PONE-D-25-16358 Longitudinal analysis of the risk factors for onset and change in tinnitus in the Busselton Healthy Ageing Study PLOS ONE

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Academic Editor

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“Core funding for data collection: Grants from the Government of Western Australia (Department of Jobs, Tourism, Science and Innovation), the Commonwealth Government (Department of Health), the City of Busselton and from private donations to the Busselton Population Medical Research Institute. In-kind support: The Western Australian Country Health Service, Pathwest, Abbott, Stallergenes, Resmed, Wesnes Cognition LTD and BD Biosciences. All funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.”

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Reviewers' comments:

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Comments to the Author

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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: Yes

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: Dear authors,

Congratulations with this very relevant and important manuscript. It are very interesting insights on the incidence of and risk factors for tinnitus. I only have a few minor comments as this work is scientifically and statistically sound.

comments:

- was there any correction used for multiple analyses to lower the chance of Type-I errors?

- the manuscript could benefit from insights on the use of tinnitus treatment between phase 1 and phase 2 to better understand the potential changes in tinnitus impact. I would also suggest to move lines 442-445 after line 451 as this information is also relevant to those we have no reported tinnitus at phase 2 anymore.

- some findings (e.g. lines 259-260, lines 334-335, line 395, lines 464-465) seem unexpected and I would like a bit more discussion on it with potential reasons for these unexpected findings.

- Line 390: 'incident tinnitus' -> 'tinnitus incidence'

- I suggest to elaborate on the limitations section a little further by also highlighting that not only the tinnitus impact relied on a single-item question but also the diagnosis. A validated diagnostic questionnaire would be preferred. Also, the age-range (46-64 yrs at time of phase 1) is small and a larger range could contribute to the insights.

Reviewer #2: This manuscript is technically sound, the analyses are appropriate and well conducted, and the data support the conclusions. A graphical representation / plots for major risk factors would however improve visual interpretation for readers. Although statistical associations have been well demonstrated, a short discussion on clinical significance and the impact of this study on patient counselling would strengthen the relevance of the study.

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Reviewer #1: Yes: Dr. Remo Arts

Reviewer #2: No

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Longitudinal analysis of the risk factors for onset and change in tinnitus in the Busselton Healthy Ageing Study

PONE-D-25-16358R1

Dear Dr.Denise Fuchten,

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,

Gauri Mankekar, MD,PhD,FACS

Academic Editor

PLOS One

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