7.4 | Quality
7.8 | Significance
Content of review 1, reviewed on April 22, 2015

The paper discusses the problems associated with current methods of quality of life measurement when applied to individuals without capacity, such as those with severe dementia. The purpose of the paper is to justify the need for a new (QALY-compatible) measure for use in dementia, and to offer a framework for its development.

Here are my thoughts on the article.

I agree with the authors’ proposals, but I am not convinced by their arguments. The paper argues that current measures – those based on functioning, capabilities or subjective well-being – lack content, face and construct validity. This may be true, but I don't think it’s quite that simple. The authors argue that because functioning and capabilities measures might invariably be at the lower bound for individuals with severe dementia, and because there may be no possibility of improvement, the measures are not valid. This is not the case; such people may be in the worst possible state of functioning and capability and the measures may be capturing this perfectly well. Furthermore, the authors argue that capabilities are not relevant to such a population because it is necessary that they receive almost constant care and assistance. On the contrary, the loss of capabilities is surely a key factor in the undesirability of dementia.

The paper drops in words like ‘unethical’, ‘immoral’ and ‘need’ without much justification. Given the purpose of the paper, justification is necessary. For example, if ‘need’ were dependent on capacity to benefit, and an improvement in a patient’s health is impossible, how can we say they are in need? Furthermore, if they cannot benefit, why is it immoral to withhold care? These issues need addressing. Of course, it may be that they have been addressed elsewhere and I just don’t know about it…

For me, the authors are more on the money when they consider subjective well-being. They state that:

"SWB has at its core the notion that the individual is the best judge of their wellbeing, yet it is clear that the method is inappropriate for people without the cognitive capacity to evaluate their life."

I agree. But the same surely applies to utility measures. Of any sort. Preference-based measures require, to be valid, that patients can actually have preferences. Yet the authors still argue that a preference-based utility measure is the way forward. An apparent contradiction. I agree with the authors that processes become more important than outcomes, but whether this is process ‘utility’ I’m not so sure.

I would be comfortable with the care of individuals with severe dementia being valued based on people’s expected preferences (largely related to processes) regarding a possible future with dementia. The preferences of the individual with dementia need not be considered as they do not have preferences. In practice this is actually similar to the way we currently use QALYs anyway, but the dismissal of experienced utility is only implicit. It isn’t that we use preferences because we don’t care what people experience in a given health state, it’s that preferences are a useful (and practical) way of estimating the value that people attach to this experience. In the case of severe dementia, I’m not sure it’s possible (logically) for preferences to be indicative of experiences. Therefore, I think there is a subtle (but important) difference; between the process of eliciting people’s preferences for a hypothetical health state (defined by generic functioning or capabilities measures) and the process of eliciting people’s preferences for a possible future health state (defined by a ‘capacity-adapted’ measure) in which they would not be capable of valuing their own experiences. This distinction needs more investigation.

Despite my reservations, I would still conclude that there is a need for a new measure, which would be valued by the public; the same conclusion as the authors! The authors’ proposed framework could be extremely valuable in developing better measures. In terms of the implementation of such a measure, should the authors get around to creating it, there will be a few difficulties. It will be necessary to identify which individuals ‘lack capacity’ because of their disease. This would require a ‘cut-off’ point in some cases. This cut-off would presumably be defined by some existing measure, which raises obvious challenges to the validity of the approach. Given the necessity of proxy questionnaires, the valuation process could be set-up to account for this (e.g. “your carer judges you to be…”).

So, I agree with the need for a new measure, and that it should probably look something like that proposed by the authors, but others may disagree. A better justification for the approach will be necessary for it to be seen as credible.


    © 2015 the Reviewer (CC BY 4.0).

Comments   (Guidelines)

Felix Jose Gonzalez Gonzalez

4:06 a.m., 8 Jul 18 (UTC) | Link

Nice example to illustrate lack of arguments and absence of important definitions and clarifications. Yet, it was a polite review.

Arjun Mani Guragain

9:15 a.m., 24 Sep 18 (UTC) | Link

Very interesting, I learn that a reviewer should have a patient to critic a paper.

Deepak Verma

6:46 p.m., 10 Oct 18 (UTC) | Link

The reviewer covered all aspects of the article.

Dr.mufeed alzaidi

6:16 a.m., 23 Oct 18 (UTC) | Link

مقال متميز ومثير للاهتمام

Radeep Krishna Radhakrishnan Nair

1:43 p.m., 28 Nov 18 (UTC) | Link

Thanks for the sample and very informative and gives different ways of approaching the thought behind the writing


2:05 p.m., 10 Dec 18 (UTC) | Link

Thanks for sharing the review. The reviewer was polite even though he or she disagreed with the authors

Ramesh Desikan

4 p.m., 15 Dec 18 (UTC) | Link

Nice comments and I learned new things from this review Thanks for sharing this valuable review

Dr. Wael R. Abdulmajeed

11:22 p.m., 17 Dec 18 (UTC) | Link

Nice example for post-publication review. Thanks

Adamkolo Mohammed Ibrahim

10:01 a.m., 18 Dec 18 (UTC) | Link

Wow. Beautiful.

abdusalam alrmali

10:54 a.m., 1 Jan 19 (UTC) | Link

nice review for interesting topic without cutoff definitions . great thanks

Prem Kumar Seelam

10 a.m., 2 Jan 19 (UTC) | Link

Perfect illustration to demonstrate the peer-review work. I got some useful tips to improve the quality of the manuscript.

Noreen Mirza

9:55 a.m., 1 Mar 19 (UTC) | Link

Great job, I think the reviewer covered most of the points. I like his convincing argumentation, though he/she was polite.

Joshua O. Ighalo

8:20 a.m., 25 Mar 19 (UTC) | Link

Honest, objective and precise

Andrew Afton Lawrence

5:06 a.m., 5 Apr 19 (UTC) | Link

Excellent example for a model review.

Dr. Muhammad Ujudud Musa

5:38 p.m., 2 May 19 (UTC) | Link

An excellent review which is highly objective, I am indeed inspired

Zulfugarzade Teymur

9:45 p.m., 2 May 19 (UTC) | Link

The work was done at a very high level, is relevant, independent research

Emmanuel Udo

10:23 p.m., 2 May 19 (UTC) | Link

Excellent review

Usman Atique

2:37 a.m., 3 May 19 (UTC) | Link

The reviewer has politely yet convincingly pin-pointed the significant aspects of this paper by conveying his thoughts. One of the best examples to argue objectively. Thanks.

Fabricio Ramos

3:03 p.m., 3 May 19 (UTC) | Link

With education and consistency the reviewer pointed out the flaws and indicated improvements to make the article adequate

Md. Monjurul Hasan

10:33 a.m., 4 May 19 (UTC) | Link

Nice review of a quality article to understand the view & mode of how to review. I have learnt a lot.

Nataliya Yuzikova

8:54 p.m., 5 May 19 (UTC) | Link

Детальный обзор статьи. Мне понравилась аргументация рецензента. Представляет интерес спорные вопросы, которые предлагаются к дальнейшей дискуссии. Рецензент дает рекомендации к статье, которые могут быть учтены и другими авторами при написании научного обзора. Благодарю за научный пример

Nzooma Shimaponda-Mataa

2:12 p.m., 10 May 19 (UTC) | Link

The reviewer was objective. He/she show that the topic is still important in spite of differing arguments

Dr. Marwan Jawad Msarah

10:18 a.m., 18 Jun 19 (UTC) | Link

Nice example, Thanks !

Dildora Ruzmetova

5:27 a.m., 30 Jun 19 (UTC) | Link

Thanks for sharing this nice example

Jack Harry Peralta Cáceres

3:03 a.m., 1 Jul 19 (UTC) | Link

Gracias por el buen ejemplo y compartir

Polinpapilinho F. Katina

4:39 p.m., 3 Jul 19 (UTC) | Link

Thanks for sharing

Iman Muwafaq Muslim Muwafaq Al-Ghabra

11:34 p.m., 5 Jul 19 (UTC) | Link

Thanks a lot. It is an interesting and useful example.

Koro Stephen

4:32 a.m., 7 Jul 19 (UTC) | Link

Insightful and objective. I Would even want to be superior than that in future

Ronaldo da Silva Cruz

11:33 a.m., 22 Jul 19 (UTC) | Link

Excelente exemplo!

María Elena Torrens Pérez

3:46 a.m., 1 Aug 19 (UTC) | Link

María Elena Torens Es un ejemplointeresante, y muy completo

Olha Nesterova

11:39 a.m., 4 Aug 19 (UTC) | Link

The reviewer uncovered a lot of contradictions associated with the paper. I think this is useful for author's further research activity

Aissa Boulmerka

3:49 p.m., 5 Aug 19 (UTC) | Link

Thank you!

Dr. Haider Alshawi

10:58 a.m., 18 Aug 19 (UTC) | Link

I benefited from this wonderful and very useful article

Muhammad Sher Baz Ali

5:28 p.m., 18 Aug 19 (UTC) | Link

I amazed to see that a review could be this much long and detailed. Too much to learn but not in a single sitting.

Silvia Regina Machado de Campos

11:20 a.m., 3 Sep 19 (UTC) | Link

Thanks for the example. Besides the comments on clarification, which the authors will have to deal with, the approach adopted by the reviewer provides some insights and contributes to the improvement of the paper.

Jack Harry Peralta Cáceres

7:02 a.m., 10 Sep 19 (UTC) | Link

Considero ante todo buenos dias o buenas noches, el revisar un articulo es interiorizarse bastante en el tema a investigar se es consiente que se aprende cada vez mas cuando uno revisa con rectitud y se cocientiza la veracidad de los sucesos con su información en todo el articulo, agradezco al consciente de su conciencia.

Ammcise Apply

1:01 a.m., 19 Sep 19 (UTC) | Link

Very good example of peer review. It is very inspiring and useful for future reviewers: objectivity, clarity, precision, respect. Thank you for sharing this good example.

Oluwafunke O Akinbule

12:51 p.m., 19 Sep 19 (UTC) | Link

Wow! Very detailed and critically reviewed. Thanks for sharing

Ali H A Alwaeli

10:02 a.m., 25 Sep 19 (UTC) | Link

Thank you for this good example to performing a post-publication review.

Maria Jesús Alonso

9:54 p.m., 29 Sep 19 (UTC) | Link

Sincero y justificado pero para mi gusto excesivamente extenso.


4:02 a.m., 1 Oct 19 (UTC) | Link

Very good job. Excellent post-publication review.

Adarshlata Singh

1:52 p.m., 12 Oct 19 (UTC) | Link

A very good example of post publication review. Very categorically the respected reviewer has explained about the positive and negative points on the paper. Critical appraisal of the article will be helpful for further research on the same disease.

Henry Eric Magezi

10:19 a.m., 19 Oct 19 (UTC) | Link

Thanks for this good example. I like the attention to detail by the reviewer.

Aditya Vedam

7:05 a.m., 14 Nov 19 (UTC) | Link

Some of the comments posted by others below the sample review were poorly scripted in grammatical sense, which, with some care---could have been avoided.


7:29 a.m., 29 Nov 19 (UTC) | Link

Well done.

Apurva Sharma

2:24 p.m., 24 Dec 19 (UTC) | Link

A very thoughtful review covering all the aspects where the reviewer had differences while agreeing to the main theme of the paper that a new framework of measurement is required in this population.

Ahmed O. Mosleh

8:04 p.m., 29 Dec 19 (UTC) | Link

Well done

Hanan M Fathi

6:06 a.m., 1 Jan 20 (UTC) | Link

The review was written in a skilled and professional manner, which showed proper handling and analysis.

Kulyay Zhaxylikova

10:05 a.m., 31 Jan 20 (UTC) | Link

I completely agree with the reviewer. I think the review will be of great benefit to the authors of the article

Ali Raza

7:05 a.m., 6 Feb 20 (UTC) | Link

For sure I found it very interesting and helpful to me. I would like to say thanks for sharing this excellent post-review publication example. Looking forward to learning more and more.


5:15 a.m., 11 Feb 20 (UTC) | Link

This is a very good example of how to review very politely! learnt a lot about language use while reviewing. Thanks!

Soumayya Aib

6:34 a.m., 13 Feb 20 (UTC) | Link

In my point of view, the reviewer certainly did catch some of the points where he didn’t completely agree on with the author. However, the reviewer himself didn’t explain much why his thoughts were deviating from those of the author’s. Other than that, Review way, used words, and attitude were as good as it should’ve been. Hence, the overall review is acceptable.

Farin Soleimani

11:36 a.m., 3 Mar 20 (UTC) | Link

Complete and accurate reviews have been made.

Dr. Madhusudan Rao Datrika

7:15 p.m., 9 Mar 20 (UTC) | Link

Excellent knowledge simplified, good start for new editors

Kamaliah Mohamad Noh

8:19 a.m., 18 Mar 20 (UTC) | Link

Good example of review based on the thinking behind the development of the framework and the relevance of research to current practice.


7:55 p.m., 25 Mar 20 (UTC) | Link

A clear example of how scientific knowledge always is in a constant evolution and it must take into account when there is need to explain emergent research questions

Mohammed Khayri Aboubeirah

8:23 p.m., 27 Mar 20 (UTC) | Link

its a very useful example of preview , and it was focused on research and professional and honest

Shreedevi Balachandran

7:32 a.m., 2 Apr 20 (UTC) | Link

I have never written a post-publication review and found this an interesting reading. Good in-depth reading and analysis of the paper is evident. Thank you for sharing. Motivates me to analyze and write post-publication review.

Qusay Medhat Salih

2:48 p.m., 5 Apr 20 (UTC) | Link

I see that the reviewer introduces a role sample model.

Sarla Achuthan

10:20 a.m., 8 Apr 20 (UTC) | Link

Very interesting review. The reviewer is very critical at the same time very polite. The reviewer has put forward the points in a lucid manner. Was a good learning.

Atyaf H. Ibrahim

6:05 p.m., 8 Apr 20 (UTC) | Link

The reviewer identified the negative aspects found in the article in a good and polite way.

Nurul Izzaty Hassan

12:10 a.m., 14 Apr 20 (UTC) | Link

The reviewer highlighted the practicality aspect of the subject group and addressed them with significant points. I'm sure the authors welcome these comments and suggestions as they sounded positive and benefitted for a long run.

Valentine Joseph Owan

7:40 a.m., 20 Apr 20 (UTC) | Link

It was a thorough critique

Hawraa Natiq Kabroot AL-Fatlawy

4:41 a.m., 21 Apr 20 (UTC) | Link

Very interesting review. The reviewer is very critical at the same time very polite. The reviewer has put forward the points in a lucid manner. With best regards

Wisal Hashim Abdulsalam

12:42 p.m., 22 Apr 20 (UTC) | Link

It's a good example of how a reviewer providing authors with courteous and constructive feedback about their submissions.


11:50 p.m., 22 Apr 20 (UTC) | Link

Se observa en gran medida que el revisor realizó una evaluación crítica de los expresado en la investigación tomando en cuenta los elementos a mejorar en la justificación y les abre la posibilidad a seguir avanzando en ella para mejorarla, es un buen ejemplo a seguir en procesos psicológicos y de enfoque cualitativo.-

Hawraa Natiq Kabroot AL-Fatlawy

8:31 a.m., 24 Apr 20 (UTC) | Link

Nice review for interesting topic . Best regards


2:16 p.m., 25 Apr 20 (UTC) | Link

Nice interesting review

Victor Ighariemu

9:40 p.m., 29 Apr 20 (UTC) | Link

nice and interesting review

Agbortoko Ashu

5:46 a.m., 4 May 20 (UTC) | Link

The review was insightful and well written.

Rabea Jamil Mahfoud

4:34 p.m., 7 May 20 (UTC) | Link

Post-publication review is really essential, since lots of colleagues and experts can provides their comments. This will help both sides of authors and reviewers of the paper to improve their skills in the future. Thanks to Publons Academy, I had the chance to learn more about the peer review process.

Asha Durafe

3:16 p.m., 8 May 20 (UTC) | Link

Perfect example framed succinctly..

Nihad Selman

7:54 p.m., 8 May 20 (UTC) | Link

Thanks for this nice polite example.


8:52 a.m., 12 May 20 (UTC) | Link

Thanks for the example. Learnt a few things in writing a post publication review.

Dr. Balasubramani R

10 a.m., 12 May 20 (UTC) | Link

Thanks for citing a good example for post-publication review. Really helpful for me to write post-publication reviews for papers in my area of interest.

Dr. Asmaa Salah Eldin Mohamed Saleh

10:06 a.m., 12 May 20 (UTC) | Link

It is a very useful

Mohammed Al-Rawi

12:39 p.m., 12 May 20 (UTC) | Link

Thank you for this good is really useful..

Tarek Mami

4:28 p.m., 12 May 20 (UTC) | Link

Good example

Kashif Hussain Talpur

6:31 p.m., 12 May 20 (UTC) | Link

Good example of post-pub review.

Dr. Saima Eman

6:49 p.m., 12 May 20 (UTC) | Link

Constructive feedback to advance scientific interests for humanity!

Jagdeep Singh

7:18 p.m., 12 May 20 (UTC) | Link

Thanks for the post-review example. Nicely documented

Maaz Alata

10:04 p.m., 12 May 20 (UTC) | Link

Good opportunity to see a clear post publication review , it covers all aspects.

Dr. Chetan Panchal

5:53 a.m., 13 May 20 (UTC) | Link

Nice, very descriptive example

Tetiana Hranchak

8:02 a.m., 13 May 20 (UTC) | Link

A good example of a post-publication review. The structure, the focus of attention, and the features of argumentation are completely clear. This is really useful.

Charles N. Muli

12:21 p.m., 13 May 20 (UTC) | Link

This is interesting though am very green. Am quite keen to think and learn through this example.

Sunil Kumar Gupta

3:21 p.m., 13 May 20 (UTC) | Link

Very well written post-publication review. Learn a lot.

Olga Predushchenko

3:37 p.m., 13 May 20 (UTC) | Link

It is a high standard post publication peer review. It is an effective review with clear structure. Each argument is unified, coherent and well-developed. The supports are logically connected. There are no grammar/spelling mistakes. The review is engaging and interesting to read. Many thanks to the reviewer.

Ismarley Lage Horta Morais

5:37 p.m., 13 May 20 (UTC) | Link

Thank you for share with us this great post-publication review.

Reem Abou Assi

6:38 a.m., 14 May 20 (UTC) | Link

I believe the work was totally out of scope and quality and the reviewer couldn't tell that directly to the authors. I've seen reviewers in such cases replying using only three words "very poor quality", and that's all, as not all reviewers have the time to send such long polite rejection. Also, the idea behind reviewing is to use the points system, so that the reviewer will later receive amendments according to each point such as question and answer letter. Thanks for sharing the knowledge.

Mabel Ezeuko

2:23 p.m., 14 May 20 (UTC) | Link

I can see clearly now what a good post publication review should look like.

tarek el-desouky

3:42 a.m., 15 May 20 (UTC) | Link

This is an objective criticism for the manuscript

Thana-Allah Kritter

6:53 a.m., 15 May 20 (UTC) | Link

This is a well structured argument with clear orientations

Layth Al-Jaberi

11:19 a.m., 15 May 20 (UTC) | Link

An excellent example of a post-publication review.

Walid M. Khalilia

8:12 a.m., 16 May 20 (UTC) | Link

Fruitful example for a post-publication review. Thanks so much.


8:28 a.m., 16 May 20 (UTC) | Link

The reviewer exhibited excellence in mastery of content, pointing out technical flaws in the article in a respectful manner. The reviewer must have put in adequate time to read and critique the paper. This teaches that one needs to be well grounded in the field and invest time in the review process so as to do a very good review.

Ramkrishna Kadam

3:17 p.m., 16 May 20 (UTC) | Link

A useful example of a post-publication review

Emmanuel Eshun

3:51 p.m., 16 May 20 (UTC) | Link

I find this review highly useful to my development. Well done!!

Morolake Dairo

4:54 p.m., 16 May 20 (UTC) | Link

This review captures the weaknesses and strengths of the paper - addressing the pitfalls and saluting the good points with sound facts.

The reviewer also expresses his/herself politely and implies that they may be unaware of certain factors that they don't understand in the paper.

Laly Antoney

3:57 a.m., 18 May 20 (UTC) | Link

A critical and constructive review. A model for those who learn how to review an article/ a paper in the post-publication phase.

Sanjay Matekar

10:14 a.m., 18 May 20 (UTC) | Link

The review covers all aspect of the paper. It gives a good idea of how a critical review is to be written with polite response to the author.

Gutierrez Alejandra C.

7:03 p.m., 18 May 20 (UTC) | Link

I find the reviewer's return interesting. It is not my field of work, I would like to know if you can give examples of reviews of Biological Sciences or chemistry.

Ariane Polidoro Dini

9:45 p.m., 20 May 20 (UTC) | Link

Useful example! Thanks!

Joshua Offe Berkoh

7:22 a.m., 22 May 20 (UTC) | Link

Perfect illustration to demonstrate the peer-review work. I got some useful tips to improve the quality of the manuscript and I find the reviewer's return interesting. It is not my field of work, I would like to know if you can give examples of reviews of Computer Science.

Bernadine Nsa Ekpenyong

5:04 p.m., 22 May 20 (UTC) | Link

I like the review, it was very constructive and critical. The reviewer was also polite and detailed

Mónica Montaño Garcés

7:42 p.m., 23 May 20 (UTC) | Link

I think it's a good example of post-publication review. The reviewer has been very didactic. Thank you for sharing.

OGUNTUASE Mary Aderonke

8:13 p.m., 23 May 20 (UTC) | Link

The reviewer has been thorough in his critiques but polite, this shows that he is an expert in the field.


1:18 p.m., 24 May 20 (UTC) | Link

Very complete educational example.

Kassim Busari

7:18 p.m., 25 May 20 (UTC) | Link

Excellent critiquing. Insightful.

Anindita Chakraborty

7:03 p.m., 26 May 20 (UTC) | Link

Thanks for the sample. Insightful critic

Mohamed Eldeeb

1:30 p.m., 27 May 20 (UTC) | Link

very helpful example

Neo Maseko

12:28 a.m., 28 May 20 (UTC) | Link

The review contextualizes the argument of the paper and provides counter-arguments and reservations, with extensive substantiation that reflects an insight into the subject matter, that is, life management, and its associated complexities. This is a good example of a thorough review.

Muhammad Kafeel

1:11 p.m., 28 May 20 (UTC) | Link

A comprehensive post pub review which is virtually very helpful for peer reviewer.

Ghilan AlMadhagy Taufiq Hail

11:07 p.m., 28 May 20 (UTC) | Link

An excellent example of the post-publication review that covered almost all aspects of the article and provided extensive and thorough justifications and remarks. Besides, I strongly agree that the reviewer was so polite and informative with the way presenting the arguments. Thanks for sharing as it is a very good source of reviewing articles in a professional way.

bader Alshamsan

12:22 a.m., 30 May 20 (UTC) | Link

Thank you, Excellent review

P. Senthil Kumari

1:43 p.m., 30 May 20 (UTC) | Link

Reviewer's knowledge i shown in the comment. Very expressive

Emmanuel N Barthalomew

5:24 a.m., 31 May 20 (UTC) | Link

A balanced example review that succinctly covers all the necessary areas without being over the top critical or too polite. Very well written indeed.

Juliana Linnette D'Sa

6:32 a.m., 9 Jul 20 (UTC) | Link

A very well written review. A very nice example of a post-publication review.

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    Jeff, R., L., S. E., Louise, J. 2014. A framework for understanding quality of life in individuals without capacity. Quality of Life Research.