Questionnaire for Orchestra Musicians: Validation of the Online Version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Polish Musicians (MPIIQM-P)

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript suffers from a number of weaknesses, the most significant of which are the following: 1. Due to the low response rate (21%), the study sample is not adequate and therefore the results of the study are not valid. 2. In addition, the reproducibility of the questionnaire is not shown in the Results. 3. There is no missing variable analysis.

Existing weaknesses cannot be overcome because research not conducted correctly (selection bias).

Author Response

We would like to thank you very much for carefully reading our work and sharing your concerns and suggestions sent to us. We have tried to take into account and improve our work based on all the comments, which undoubtedly increased its quality and also allowed us to describe the study in an understandable and clear way for the reader. We hope that the corrections made are satisfactory and will allow the acceptance of the prepared manuscript as ready for publication.

1. Due to the low response rate (21%) , the study sample is not adequate and therefore the results of the study are not valid.

Received response rate is comparable in other surveys conducted in this area using this tool. The response rate it is not very high due to the use of the specifics of the study group, as well as the use of the questionnaire in online form. However, the results are reliable because all analyses were performed on an adequate number of respondents. Despite the response rate of 21%, the number of respondents was one of the largest in the validations conducted to date worldwide.

2. In addition, the reproducibility of the questionnaire is not shown in the Results.

The reproducibility of the questionnaire is shown in the results (lines 112-117) and presented in detail in Table 2. The ICC value for most variables is above 0.75 (good reliability). Three variables showed moderete value (0.5-0.75), only two variables received an ICC value lower than 0.5 (poor reliability). ICC value in conducted reaserch was calculated based on the 30 respondent’s answers. The author of the original version of the MPIIQM questionnaire, Berque et al. 2014 also scored value of ICC as <0.5 for one item and >0.5 for 8 of 9 items based on the responses of 19 respondents.

We thank you for this comment and are also aware of the problems arising from conducting statistical analysis with a small number of respondents. In future surveys, this is a challenge that we will certainly take into account in our future work.

     3. There is no missing variable analysis. 

Missing variables were not made because, as described in the material and methods section (lines 128-129) the questionnaire could not be completed without answering all the questions. The online questionnaire in this case avoids missing data, unlike the paper version.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

Please mention the full term in the first use and the abbreviation in parentheses In the following times, the abbreviation can be used alone. This rule applies separately to the abstract and the full text.

Is the order of references in the introduction starting from 18? Please update the order of references with EndNote or other referencing software in the manuscript.

Please mention the type of study design at the beginning of the method section: Methodological or cross-sectional study.

why the expert group's opinion not used for content validity? Qualitatively or quantitatively (CVI and CVI).

Why was exploratory factor analysis (EFA) used and not confirmatory factor analysis (CFA)? Were the factors not already known in the previous version of the bulletin?

Author Response

Dear Rewiever,

We would like to thank you very much for carefully reading our work and sharing your concerns and suggestions sent to us. We have tried to take into account and improve our work based on all the comments, which undoubtedly increased its quality and also allowed us to describe the study in an understandable and clear way for the reader. We hope that the corrections made are satisfactory and will allow the acceptance of the prepared manuscript as ready for publication.

1. Please mention the full term in the first use and the abbreviation in parentheses In the following times, the abbreviation can be used alone. This rule applies separately to the abstract and the full text.

The improvement has been made. Please see the attachment. Changes are marked in yellow.

2. Is the order of references in the introduction starting from 18? Please update the order of references with EndNote or other referencing software in the manuscript.

The order of references has been updated. Changes are marked in yellow. Please see the attachment.

3. Please mention the type of study design at the beginning of the method section: Methodological or cross-sectional study.

The improvement has been made. Please see the attachment. Changes are marked in yellow.

4. Why the expert group's opinion not used for content validity? Qualitatively or quantitatively (CVI and CVI).

The opinion of the expert group is one of the stages of validation of the questionnaire but involves translation and language adaptation. Validation of the online version of the questionnaire involved an already translated version, so the process was not duplicated once again.

5. Why was exploratory factor analysis (EFA) used and not confirmatory factor analysis (CFA)? Were the factors not already known in the previous version of the bulletin?

Confirmatory factor analysis is used to confirm or reject a certain model of a construct that already exists. Empirical factor analysis does not assume any model in advance and examines the structure only based on the empirical data received. If there is no well-established model in a given issue, or the conditions of the study (population, instrument, etc.) change, it is considered necessary to study the structure of the relationship, as it were, from scratch, that is, without initial assumptions about the links between observable and latent variables. Moreover, exploratory factor analysis (EFA) was used because we wanted to repeat the analysis as other authors did and as in assessing the psychometric properties of the Polish-language questionnaire. Arguably, it would not have been wrong to use confirmatory factor analysis (CFA), but the previous assumption of the number of factors determined from the data of the paper version could have been incorrect when analyzing data from the online version of the questionnaire.

Author Response File: Author Response.docx

Reviewer 3 Report

Comments and Suggestions for Authors

This research examines the psychometric properties of online tools that are considered unoriginal and uninteresting. However, the researchers performed the research correctly according to the research methods. I have just a few suggestions:

In addition to explaining its psychometric properties, You should provide a discussion of its utility in additional orchestral groups.

Author Response

Dear Rewiever,

We would like to thank you very much for carefully reading our work and sharing your concerns and suggestions sent to us. We have tried to take into account and improve our work based on all the comments, which undoubtedly increased its quality and also allowed us to describe the study in an understandable and clear way for the reader. We hope that the corrections made are satisfactory and will allow the acceptance of the prepared manuscript as ready for publication.

1. In addition to explaining its psychometric properties, You should provide a discussion of its utility in additional orchestral groups.

The additional explanation about utility of questionaire has been made in discussion section. Changes are marked in green. Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The low response rate cannot be considered valid because similar results have been obtained in other studies.

 

Author Response

Dear Reviewer,

We hope that the corrections and explanations made are satisfactory and will allow the acceptance of the prepared manuscript as ready for publication.

Sample size guidelines suggest subject-to-variable ratio of 5:1 (De Vellis R: Scale development: Theory and applications. 3rd ed. London: Sage Publications Ltd., 2012) in studies using exploratory factor analysis (EFA). Therefore, in this study, the EFA on the 9 items would require at least 45 respondenst (our sample size was 85). Data from 30 participants were available for test-retest reliability and only in this analysis the sample size is smaller than recommended size. Therefore, the test-retest reliability results should be treated with some caution, which was noted in the study.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

Thanks for the corrections. I have no other comment.

Author Response

Dear Rewiever,

We would like to thank you very much for carefully reading our work and sharing your concerns and suggestions sent to us!