Journal of Mid-life Health Journal of Mid-life Health
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 Table of Contents 
Year : 2021  |  Volume : 12  |  Issue : 4  |  Page : 324  

Response from the author

Department of Midwifery, Nursing and Midwifery School, 28 Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Date of Submission28-Nov-2021
Date of Decision23-Dec-2021
Date of Acceptance25-Dec-2021
Date of Web Publication20-Jan-2022

Correspondence Address:
Dr. Parvin Abedi
Department of Midwifery, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0976-7800.336147

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How to cite this article:
Abedi P. Response from the author. J Mid-life Health 2021;12:324

How to cite this URL:
Abedi P. Response from the author. J Mid-life Health [serial online] 2021 [cited 2022 May 18];12:324. Available from:

Dear Editor,

We appreciate and welcome the balanced critique of the article and heartily thank the critics for pointing out some discrepancies.

We sincerely apologize for the inadvertent errors in the manuscript that confused the replicability and generalizability of the study findings. Below, we have addressed each of the queries raised;

The statement - hormone levels, hot flashes, and sleep disruptions are associated with women's quality of life in the introduction section is from reference one.[1] We determined the sample size calculation based on the following publication by Yazdani Ahiabady M.[2] Regarding the 15-unit change in the Quality of Life Score was considered clinically significant based on the authors' clinical acumen. For allocation concealment, the codes allotted to each participant after randomization were kept with the secretary of the counseling clinic and hence neither the researcher nor the statistician were aware of the allocation until the whole analysis was complete. The P values of the demographic characteristics of the participants were initially presented in [Table 1]. However, one of the reviewers pointed out that any differences in the baseline profile of the participants are ascribable to Type I error, and P values are not presented for baseline profile in a randomized trial. We used a generalized estimating equation (GEE) for analyzing the data. The legend for [Table 2] should have mentioned the following: “The P value for Group × Time interaction (based on the results of GEE analysis.). We modified the analysis strategy based on reviewers' comments. We should have mentioned the following in the methods section: GEE models were used to examine the association between the type of intervention and changes in the Quality of Life Score, vasomotor score, psychological, physical, sexual, hot flash severity, and hot flash frequency over time. The GEE models included two main effects (group and time) and the interaction of these effects. The Bonferroni correction was applied for pairwise comparisons following GEE analysis. Other P values are based on multiple comparisons with Bonferroni correction.”

There was also a typo in [Table 3]. The frequency of hot flashes at baseline, postintervention, and 3 months postintervention in the control group were 20.96 ± 12.91, 21.90 ± 13.37, and 23.41 ± 13.90, respectively. Regarding the query on the normality of the data, please note the robustness of the parametric tests. Furthermore, note that we are talking about the normality of the mean and not normality of the original variable. This is nicely elaborated by Norman.[3] Besides this, we used GEE, which does not assume the normality of the variables involved. The baseline values are entered into the GEE model, and hence any differences at baseline are automatically adjusted. We should have reported the 95% confidence interval of the estimates.

We hope that this elaboration will enable the readers to understand the finer nuances without ambiguity.

   References Top

Whiteley J, DiBonaventura MD, Wagner JS, Alvir J, Shah S. The impact of menopausal symptoms on quality of life, productivity, and economic outcomes. J Womens Health (Larchmt) 2013;22:983-90.  Back to cited text no. 1
Yazdani Ahiabady M. The effect of mindfulness training on quality of life in postmenopausal women [Dissertation]. (Ahvaz, Iran): College of Nursing and Midwifery, Jundishapur University of Medical Science 2016;32:34-7.  Back to cited text no. 2
Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ Theory Pract 2010;15:625-32.  Back to cited text no. 3


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