Loss of Independence after Index Hospitalization Following Proximal Femur Fracture

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

• The title does not seem correct. This is not a narrative article.
• The last section of the abstract should be the conclusion.
• The conclusion in the abstract is too broad. Provide more details in your abstract conclusion.
• The inclusion and exclusion criteria are not correct. You should mention the specific inclusion and exclusion criteria for the articles chosen to be part of your review.
• The methodology of the article is not satisfactory. Provide more details about the article selection process. What criteria did you use for quality control of the articles included?

 

 

Comments on the Quality of English Language

Good.

Author Response

Reviewer 1:

• The title does not seem correct. This is not a narrative article.

Answer: Thank you for your correction. We corrected the title.

• The last section of the abstract should be the conclusion.

Answer: We corrected it in the revised manuscript.

• The conclusion in the abstract is too broad. Provide more details in your abstract conclusion.

Answer: We added some additional points in the abstract conclusion section as requested.

• The inclusion and exclusion criteria are not correct. You should mention the specific inclusion and exclusion criteria for the articles chosen to be part of your review.

Answer: We added some more information to expand on the inclusion exclusion criteria and also added the PICO criteria for our paper in the methods sections.

• The methodology of the article is not satisfactory. Provide more details about the article selection process. What criteria did you use for quality control of the articles included?

Answer: we conducted a quality assessment of all the included studies and added a supplementary table that explains the quality of all the studies with risk of bias assessment.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

The authors led by Maqsood and Saleh present a literature review and analysis of retrospective studies on proximal femur fractures (PFF) and risk factors for loss of independence. They identified and included a total of 24 articles in a PRISMA-based search.

Their study aims to assess the loss of independence after a proximal femur fracture and to provide information on the associated economic impact. To this end, they evaluated the demographic data of patient cohorts, characterized risk factors, and analyzed the influence of economic, social, and psychological factors on outcomes in PFF. In their study, they were able to show differences in terms of outcome and costs in different populations. Given a growing and aging world population, there are considerable socio-cultural costs for societies to face.

The study presented is well elaborated and has identified important aspects in relation to the research question, despite the very heterogeneous nature of the studies.

 

My points of criticism are as follows:

One main point of criticism concerns the underlying studies themselves. Most studies have formulated the exclusion and inclusion criteria in a way that they exclude most patients. To what extent are such studies relevant for corresponding statements?

Comments on the Quality of English Language

The authors introduce a lot of new abbreviations which make the article difficult to read. Writing out some of these abbreviations would not unnecessarily lengthen the manuscript but would make it easier to read.

The authors may wish to check whether some of the terms they use could be misinterpreted in international usage. A translation and retranslation into another language may help here.

Author Response

 

 

My points of criticism are as follows:

• One main point of criticism concerns the underlying studies themselves. Most studies have formulated the exclusion and inclusion criteria in a way that they exclude most patients. To what extent are such studies relevant for corresponding statements?

Answer: Thank you for bringing up this point. We definitely agree with the heterogeneity of the included studies and the quality of the included studies related to the population and the outcomes.

Our main focus was to cover the different outcome impacts related to the disposition in old age population and different studies have discussed it differently. That’s why we included those studies that cover at least one aspect of the outcome. We additionally added a quality assessment of the included studies in our revised manuscript with risk of bias evaluation by Newcastle-Ottawa score.

 

 

• The authors introduce a lot of new abbreviations which make the article difficult to read. Writing out some of these abbreviations would not unnecessarily lengthen the manuscript but would make it easier to read. The authors may wish to check whether some of the terms they use could be misinterpreted in international usage. A translation and retranslation into another language may help here.

Answer: We definitely appreciate the concern related to the abbreviations and to simplify it we combed through the manuscript and wrote out most of the abbreviations in the manuscript to ease the readers. Additionally, we separated all the abbreviations in the manuscript and compiled those in the end of the manuscript.

Reviewer 3 Report

Comments and Suggestions for Authors

Point 1;- line 155-156 you mentioned different percentage of occurrence in patient ut id it total patient from 5077, your percentage is showing more than total can you justify 

Point 2 ;- is it systemic review as it in title you mentioned simple review 

Point 3:- in table 1 you had not mentioned heading of table 1

Point 4:- reference are less  as per manuscript 

Point 5:- total article you selected for study is 24 article, in that how many females and males 

Point 6:you had collected data from 1900-2023. Is it latest articles to be included 

Author Response

Point 1;- line 155-156 you mentioned different percentage of occurrence in patient ut id it total patient from 5077, your percentage is showing more than total can you justify 

Answer: Thank you for reviewing our manuscript thoroughly. These percentages are mentioned after classifying the patient population into different subclasses on the basis of the age groups.

Point 2 ;- is it systemic review as it in title you mentioned simple review 

Answer: To avoid confusion, we removed the narrative review from the title, and we wrote this manuscript as a systematic/Literature review.

Point 3:- in table 1 you had not mentioned heading of table 1

Answer: We mentioned the table heading in the bottom of the table as “Summary of Studies included for Proximal Femur Fractures and Significant Outcomes”.

Point 4:- reference are less  as per manuscript 

Answer: We included 24 studies in our paper and added 38 references. Our added studies supported our manuscript points and to avoid redundant citations, we only included 38 references.

Point 5:- total article you selected for study is 24 article, in that how many females and males 

Answer; There is indeed variability in outcomes based on gender, but only a few articles provided specific numbers for male and female patients. One article highlighted that females were predominantly associated with loss of independence. However, our manuscript did not primarily focus on gender-based outcomes. It is a significant point that we can certainly consider in future studies.

Point 6:you had collected data from 1900-2023. Is it latest articles to be included 

Answer: We collected data up until 2023 and finalized our manuscript in early 2024. Upon a quick review of databases before submission, we found no articles meeting our inclusion criteria published in the meantime.

 

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript has improved.

Comments on the Quality of English Language

Needs some editing.

Reviewer 3 Report

Comments and Suggestions for Authors

Point 1:- all comment are fulfilled and satisfied 

Point 2:- make sure all fonts in manuscript should be same specially in tables