PONE-D-24-45712Analysis of the incidence and influencing factors of high-risk foot in elderly patients with type 2 diabetes in a community in BeijingPLOS ONE

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Sanaullah Sajid, M.Phil/PhD

Academic Editor

PLOS ONE

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Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1:  1. The authors collected and measured data related with diabetic foot risk for 269 elderly patients with type 2 diabetes in a Chinese community. They detected the incidence rate of high-risk foot and identified influencing factors using univariate hypothesis tests and multivariate logistic regression. The results highlighted the importance for examination of high-risk foot in elderly diabetic patients, and proposed several risk factors that warrant attention.

2. In the univariate analysis part, t test requires data to be normal distribution, so it would be more rigorous to test the normality of data distribution before t test, or to use the nonparametric Wilcoxon rank sum test would be safe. After performing hypothesis tests for each factor in Table 1, it would be more rigorous to perform FDR (false discovery rate)-controlling procedure to ensure the overall false positivity lower than a given level. In the logistic regression part, the accuracy of coefficient estimates and the calculation of p-values often rely on some assumptions for the data, so it would be more rigorous to perform some regression diagnostics for the data and results, if convenient.

3. The original data from the questionnaire, medical records, and foot examination are not available in the manuscript or supporting information. If without special restrictions, the original data should be provided.

4. The abbreviations in the tables should be better explained in the footnotes, such as TC, TG, LDL-C, HDL-C in Table1; B, SE, Wald, OR, CI in Table2. The table titles should be "risk factors for high-risk foot" rather than "risk factors for type 2 diabetes", and "in an elderly community" rather than "in elderly communities". The significant p-values in the tables should be better marked, for example, using asterisks.

Some typos should be checked. (1) Whether to capitalize the first letters, such as headings and subheadings, the table items, etc. The first word after semicolon should not be capitalized. (2) Brackets appear to be typed in both Chinese and English modes. (3) Space should be inserted between one word and its successive left bracket, between one word and its front comma or period. (4) "High-risk foot" or "High-risk feet", there are two different expressions across the manuscript. (5) Singular or plural nouns, such as "statistically significant variables" and "independent variables" in Section 3.3. (6) "HBA1c" should be "HbA1c" in Section 4.

Reviewer #2:  Minor concerns:

Since convenient sampling was used, the authors may consider acknowledging the potential limitation regarding generalizability.

The manuscript could be further improved by discussing possible confounding factors that might influence the outcomes.

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Reviewer #1: No

Reviewer #2: Yes:  Dr. Samiullah Sajid

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Analysis of the incidence and influencing factors of high-risk foot in elderly patients with type 2 diabetes in a community in Beijing

PONE-D-24-45712R1

Dear Dr. Ding,

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.

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Kind regards,

Sanaullah Sajid, M.Phil/PhD

Academic Editor

PLOS ONE

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