Impact of Clinical and Socio-Demographic Factors on the Quality of Life in Romanian People with Epilepsy

Round 1

Reviewer 1 Report

INTRODUCTION

Already delivered well. Please use anti-seizure medication (ASM) instead of anti-epileptic drugs (AED). 

 

METHOD

Although QOLIE-31 has already being used widely, please describe how to assess using the instrument. How many domains were assessed? How many items in each domain? Was it using Likert scale? What is the minimum and maximal score for each domain? What is the meaning of low and high score?

 

RESULT

Line 132: “The majority of the patients were on monotherapy and had no aura preceding seizures. (Table 1)”. 

Table 1 should include univariate variable of all subjects instead of cross-over table between socio-demographic and QOLIE-31.

 

 

Line 138: 23.1% (N=21) patients had low QOL, 49.5% (N=45) had average and 27.5% (N=25) had high QOL. The number should not be stated at first sentence. It should be written as : “Twenty-three point one percent (N=21) patient………..”

 

Style of table should be as “list style” which there is no horizontal lines except for top row and the bottom of table. 

 

DISCUSSION

The association between seizure frequency and QOL is widely known. The author discuss about QOL assessment in VEEG monitoring unit. However, it hasn’t been discussed yet regarding how often should QOL being assessed? Should it be every month/ every 3 months/ 6 months? What is the difference of Romanian’s PWE compare to other people? Are there cultural differences among Romanians that make a difference to the QOLIE results?

 

What is the limitation of this study? 

 

Line 214: “Once the interpretation of the investigation is released, the patient will receive recommendations based also on the QOL score”. What kind of recommendation would patient get? Please give some examples. 

Author Response

Please see the attachment 

Author Response File: Author Response.docx

Reviewer 2 Report

The study investigated significant sociodemographic factors and clinical factors on the quality of life in patients with epilepsy. It provided overall score of quality of life in study population and scores of subsets called to domain of quality of life. Significant findings may contribute to building enhanced care guideline for providers as well as patients with epilepsy. The study has some points to be improved for better quality. Particularly, the entire discussion section should be revised with more literature references and clear lead statements. Details of suggestions is provided at below. Therefore, I would recommend major revision.

 

Methods

Page3, Line 110-112: It is a bit confusing to understand the methods. P-values on table 2 came from this multiple linear regression? If so, domain scores are the outcome of each regression model? Is it adjusted regression with variables? Please clarify it.

Page 3, line 112-114: t-test and ANOVA are the test to compare mean differences between groups instead of revealing the connection. P-values on table 1 represent significance from those tests? If so, it should be interpreted that significant difference exists between groups with regards to a domain score. Clarify the point.

Results

Page3, line 134-page4, line 153: P-values in parenthesis should be mismatched to the interpretation. For instance, p-value of the Energy domain (0.0155) means the significant difference of mean score of the Energy domain between different age group. However the statement interpreted the score of age 44-79 as the lowest score with this p-value. It might confuse readers to understand what p-value really means. So remove p-values after each domain in the paragraph and address p-values in separate sentences.

Discuss

Overall, the study could provide meaningful implication of some findings particularly for improvement of follow-up care and management of epilepsy tailored to low socioeconomic status population. However, current discussion section duplicated the results with a literature without further discussion and implication. Each paragraph needs a clear lead statement highlighting the key findings of the study. The discussion should highlight the significant findings that would be comparable to other studies and contribute to this particular patient group, related providers and healthcare system. In addition, it needs more references to be discussed. Most discussion points did not mention literature references. I would recommend to add further discussion of strong points of the study.

For instance, the first paragraph of the discussion did not discuss the meaningful implication of higher or lower score of Romanian comparing to other European countries. A main point and the implication are not clear.

Page8, line 184-194: it is a good discussion. However I would recommend to re-organize the statements.

 

Table 1: the title of table 1 should be revised as t-test and ANOVA is not the test for identifying relationship. The title should be descriptive analysis or baseline characteristics of study population. 

Author Response

Please see the attachment 

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

All my suggestions are addressed in the revised one. 

No more comments.