the Comprehensive Feeding Practices Questionnaire with parents of 10-to-12-year-olds Authors: Elisabeth L Melbye (elisabeth.l.melbye@uis.no) Torvald Øgaard
More informationTitle: Correlates of quality of life of pre-obese and obese patients: a pharmacy-based cross-sectional survey
Author's response to reviews Title: Correlates of quality of life of pre-obese and obese patients: a pharmacy-based cross-sectional survey Authors: Laurent Laforest (laurent.laforest@chu-lyon.fr) Eric
More informationAuthor's response to reviews
Author's response to reviews Title: Study protocol: Evaluating the effectiveness of GP endorsement on increasing participation in the NHS Bowel Cancer Screening Programme: a feasibility trial Authors:
More informationPEER REVIEW HISTORY ARTICLE DETAILS VERSION 1 - REVIEW. Ball State University
PEER REVIEW HISTORY BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (see an example) and are provided with free text boxes to
More informationTitle: Protocol-based management of older adults with hip fractures in Delhi, India: a feasibility study
Reviewer s report Title: Protocol-based management of older adults with hip fractures in Delhi, India: a feasibility study Version: 0 Date: 16 Nov 2015 Reviewer: Cristin Ryan Reviewer's report: This paper
More informationINTERNAL VALIDITY, BIAS AND CONFOUNDING
OCW Epidemiology and Biostatistics, 2010 J. Forrester, PhD Tufts University School of Medicine October 6, 2010 INTERNAL VALIDITY, BIAS AND CONFOUNDING Learning objectives for this session: 1) Understand
More informationConfounding and Interaction
Confounding and Interaction Why did you do clinical research? To find a better diagnosis tool To determine risk factor of disease To identify prognosis factor To evaluate effectiveness of therapy To decide
More informationAuthor's response to reviews
Author's response to reviews Title: A multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department
More informationConfounding Bias: Stratification
OUTLINE: Confounding- cont. Generalizability Reproducibility Effect modification Confounding Bias: Stratification Example 1: Association between place of residence & Chronic bronchitis Residence Chronic
More informationSurvey of Smoking, Drinking and Drug Use (SDD) among young people in England, Andrew Bryant
Survey of Smoking, Drinking and Drug Use (SDD) among young people in England, 2010 Andrew Bryant Newcastle University Institute of Health and Society Background Background Young people s drinking behaviour
More informationTitle: Defensive coping and health-related quality of life in Chronic Kidney Disease: a cross-sectional study
Author's response to reviews Title: Defensive coping and health-related quality of life in Chronic Kidney Disease: a cross-sectional study Authors: Anna Kaltsouda (akalts@cc.uoi.gr) Petros Skapinakis (p.skapinakis@gmail.com)
More informationVariables and Data. Gbenga Ogunfowokan Lead, Nigerian Regional Faculty The Global Health Network 19 th May 2017
Variables and Data Gbenga Ogunfowokan Lead, Nigerian Regional The Global Health Network 19 th May 2017 Objectives At the end of this presentation you should be able to 1) Define a variable 2) Classify
More informationAddendum: Multiple Regression Analysis (DRAFT 8/2/07)
Addendum: Multiple Regression Analysis (DRAFT 8/2/07) When conducting a rapid ethnographic assessment, program staff may: Want to assess the relative degree to which a number of possible predictive variables
More informationTitle: Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals
Author's response to reviews Title: Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals Authors: Jon B. Haug (jobhau57@gmail.com) Randi Myhr
More informationDrafting a quantitative epidemiological research paper
Drafting a quantitative epidemiological research paper Developed by Emily Banks, Cathy Day, Ellie Paige, Katie Thurber and Kerri Viney for the Epidemiology for Policy and Practice Group Last updated 23
More information2. Could you insert a reference, proving your statement on p. 5, l. 66/67?
Author s response to reviews Title: Representative survey on idiopathic environmental intolerance attributed to electromagnetic fields in Taiwan and comparison with the international literature Authors:
More informationSMOKING RELAPSE ONE YEAR AFTER DELIVERY AMONG WOMEN WHO QUIT SMOKING DURING PREGNANCY
International Journal of Occupational Medicine and Environmental Health, 2005;8(2):59 65 SMOKING RELAPSE ONE YEAR AFTER DELIVERY AMONG WOMEN WHO QUIT SMOKING DURING PREGNANCY KINGA POLAŃSKA, WOJCIECH HANKE,
More informationReference: manuscript BPSY-D Treatment adequacy of anxiety disorders among young adults in Finland
Author s response to reviews Title: Treatment adequacy of anxiety disorders among young adults in Finland Authors: Teija Kasteenpohja (teija.kasteenpohja@thl.fi) Mauri Marttunen (mauri.marttunen@thl.fi)
More informationThese comments are an attempt to summarise the discussions at the manuscript meeting. They are not an exact transcript.
Dear dr. Weber, We would like to thank you for the review of our manuscript entitled Cervical screening with an interval beyond five years requires different rescreen times for HPV-negative and HPVpositive,
More informationAuthor's response to reviews
Author's response to reviews Title:Differences upon admission and in hospital course of children hospitalized pneumonia: a retrospective cohort study Authors: Raquel Simbalista (r.simbalista@terra.com.br)
More informationManuscript ID BMJ entitled "Benzodiazepines and the Risk of Allcause Mortality in Adults: A Cohort Study"
12-Jan-2017 Dear Dr. Patorno Manuscript ID BMJ.2016.036319 entitled "Benzodiazepines and the Risk of Allcause Mortality in Adults: A Cohort Study" Thank you for sending us your paper. We sent it for external
More informationAuthor's response to reviews
Author's response to reviews Title:Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality? A post-hoc analysis of the 4-year UPLIFT trial Authors:
More informationTitle: Prognostic factors for non-success in patients with sciatica and disc herniation
Author's response to reviews Title: Prognostic factors for non-success in patients with sciatica and disc herniation Authors: Anne J Haugen (annhau@so-hf.no) Jens I Brox (j.i.brox@medisin.uio.no) Lars
More informationAuthor's response to reviews
Author's response to reviews Title:Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for
More informationEPF s response to the European Commission s public consultation on the "Summary of Clinical Trial Results for Laypersons"
EPF s response to the European Commission s public consultation on the "Summary of Clinical Trial Results for Laypersons" August 2016 This document received funding under an operating grant from the European
More informationTitle: Do general practitioners and psychiatrists agree about defining cure from depression? The DESCRIBE survey
Author's response to reviews Title: Do general practitioners and psychiatrists agree about defining cure from depression? The DESCRIBE survey Authors: koen demyttenaere (koen.demyttenaere@med.kuleuven.be)
More informationSince 1980, obesity has more than doubled worldwide, and in 2008 over 1.5 billion adults aged 20 years were overweight.
Impact of metabolic comorbidity on the association between body mass index and health-related quality of life: a Scotland-wide cross-sectional study of 5,608 participants Dr. Zia Ul Haq Doctoral Research
More informationCOUNCIL OF THE EUROPEAN UNION. Brussels, 7 September 2009 (OR. en) 11261/09 Interinstitutional File: 2008/0002 (COD) DENLEG 51 CODEC 893
COUNCIL OF THE EUROPEAN UNION Brussels, 7 September 2009 (OR. en) 11261/09 Interinstitutional File: 2008/0002 (COD) DLEG 51 CODEC 893 LEGISLATIVE ACTS AND OTHER INSTRUMTS Subject: Common Position with
More informationTitle:Emergency ambulance service involvement with residential care homes in the support of older people with dementia: an observational study
Author's response to reviews Title:Emergency ambulance service involvement with residential care homes in the support of older people with dementia: an observational study Authors: Sarah Amador (s.amador@herts.ac.uk)
More informationJonathan Williman University of Otago, Christchurch New Zealand 06-Nov-2013
PEER REVIEW HISTORY BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (see an example) and are provided with free text boxes to
More informationAuthor's response to reviews
Author's response to reviews Title: Effect of a multidisciplinary stress treatment programme on the return to work rate for persons with work-related stress. A non-randomized controlled study from a stress
More informationTitle: Systematic review of lung function and COPD with peripheral blood DNA methylation in population based studies
Author s response to reviews Title: Systematic review of lung function and COPD with peripheral blood DNA methylation in population based studies Authors: Matthew Machin (matthew.machin12@imperial.ac.uk)
More informationTitle: The Limitations of Voluntary Medical Male Circumcision and the Importance of Sustained Condom Use: A Kenyan Newspaper Analysis
Author's response to reviews Title: The Limitations of Voluntary Medical Male Circumcision and the Importance of Sustained Condom Use: A Kenyan Newspaper Analysis Authors: Charlene N Muzyka (charlene.muzyka@gmail.com)
More informationTitle: The role of cognitive stimulation at home in low-income preschoolers' nutrition, physical activity and Body Mass Index
Reviewer s report Title: The role of cognitive stimulation at home in low-income preschoolers' nutrition, physical activity and Body Mass Index Version: 1 Date: 23 Feb 2017 Reviewer: Pattanee Winichagoon
More informationTitle: Differences between patients' and clinicians' report of sleep disturbance: A field study in mental health care in Norway.
Author's response to reviews Title: Differences between patients' and clinicians' report of sleep disturbance: A field study in mental health care in Norway. Authors: Håvard Kallestad (havard.kallestad@ntnu.no)
More informationTitle: Reliability and Relative Validity of a Food Frequency Questionnaire to Assess Food Group Intakes in New Zealand Adolescents
Author's response to reviews Title: Reliability and Relative Validity of a Food Frequency Questionnaire to Assess Food Group Intakes in New Zealand Adolescents Authors: Jyh Eiin Wong (jyh.wong@otago.ac.nz)
More informationSpecial guidelines for preparation and quality approval of reviews in the form of reference documents in the field of occupational diseases
Special guidelines for preparation and quality approval of reviews in the form of reference documents in the field of occupational diseases November 2010 (1 st July 2016: The National Board of Industrial
More informationTitle: Response to M. tuberculosis selected RD1 peptides in Ugandan HIV-infected patients with smear positive pulmonary tuberculosis: a pilot study
Author's response to reviews Title: Response to M. tuberculosis selected RD1 peptides in Ugandan HIV-infected patients with smear positive pulmonary tuberculosis: a pilot study Authors: Delia Goletti (d.goletti@tiscali.it)
More informationDRAFT (Final) Concept Paper On choosing appropriate estimands and defining sensitivity analyses in confirmatory clinical trials
DRAFT (Final) Concept Paper On choosing appropriate estimands and defining sensitivity analyses in confirmatory clinical trials EFSPI Comments Page General Priority (H/M/L) Comment The concept to develop
More informationTitle:Spousal diabetes as a diabetes risk factor: A systematic review and meta-analysis
Author's response to reviews Title:Spousal diabetes as a diabetes risk factor: A systematic review and meta-analysis Authors: Aaron Leong (aaron.leong@mail.mcgill.ca) Elham Rahme (elham.rahme@mcgill.ca)
More informationTitle:Impaired renal function and associated risk factors in newly diagnosed HIV-infected Adults in Gulu Hospital, Northern Uganda
Author's response to reviews Title:Impaired renal function and associated risk factors in newly diagnosed HIV-infected Adults in Gulu Hospital, Northern Uganda Authors: Pancras Odongo (odongopancras@gmail.com)
More informationProject Officer Australian Alcohol Guidelines Evidence Translation Section NHMRC GPO Box 1421 CANBERRA ACT December 11, 2007
Project Officer Australian Alcohol Guidelines Evidence Translation Section NHMRC GPO Box 1421 CANBERRA ACT 2601 December 11, 2007 I am pleased to forward for your consideration the Australian Medical Association
More informationRisk factors for the initiation and aggravation of lymphoedema after axillary lymph node dissection for breast cancer
HEALTH SERVICES RESEARCH FUND Risk factors for the initiation and aggravation of lymphoedema after axillary lymph node dissection for breast cancer Key Messages 1. Previous inflammation or infection of
More informationTitle: Healthy snacks at the checkout counter: A lab and field study on the impact of shelf arrangement and assortment structure on consumer choices
Author's response to reviews Title: Healthy snacks at the checkout counter: A lab and field study on the impact of shelf arrangement and assortment structure on consumer choices Authors: Ellen van Kleef
More informationSection Editor Steven T DeKosky, MD, FAAN Kenneth E Schmader, MD
Prevention of dementia Author Daniel Press, MD Michael Alexander, MD Section Editor Steven T DeKosky, MD, FAAN Kenneth E Schmader, MD Deputy Editor Janet L Wilterdink, MD Last literature review version
More informationAuthor's response to reviews
Author's response to reviews Title: Gender, ethnicity, health behaviour & self-rated health in Singapore Authors: Wei-Yen Lim (Lim_Wei_Yen@moh.gov.sg) Stefan Ma (Stefan_Ma@moh.gov.sg) Derrick Heng (Derrick_Heng@moh.gov.sg)
More informationTitle: Vicissitudes of depressive symptoms during a medical course - a cross sectional study
Author's response to reviews Title: Vicissitudes of depressive symptoms during a medical course - a cross sectional study Authors: Sergio Baldassin (spbaldassin@uol.com.br) Tânia CTF Alves (tania_alves@hotmail.com)
More informationDMRI Drug Misuse Research Initiative
DMRI Drug Misuse Research Initiative Executive Summary Comorbidity in the national psychiatric morbidity surveys Research Report submitted to the Department of Health in February 2004 Report prepared by:
More informationTitle:Prevalence of binge drinking and associated behaviours among 3286 college students in France
Author's response to reviews Title:Prevalence of binge drinking and associated behaviours among 3286 college students in France Authors: Marie-Pierre Tavolacci (marie-pierre.tavolacci@chu-rouen.fr) Eloise
More informationTitle:Prediction of poor outcomes six months following total knee arthroplasty in patients awaiting surgery
Author's response to reviews Title:Prediction of poor outcomes six months following total knee arthroplasty in patients awaiting surgery Authors: Eugen Lungu (eugen.lungu@umontreal.ca) François Desmeules
More informationReproductive Health s Knowledge, Attitudes, and Practices A European Youth Study Protocol October 13, 2009
Reproductive Health s Knowledge, Attitudes, and Practices A European Youth Study Protocol October 13, 2009 I. Introduction European youth has been facing major socio-demographic and epidemiological changes
More informationTitle: What 'outliers' tell us about missed opportunities for TB control: a cross-sectional study of patients in Mumbai, India
Author's response to reviews Title: What 'outliers' tell us about missed opportunities for TB control: a cross-sectional study of patients in Authors: Anagha Pradhan (anp1002004@yahoo.com) Karina Kielmann
More informationReflection paper on assessment of cardiovascular safety profile of medicinal products
25 February 2016 EMA/CHMP/50549/2015 Committee for Medicinal Products for Human Use (CHMP) Reflection paper on assessment of cardiovascular safety profile of medicinal products Draft agreed by Cardiovascular
More informationDIETARY FACTORS OR DIETARY PATTERNS? HOW TO EFFECTIVELY PREVENT CARDIOVASCULAR DISEASE THROUGH NUTRITION
DIETARY FACTORS OR DIETARY PATTERNS? HOW TO EFFECTIVELY PREVENT CARDIOVASCULAR DISEASE THROUGH NUTRITION Demosthenes B. Panagiotakos, PhD, FRSPH, FACE Associate Professor of Biostatistics & Epidemiology
More informationTitle: Co-morbidities, complications and causes of death among people with femoral neck fracture - A three-year follow-up study.
Author s response to reviews Title: Co-morbidities, complications and causes of death among people with femoral neck fracture - A three-year follow-up study. Authors: Monica Berggren (monica.langstrom@umu.se)
More informationAuthor s response to reviews
Author s response to reviews Title: Lifestyle-related factors that explain disaster-induced changes in socioeconomic status and poor subjective health: a cross-sectional study from the Fukushima Health
More informationAuthor's response to reviews
Author's response to reviews Title: Validation of Doloplus-2 among nonverbal nursing home patients - An evaluation of Doloplus-2 in a clinical setting An evaluating of Doloplus-2 in a clinical setting
More informationTitle: Correlates of STI symptoms among female sex workers with trucker driver clients in two Mexican border towns
Author's response to reviews Title: Correlates of STI symptoms among female sex workers with trucker driver clients in two Mexican border towns Authors: Nadine E Chen (nadinechen@ucsd.edu) Steffanie A
More informationPart 8 Logistic Regression
1 Quantitative Methods for Health Research A Practical Interactive Guide to Epidemiology and Statistics Practical Course in Quantitative Data Handling SPSS (Statistical Package for the Social Sciences)
More informationTitle:Contraceptive use and Unmet need for Family Planning among HIV Positive Women on Antiretroviral Therapy in Kumasi, Ghana
Author's response to reviews Title:Contraceptive use and Unmet need for Family Planning among HIV Positive Women on Antiretroviral Therapy in Kumasi, Ghana Authors: DENNIS O LARYEA (dlaryea@kathhsp.org)
More information