Age at natural menopause and its determinants in female population of Kharameh cohort study: Comparison of regression, conditional tree and forests

Zahra Pasokh; Mozhgan Seif; Haleh Ghaem; Abbas Rezaianzadeh; Masoumeh Ghoddusi Johari

doi:10.1371/journal.pone.0300448

Peer Review History

Original SubmissionNovember 2, 2023
14 Jan 2024 Decision Letter - Zahra Cheraghi, Editor PONE-D-23-34559Age at Natural Menopause and Its Determinants in Female Population of Kharameh Cohort Study: Comparison of Regression, Conditional Tree and ForestsPLOS ONE Dear Dr. Seif, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== ACADEMIC EDITOR: Please submit your revised manuscript by Feb 28 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Note from Emily Chenette, Editor in Chief of PLOS ONE, and Iain Hrynaszkiewicz, Director of Open Research Solutions at PLOS: Did you know that depositing data in a repository is associated with up to a 25% citation advantage (https://doi.org/10.1371/journal.pone.0230416)? If you’ve not already done so, consider depositing your raw data in a repository to ensure your work is read, appreciated and cited by the largest possible audience. You’ll also earn an Accessible Data icon on your published paper if you deposit your data in any participating repository (https://plos.org/open-science/open-data/#accessible-data). 3. Thank you for stating the following financial disclosure: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007).” Please state what role the funders took in the study. If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. 4. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007). This study was approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.SCHEANUT.REC.1400.104).” We note that you have provided funding information that is currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007).” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 5. In the online submission form you indicate that your data is not available for proprietary reasons and have provided a contact point for accessing this data. Please note that your current contact point is a co-author on this manuscript. According to our Data Policy, the contact point must not be an author on the manuscript and must be an institutional contact, ideally not an individual. Please revise your data statement to a non-author institutional point of contact, such as a data access or ethics committee, and send this to us via return email. Please also include contact information for the third party organization, and please include the full citation of where the data can be found. 6. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. [Note: HTML markup is below. Please do not edit.] 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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ****** 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 ****** 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 ****** 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: This is an interesting, well-written article with excellent methodology that examines factors affecting ANM using various machine learning methods. In my opinion, this article is suitable for publication in PLoS ONE, just correct the following points in the modified version. 1. What is meant by natural menopause? Please explain it in the abstract section. 2. The authors wrote in the introduction that ethnicity, region, socioeconomic position, environment, life style, occupation, education, residence, and marital status have an effect on menopause. Please specify which subgroups of these variables have a positive effect on premature menopause. 3. The phrase " As can be seen, breastfeeding has little impact on ANM and this statistical significance may be due to the large sample size." should be transferred to the discussion in the findings section. Reviewer #2: This study investigated the age at Natural Menopause and Its Determinants in Female Population of Kharameh Cohort Study: Comparison of Regression, Conditional Tree and Forests. The topic is interesting. The topic is interesting. However, there are some concerns that need to be addressed. Abstract Results: All methods simultaneously recognized the number of pregnancies, duration of breastfeeding, mother’s ethnicity, job, and residence as the most important predictors of ANM. -The sentence is ambiguous and the direction of association is unclear. For example, it is not clear whether the association is positive or negative. For instance, it is unclear whether increasing the frequency of pregnancy lowers or increases the age of menopause. Similarly, an unclear and vague relationship has been reported for other variables. Methods -Is the age range of 40-70 years appropriate and based on a reliable reference? Typically, the onset of menopause occurs between the ages of 45 and 55. Could you please provide the reference used to select this age group? -What was the response rate in this study? Discussion -In this study, the cross-sectional phase was used. Therefore, the relationships obtained are not necessarily causal. It is important to explain these relationships with caution and to include them in the limitations section. ****** 6. 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: Fatemeh Shahbazi Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: comments.docx https://doi.org/10.1371/journal.pone.0300448.r001
Revision 1
21 Feb 2024 Author Response Dear Editor, We would like to express our gratitude for the opportunity to submit a revised draft of the manuscript. We sincerely appreciate the time and effort you and the reviewers have dedicated to providing feedback on our work. After carefully reviewing the comments, we have made the necessary revisions to the manuscript, which are highlighted within the document. We have also addressed the reviewers' comments point by point below. With the implemented changes, we believe that the revised version is now suitable for publication. We eagerly await your response. Thank you once again for your consideration. Sincerely, Mozhgan Seif Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Author's response: Done, we applied the requirements in the manuscript. We added Author contributions before the Abstract, used the level 1 heading for major sections, and level 2 heading for sub-sections of major sections, abbreviated the word “Figure” to “Fig” and placed figures after the paragraph in which they are first cited, and used bold type for figures titles. We placed tables after the paragraph in which they are first cited, and used bold type for table titles. We added page number and page line, cited references in brackets, and removed competing interests and data availability statements at the end of the manuscript. 2. Note from Emily Chenette, Editor in Chief of PLOS ONE, and Iain Hrynaszkiewicz, Director of Open Research Solutions at PLOS: Did you know that depositing data in a repository is associated with up to a 25% citation advantage (https://doi.org/10.1371/journal.pone.0230416)? If you’ve not already done so, consider depositing your raw data in a repository to ensure your work is read, appreciated and cited by the largest possible audience. You’ll also earn an Accessible Data icon on your published paper if you deposit your data in any participating repository (https://plos.org/open-science/open-data/#accessible-data). Author's response: Dr. Abbas Rezaianzadeh is the principal responsible for the Kharameh cohort study. Although he is a co-author of this manuscript, he doesn’t allow the data to be publicly available. However, he provides the data to researchers under special circumstances by corresponding with him. (Contact via: rezaiana@gmail.com) 3. Thank you for stating the following financial disclosure: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007).” Please state what role the funders took in the study. If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. Author's response: the funders had no role in this research. We edited the funding statement and moved the funding statement to the cover letter. 4. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007). This study was approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.SCHEANUT.REC.1400.104).” We note that you have provided funding information that is currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “This article was a part of Zahra Pasokh’s M.Sc. thesis approved and financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences (grant No. 25007).” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. Author's response: done, we omitted the funding information from the acknowledgments section. Actually, we removed the funding information from any part of the manuscript and referenced it in the cover letter. 5. In the online submission form you indicate that your data is not available for proprietary reasons and have provided a contact point for accessing this data. Please note that your current contact point is a co-author on this manuscript. According to our Data Policy, the contact point must not be an author on the manuscript and must be an institutional contact, ideally not an individual. Please revise your data statement to a non-author institutional point of contact, such as a data access or ethics committee, and send this to us via return email. Please also include contact information for the third party organization, and please include the full citation of where the data can be found. Author's response: Dr. Abbas Rezaianzadeh is the principal responsible for the Kharameh cohort study. Although he is a co-author of this manuscript, he doesn’t allow the data to be publicly available. However, he provides the data to researchers under special circumstances by corresponding with him. (Contact via: rezaiana@gmail.com) 6. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. Author's response: We had mentioned the ethics statement in the acknowledgment section. According to your comment, we removed it from acknowledgment and mentioned it in the methods section (page 6 lines 121-124). Reviewer #1: This is an interesting, well-written article with excellent methodology that examines factors affecting ANM using various machine learning methods. In my opinion, this article is suitable for publication in PLoS ONE, just correct the following points in the modified version. 1. What is meant by natural menopause? Please explain it in the abstract section. Author's response: done, thank you for your suggestion. Natural menopause is defined as the permanent cessation of menstruation that occurs after 12 consecutive months of amenorrhea without any obvious pathological or physiological cause. This type of menopause is defined in contrast to induced menopause. Induced menopause is the menopause that occurs after surgery to remove the ovaries, chemotherapy or radiation damage to the ovaries, or the use of other drugs to intentionally induce menopause as part of the treatment of certain diseases. We added definition of natural menopause in the abstract (page 1). 2. The authors wrote in the introduction that ethnicity, region, socioeconomic position, environment, life style, occupation, education, residence, and marital status have an effect on menopause. Please specify which subgroups of these variables have a positive effect on premature menopause. Author's response: done (page 4 lines 79-87). Thank you for your suggestion. 3. The phrase " As can be seen, breastfeeding has little impact on ANM and this statistical significance may be due to the large sample size." should be transferred to the discussion in the findings section. Author's response: corrected (page 18, lines 357-358), thank you. Reviewer #2: This study investigated the age at Natural Menopause and Its Determinants in Female Population of Kharameh Cohort Study: Comparison of Regression, Conditional Tree and Forests. The topic is interesting. The topic is interesting. However, there are some concerns that need to be addressed. Abstract Results: All methods simultaneously recognized the number of pregnancies, duration of breastfeeding, mother’s ethnicity, job, and residence as the most important predictors of ANM. -The sentence is ambiguous and the direction of association is unclear. For example, it is not clear whether the association is positive or negative. For instance, it is unclear whether increasing the frequency of pregnancy lowers or increases the age of menopause. Similarly, an unclear and vague relationship has been reported for other variables. Author's response: corrected (page 2), thank you. Methods -Is the age range of 40-70 years appropriate and based on a reliable reference? Typically, the onset of menopause occurs between the ages of 45 and 55. Could you please provide the reference used to select this age group? Author's response: thanks for our question. As you mentioned, natural menopause normally occurs between the ages of 45 and 55 but some people may experience natural menopause earlier or later of this age group. We have used the data collected in the Kharameh cohort study. The Kharameh cohort study is a comprehensive study conducted on people aged 40-70 years old. This study aimed to determine the factors which may affect age at natural menopause. Therefore, considering the availability of data, the age range considered in this study is 40 to 70 years old. -What was the response rate in this study? Author's response: as we have mentioned in page 5, out of 10,836 people, 10,663 people (5,944 women and 4,719 men), which is equivalent to 98.4% of the population of Kharamah, participated in this census and answered questioners. Out of 5944 women, 2517 people were reported to be naturally menopause. So, we used these women’s information for our study which all were completed the questioners. (page 5 lines 113-115, page 6 line 119-120) Discussion -In this study, the cross-sectional phase was used. Therefore, the relationships obtained are not necessarily causal. It is important to explain these relationships with caution and to include them in the limitations section. Author's response: thank you, we applied your suggestion in limitations (page 20-21 lines 403-404). Attachments Attachment Submitted filename: Response to Reviewers..docx https://doi.org/10.1371/journal.pone.0300448.r002
28 Feb 2024 Decision Letter - Zahra Cheraghi, Editor Age at Natural Menopause and Its Determinants in Female Population of Kharameh Cohort Study: Comparison of Regression, Conditional Tree and Forests PONE-D-23-34559R1 Dear Dr. Seif, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Zahra Cheraghi, Ph.D Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0300448.r003
Formally Accepted
4 Apr 2024 Acceptance Letter - Zahra Cheraghi, Editor PONE-D-23-34559R1 PLOS ONE Dear Dr. Seif, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Zahra Cheraghi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0300448.r004

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