Postoperative Radiation Referral Rates for Metastatic Bone Disease Within the Veteran’s Health Administration and at an Academic Center

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments: The Discussion illustrates the importance of the quality benchmark for referral to radiation, depending upon the patient population, for providing high quality and equitable care to patients. The study further highlights the limitations of the retrospective study conducted. The authors present an inclusive analysis of the rates that provides a useful starting point for the consideration of possible quality metrics. Lastly, the Conclusion underlines the nationwide variation in referral rate that will help in establishing radiation referral benchmarks for high-reliability care.

Literature

Q: Does the author utilize relevant literature?

A: Good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Writing style

Q: Is it clear and understandable?

A: Good

Comments: There are few issues found in the manuscript, which are as follows:

·       In Background section under Introduction, 2^nd paragraph, 1^st sentence, “Existing literature suggests that patients with metastatic bone diseased are best served …” should be written as “Existing literature suggests that patients with metastatic bone diseases are best served…”.

·       Under Discussion, 1^st paragraph, 1^st sentence, “The high proportion of patients referred at the VHA group and at the academic medical center is consistent with recommendations” should be rewritten as “The high proportion of patients referred to the VHA group and at the academic medical center, is consistent with recommendations”.

Further comments on the paper

Comments: The Research puts forth a retrospective cohort study highlighting postoperative radiation referral rates for metastatic bone disease within the Veteran’s Health Administration (VHA) and academic center. The observed regional variation within the VHA indicates the importance of establishing quality benchmarks. The Research provides the elaborated study design, demographics, statistical analysis, covariates, the outcome variables and comes up with the possible results.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team