Properties of Polyunsaturated Fatty Acids in Primary and Secondary Prevention of Cardiovascular Diseases in the View of Patients (Silesia, Poland)

Round 1

Reviewer 1 Report

Dear authors, thank you for this research article that contributes to the cardiovascular prevention and nutrition.
Please, allow me to make some major comments about the questionnaire which is developed from your research team. a) Have you made any validation study for it? If not, it is very difficult to establish an evidence based validated result using this tool. b) Another critical point of your methods is the population sampling which are inpatients in cardiology ward. This could lead to bias an d not so evident results, because they are already ill, in other words they can not be a random sample for prevention and assessment of their behaviour in polyunsaturated fatty acids since they already have a health problem. 

I am regret to say that these points lead me to have serious issues enough, not to accept this article.

Author Response

Dear Reviewer,
At the outset, we would like to thank you for your thorough analysis of our manuscript. We agree with most of the reviewers' comments, which are valid and have helped to catch shortcomings in our article. Our responses are highlighted in green. We have made some changes to our manuscript believing that they address all comments. 
We find no excuse for not including information about the validation of our questionnaire, of course it was conducted and we have included it in the material and method section. All our studies that are not based on standardized questionnaires go through a validation process.
The selection of the sample was purposeful, we wanted to see if already sick patients were aware of the possibility of primary and secondary prevention of cardiovascular diseases using the properties of polyunsaturated fatty acids, which would enable future educational efforts for a selected population group. 
Any limitations of our study have additionally been edited in the strengths and limitations section.
We hope that the improvements made will allow you to consider accepting our manuscript for publication.
With best regards, Authors

Reviewer 2 Report

Krupa-Kotara et al. presented a manuscript about a survey on the awarness of the role of polyunsatured fatty acids in cardiovascular diseases among patients hospitalized in Cardiology department.

Here are my comments:

1. The reason for the hospitalization are different, as we can imagine by the methods section ". The following inclusion criteria were undergoing hospitalization in a cardiology department, age ≥18 years, and giving written consent to participate in the study". I suggest to report the main reason for hospitalization, adding a table on the baseline characteristics of the patients which partecipate to this survey (myocardial infarction, heart failure, arrhytmias..) because could improve the quality of the data presented. Moreover, I suggest to add other baseline characterics of the population to better understand at whom the survey was addressed (comorbidities, educational level, medications etc).

2. The population was young (mean age: 50±11.3). Were the patients progressively enrolled? Did you find difficulties in submitting the survey to older people? I think this should be eventually specify the type of enrolment and to add if you apply any exclusion criteria. You should also add in the paragraph "Strenght and Limitation", this bias (recruitment/exclusion of proportion of patients).

3. It could be useful to have also the questionnaire you submitted to the patients? Could you add it in the supplementary material?

4. Also, I saw a document in the unpublished material that it is in Polish, could you specify what it is?

Author Response

Dear Reviewer,
At the outset, we would like to thank you for your thorough analysis of our manuscript. We agree with most of the reviewers' comments, which are valid and have helped to catch shortcomings in our article. Our responses are highlighted in green. We have made some significant changes to our manuscript believing that they address all comments. 
Any limitations of our study have additionally been edited in the strengths and limitations section.
We attach our questionnaire as Appendix 2, along with the validation information included in the Materials and Methods section.
The document in Polish is a consent to the study and the authors' statement of confidentiality for the processing of personal data.
We hope that the improvements made will allow you to consider accepting our manuscript for publication.
With best regards, Authors

Round 2

Reviewer 1 Report

Dear authors, thank you for your revised paper. You have made the appropriate changes, based on the comments. Now I agree to proceed the paper further.