Title: The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality
in South Korea: a population based cohort study
Version: 5 Date: 27 Jul 2021
Reviewer's report:
The authors did not address my previous comments. The authors agree with the comment
that the variables in Table 1 should be put into the logistic regression model to calculate the
propensity score (including Charlson comorbidity index). However, the authors did not do
so. The study conclusion is that menopausal hormone therapy (MHT) was associated with a
decreased diagnosis of GI cancer, especially for CRC and GC, and was significantly associated
with decreased mortality from CRC and GC. According to Table 1, the Charlson comorbidity
index (CCI) score was significantly lower in the MHT group than the non-MHT group. As the
CCI was initially designed to predict the mortality risk, the difference of CCI between treatment
and control groups could be an important source of bias by confounding effect. If possible, I
would like to know the study results in which the CCI was also considered in the propensity
score matching method. Did the study results and conclusions become different?
In addition, regarding the propensity score matching method, the authors only mentioned that
“The algorithm used a caliper matching without replacement.” Please clearly specify the caliper
widths and the algorithm types. The authors could refer to the reference (Stat Med. 2014 Mar
15;33(6):1057-69. DOI: 10.1002/sim.6004).
Title: The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality
in South Korea: a population based cohort study
Version: 5 Date: 27 Jul 2021
Reviewer's report:
The authors did not address my previous comments. The authors agree with the comment
that the variables in Table 1 should be put into the logistic regression model to calculate the
propensity score (including Charlson comorbidity index). However, the authors did not do
so. The study conclusion is that menopausal hormone therapy (MHT) was associated with a
decreased diagnosis of GI cancer, especially for CRC and GC, and was significantly associated
with decreased mortality from CRC and GC. According to Table 1, the Charlson comorbidity
index (CCI) score was significantly lower in the MHT group than the non-MHT group. As the
CCI was initially designed to predict the mortality risk, the difference of CCI between treatment
and control groups could be an important source of bias by confounding effect. If possible, I
would like to know the study results in which the CCI was also considered in the propensity
score matching method. Did the study results and conclusions become different?
In addition, regarding the propensity score matching method, the authors only mentioned that
“The algorithm used a caliper matching without replacement.” Please clearly specify the caliper
widths and the algorithm types. The authors could refer to the reference (Stat Med. 2014 Mar
15;33(6):1057-69. DOI: 10.1002/sim.6004).
Please review this paper.
user
Title: The effect of menopausal hormone therapy on gastrointestinal cancer risk and mortality
in South Korea: a population based cohort study
Version: 5 Date: 27 Jul 2021
Reviewer's report:
The authors did not address my previous comments. The authors agree with the comment
that the variables in Table 1 should be put into the logistic regression model to calculate the
propensity score (including Charlson comorbidity index). However, the authors did not do
so. The study conclusion is that menopausal hormone therapy (MHT) was associated with a
decreased diagnosis of GI cancer, especially for CRC and GC, and was significantly associated
with decreased mortality from CRC and GC. According to Table 1, the Charlson comorbidity
index (CCI) score was significantly lower in the MHT group than the non-MHT group. As the
CCI was initially designed to predict the mortality risk, the difference of CCI between treatment
and control groups could be an important source of bias by confounding effect. If possible, I
would like to know the study results in which the CCI was also considered in the propensity
score matching method. Did the study results and conclusions become different?
In addition, regarding the propensity score matching method, the authors only mentioned that
“The algorithm used a caliper matching without replacement.” Please clearly specify the caliper
widths and the algorithm types. The authors could refer to the reference (Stat Med. 2014 Mar
15;33(6):1057-69. DOI: 10.1002/sim.6004).
assistant