Quality of Life in Multiple Sclerosis: The Predictive Roles of Positive Body Image and Meaning in Life
, Sandra Torres, Raquel Barbosa, Filipa Vieira, Leonor Lencastre and Marina Prista Guerra *
Junichi Kitanaka
Round 1
Reviewer 1 Report
The manuscript "Quality of Life in Multiple Sclerosis: The Predictive Role of Positive Body Image and Meaning in Life" is an interesting and important work to better understand the different dimensions of well-being in people with multiple sclerosis. Overall, the paper is well-written. The introduction is concise but exhaustive, while the study design is appropriate for the goal of this study. However, methods and results sections require improvements.
1. Please add to Table 1 effect size for Chi-square test of independence (e.g., phi for binary variable, and Cramer's V for multiple categories).
2. Please add all categories of demographic variables and its coding (for correlation and regression analyses) to the description on page 5 lines 199.
3. It is unclear, how the participant with MS answered for disease-specific questions. Please add all response options to each variable, describing on page 5 lines 200-202.
4. Procedure is unclear and does not allow replication of this study. In particular, how were the participants invited to the study? Did you use any e-mailing list with a link to the questionnaire, or some social media (e.g. Facebook), or other way? Please describe step by step, how questionnaires were disseminated, and how many people refused participation in this study. What was the response rate?
5. What is the power of statistical analyses? How was the sample size determined?
6. Table 4 needs extension. If multiple regression models are performed, some statistics should be added, namely SE for unstandardized B and standardized beta coefficient. Also, if you performed five times regression models using the same set of predictor variables, the corrected p-value should be implemented to avoid bias (e.g. Bonferroni correction). Therefore, some significant effects could be insignificant after these corrections. Please revise the description of the results according to these new evidence.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
In this work, Dr. Barbosa et al. evaluated the quality of life, under several nuances, in a decent number of mixed gender subjects with Multiple Sclerosis (MS). The methodological structure is narrowly focused, the measures are sound, so do the underneath psycho-social constructs. Results are conceivable although the rationale appears weak to me: it is well-established and entirely expected, indeed, that the quality of life is lower in subjects with multiple sclerosis. Here are as follows my points:
- The Authors should support their willingness to investigate such hypothesis in front of the extant literature, unless they admit they wanted to run a replicative study (besides, I saw that this work originates from a previous project) being confirmative of the evidence emerged in the body of literature.
- I noticed an unequal gender balance in the sample composition, for which I wonder whether a weighed analysis was performed.
- The manuscript would benefit from a thorough polishing, preferably by a native speaker as numerous typos and syntax errors are scattered.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Reviewer 3 Report
The authors have submitted a research article of demonstrating an impact of physiological condition of multiple sclerosis (MS) on Quality of life (QOL) that the person feels and the way of thinking about how we think ourselves under the clinical state of MS. It has been well recognized that the state of MS generally tends to perceive itself in a bad way, but as the authors mentioned it is likely that if the social interactions are positive, the patients will have a positive outlook on the meaning of life. In this regard, maintenance of the good situation of the social interactions appears to improve GOL of the MS patients. This issue is of interest, and impact of their article is strong. My overall concern with the article describing the available data regarding beneficial availability of estimated measurable values that indicate the state of MS is that information provided may offer something substantial that helps advance our understanding of effective management which draws novel class of effective treatments available for MS in clinic.
To strengthen authors’ perspectives, the authors are strongly recommended to add a discussion regarding an impact of kinds of social interactions on improvement of the QOL in MS patients as compared with healthy people.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
The authors revised the manuscript, as suggested.
Reviewer 3 Report
The authors have done a good job responding to reviewer comments and concerns in their revision. I believe the manuscript is significantly improved as a result. Now I recommend that this revised version of the manuscript can be accepted for publication in the journal Screlosis.
