The Development and Evaluation of the Application for Assessing the Fall Risk Factors and the Suggestion to Prevent Falls in Older Adults

Round 1

Reviewer 1 Report (Previous Reviewer 1)

Comments and Suggestions for Authors

The manuscript proposes and evaluates a mobile application integrating two validated fall-risk assessment tools, namely the Stay Independent Brochure (SIB) and the Thai Home Falls Hazards Assessment Tool (Thai-HFHAT).
The authors details the materials and method for their research and analyze the results.

The manuscript is a resubmitted version of a previously submitted manuscript.

The authors provide an updated version of their previous manuscript highlighting the changes and the additional material.
Moreover, the authors provide point-to-point answers to the previous reviewer comments.
The answers provided precisely refers to the additional content and the changes provided in the manuscript.

The authors address every comments of the previous review round precisely.
There still are some inaccuracies, for example related to the security parts.
However, the manuscript has improved and the new content clarifies the major issues previously identified.

Author Response

Comment 1: The manuscript proposes and evaluates a mobile application integrating two validated fall-risk assessment tools, namely the Stay Independent Brochure (SIB) and the Thai Home Falls Hazards Assessment Tool (Thai-HFHAT).

The authors details the materials and method for their research and analyze the results.

The manuscript is a resubmitted version of a previously submitted manuscript.

The authors provide an updated version of their previous manuscript highlighting the changes and the additional material.

Moreover, the authors provide point-to-point answers to the previous reviewer comments.

The answers provided precisely refers to the additional content and the changes provided in the manuscript.

The authors address every comments of the previous review round precisely.

There still are some inaccuracies, for example related to the security parts.

However, the manuscript has improved and the new content clarifies the major issues previously identified.

Response 1: We sincerely thank you for your time and thoughtful comments on our revised manuscript. We are grateful for your recognition that the manuscript has improved and that the newly added content has addressed the major issues raised in the previous review round.

Regarding your remark on remaining inaccuracies, particularly those related to the security aspects. However, the manuscript has shown notable improvement, and the newly added content effectively addresses the major issues identified in the previous review, as you mentioned.

Author Response File: Author Response.pdf

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

Dear authors,

please look at the following lines which require changes in my oppinion:

58          Falls prevention... should be Fall prevention...

104-105 this one sentence should be extended

109-110 please rewrite grammar here

111         You should mention here how many participants you had

221          You straight start with (1). I suggest that you add an intro sentence before

244-246 Is repeating information. I suggest to delete the whole first sentence

400-401 Your paragraph reads like 0.8 is responding to excellent and 0.77 responds to good. I guess that should be the other way around

generell:

Once you have introduced an acronym you should be only using that one. In your text however you are nearly every time explain again what e.g. Thai-HFHAT or TUG means. You should do that only once!!

 

Comments on the Quality of English Language

There are some inconsistencies, grammar mistakes in the document. Some sentences also read wired. I guess that is due to the use of Chat-GPT.

Please carefully read the whole document again and rework these sentences

Author Response

Comment 1: Line 58          Falls prevention... should be Fall prevention...

Response 1: I agree with this comment. Therefore, I have revised this point by writing Fall prevention. You can find this change in page number 2, paragraph 2, line 58-59.

Comment 2: Line 104-105 this one sentence should be extended

Response 2: I agree with this comment. Therefore, I have revised this point by writing the

extended sentence. You can find this change in page number 3, paragraph 1, line 104-107.

Comment 3: Line 109-110 please rewrite grammar here

Response 3: I agree with this comment. Therefore, I have revised this point by rewriting the sentence. You can find this change in page number 3, paragraph 2, line 112-113.

Comment 4: Line 111 You should mention here how many participants you had

Response 4: I agree with this comment. Therefore, I have revised this point by writing the number of populations. You can find this change in page number 3, paragraph 3, line 114-115.

Comment 5: Line 221 You straight start with (1). I suggest that you add an intro sentence before

Response 5: I agree with this comment. Therefore, I have revised this point by writing an intro sentence. You can find this change in page number 7, paragraph 1, line 224-226.

Comment 6: Line 244-246 Is repeating information. I suggest to delete the whole first sentence

Response 6: I agree with this comment. Therefore, I have revised this point by deleting the whole first sentence. You can find this change in page number 8, paragraph 3, line 248-253.

Comment 7: Line 400-401 Your paragraph reads like 0.8 is responding to excellent and 0.77 responds to good. I guess that should be the other way around.

Response 7: I agree with this comment. Therefore, I have revised this point by rewriting. You can find this change in page number 13, paragraph 5, line 405.

Comments on the Quality of English Language

Comment 8: There are some inconsistencies, grammar mistakes in the document. Some sentences also read wired. I guess that is due to the use of Chat-GPT.

Please carefully read the whole document again and rework these sentences

Response 8: I agree with this comment. Therefore, I have revised this point by re-examined the entire document:

• Edited out any sentences that sounded machine-like or awkward.
• Made the language more polished, authoritative, and appropriate for publication in an academic journal.

You can check it out from all the sentences that I highlighted in blue.

 

 

 

Author Response File: Author Response.pdf

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript proposes and evaluates a mobile application integrating two validated fall-risk assessment tools, namely the Stay Independent Brochure (SIB) and the Thai Home Falls Hazards Assessment Tool (Thai-HFHAT).
The authors details the materials and method for their research and analyze the results.

I personally like the idea of app supporting healthcare professional in their activities.
However, I think the authors convey their ideas very confunsingly. In addition, the idea of the application described is not novel.

Here are the major comments:
- The organization of the manuscript can be revised. The authors blend the Introduction of the topic with the State-of-the-art. I find both incomplete.

- The Introduction section does not clearly state what the main contributions of the manuscript are.

- As mentioned, State-of-the-art is embedded into the Introduction section. But the question that arise is: is there no other app like yours? Could you *clearly* highlight the advantages of yours?

- Concerning Data Security, which is crucial nowadays and even more in application handling PII, there is almost no information on this subject. 
The authors state: "All personally identifiable information (PII) is encrypted using AES-256 encryption, and cloud storage follows HIPAA-compliant protocols for health data confidentiality". How is the data exchanged between the mobile app and the cloud?

- Why are the healthcare professional telling you wether is it easy to use? Should not the app be used by patients? Who is the target of the app, the patient or the healthcare professional? This is not clear since the beginning

- Starting from the previous point, the manuscript misses an architectural view, describing their idea of the app

- If your idea is an app that collect data, where is the novelty in that? Does it simply gathers data?

- In the Discussion section, the results being discussed relates more to the SIB and Thai-HFHAT, not on the app development.

Additional comments:
- Fig 3: cannot be understood. Seems a flow. 
- Fig 3: Add a more meaningful Label
- All tables (especially Table 2 and Table 3): issue in formatting
- Line 143: "Data Security and Compliance of the application adheres to ISO/IEC 27001 security". What does this sentence mean? I think you must expand more on the subject of security
- Line 131-133: layout issues (newline not necessary)
- Line 119, 121: add reference/link and short description for both TUG (Time Up and Go) and G*Power

 

Comments on the Quality of English Language

There are some language issues. 
In some cases they prevent the correct understanding of the idea of the authors.

Consider the following sentences as examples:
L177: "This method is the applying to older adults as participant..."
L178: "Sixty-seven participants are assessed the demographic data..."

I suggest not only a spell-check but also accurate cross- and proof-reading.

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Abstract

- The abstract contains the purpose, method, and main results of the study, but the conclusion is weakly described. The research results and future directions should be summarized more clearly.

Introduction
- The necessity of the study is well explained, but there is a lack of comparison with previous studies from an international perspective, and most of them are limited to studies in Thailand. It is necessary to emphasize the originality and contribution of this study by comparing it with global research trends, and additional citations of international peer-reviewed papers are needed.

Methods
- The research design description of Phase 1 and Phase 2 is relatively clear, but the education or guidance method for how to use the app is not specifically explained (especially for elderly users).
- There is a statistical analysis procedure, but the results of the normality test and the clarity of the statistical test are lacking (e.g., supplement the explanation of p-value and power).
- Figures 1~3 have low resolution and lack visual readability, and need to be remade.

Results
- Add interpretations, not result values, for the results in the table.
- The numbers and results shown in Tables 2~5 need to be interpreted and described more specifically in the discussion section. - Visual materials (Figure 4, etc.) are not clear enough, and editing is needed to improve readability.

Discussion
- The summary and discussion of the results are relatively faithful, but the comparison with existing studies is insufficient.
- The limitations are stated, but it would be better if the future research direction were a little more specific.

References
- Inconsistent
- Add international papers

Author Response

Please see the attachment.

Author Response File: Author Response.pdf