PONE-D-19-18400

Overactive Bladder and Bladder Pain Syndrome/Interstitial Cystitis in Primary Sjögren’s Syndrome: A Nationwide Population-based Study

PLOS ONE

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I commend the authors on a well written manuscript on an interesting finding. The high incidence of OAB and BPS/IC in women with Sjogren's is remarkable for sure.

I have several questions/comments for the authors:

1) Under 'Data Source' line 5 should read " Taiwan are included"

2) Can you further explain the decision to exclude subjects with diagnosis before 2001? Was the decision for newly diagnosed patients only to see progression more objectively?

3) In "Risks of OAB and BPS/IC" Why was the age of 65 years old chosen as a cut off?

4) In "Risks of OAB and BPS/IC" lines 12-14 does not make sense. I am not sure what you are trying to say here. Please rewrite.

5) In "Discussion" Why do you think rates of OAB BPS/IC were lower in your normal cohort population than described rates? Do you think it could be due to under diagnosis by physicians in the care of "normal" patients? Please explains.

All in all, a well written manuscript on an interesting subject.

Reviewer #2: Sjögren’s syndrome (SS) is an autoimmune disease affecting lacrimal and salivary glands. Primary SS has long been associated with interstitial cystitis/bladder pain syndrome (IC), but the extent of association remains unclear. Lee and colleagues used data from Taiwan’s National Health Insurance Research Database to examine the occurrence of IC and overactive bladder (OAB) among newly-diagnosed pSS patients over a 10-year period, relative to a non-pSS control group. Among 11,526 pSS patients, elevated hazard ratios were identified for both IC and OAB, and younger age, female gender, and sever glandular dysfunction were identified as risk factors.

The manuscript is generally well written, although tables should not be incorporated into the text, and page numbers would facilitate review.

Concerns:

1. On Page 15, minor editing should be applied to Lines 5-8. “…mast cells may induce…” and “drive mast cells to the bladder lamina propria…”

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Reviewer #1: Yes: Sangeeta T Mahajan MD

Reviewer #2: Yes: Dr. David James Klumpp

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Overactive Bladder and Bladder Pain Syndrome/Interstitial Cystitis in Primary Sjögren’s Syndrome: A Nationwide Population-based Study

PONE-D-19-18400R1

Dear Dr. Chen,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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With kind regards,

Yoshiaki Taniyama, MD, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for your comments and corrections. A very interesting manuscript and a good contribution to the medical literature.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Sangeeta T Mahajan MD