Quality-of-Life Assessment in Pediatric Advanced Cancer: Development of the Patient-Reported Outcome Measure Advance QoL
, Julie Felipe 1, Michel Duval 3,4, Bruno Michon 5, Marianne Olivier-D’Avignon 6, Sébastien Perreault 2,7, Mathias Tyo-Gomez 8, Marc-Antoine Marquis 3,9 and Serge Sultan 1,2,3,*
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
Congratulations on completing the manuscript and undertaking such an interesting study. The manuscript is very well prepared; however, I have a few recommendations and suggestions of a more technical nature.
1. It would be beneficial to specify in Table 2 the specific domain (item) of the tested tool to which each example refers. A comparison between the original and the resulting improved versions would also be useful. Table 4 attempts to do this to some extent, but the information is not systematic, as it gives only a few examples of the changes made.
2. I recommend that Table 2 include an explanation of the meaning behind the abbreviations A3, C3, C7, etc. If these abbreviations represent participant codes, it would be useful to include them in Table 1 as well.
3. The purpose and results presented in Table 2 should be explained in more detail, both in the results section and in the discussion.
4. In Section 3.1.2, it would be beneficial to situate the approach within the broader set of procedures used in cognitive interviewing. It would also be helpful to specify whether the focus was solely on comprehension, i.e., the first stage of the cognitive process, or whether the other three stages (i.e., memory retrieval, judgment, and response formatting) were also considered.
5. There is no discussion of potential response bias. Presumably, the adjustments made were not solely focused on comprehensibility.
6. The paragraph on lines 280-294 casts some doubt on the suitability of the tested instrument for self-completion. What is the conclusion here? Is the tool suitable for self-completion, or is assistance required?
7. Four phases are mentioned on line 259, but only three are described in detail in the following paragraphs. Can you explain this discrepancy?
8. Including the final wording of each AQoL item in the article would probably be beneficial to readers.
I look forward to seeing the final version and wish you every success in implementing this useful tool in clinical practice.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for Authors
This is an amazing manuscript
congratulations on your hard and rigorous work.
The authors want to adapt a proxy version of Advance QoL to be used by children and adolescents as a self-report.
This tool exists but the language level of this version is too complex for children and adolescents requiring a college reading level.
The topic is original and relevant because the tool exists, but the language level of this version is too complex for children and adolescents requiring a college reading level.
Also, it is important to involve fully this population so HCP can really determine what contributes to their QoL.
It addressed the needs of child and adolescents reading level to assess their QoL.
This manuscript is professionally written and so informative.
Well covered and the authors made sure that each question had answers and supporting evidence.
The references are appropriate. Tables and figure are clearly presented and highly informative.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for Authors
Dear Authors,
I am pleased to inform you that after reviewing the updated manuscript, I have no further comments.
The revisions meet the expectations expressed in my previous comments. In my view, the manuscript now effectively communicates the research findings and provides valuable insights.
I wish you all the best,
