This paper has a number of substantial issues which raise concerns about the methodology and the review process it has undergone. In particular:

• The sample is poorly described • The procedure for identifying new and prevalent cases is inadequate • The abstract reports 400,000 cases of schizophrenia but the actual figure in the paper is 348,801. Even rounding to the nearest 100,000 doesn’t make this accurate. • It is totally unclear how disease course stages were identified and recorded; it is somewhat unclear why they chose to analyse the results by disease course stage; how and when data were recorded during the disease course is also unclear • What does “cured” mean in equation (1)? There is no cure for schizophrenia, but patients can undergo periods of remission and recovery. • What does efficiency mean in this context? Why is it important? How does it relate to the research questions and hypotheses of the study? • It is unclear what they mean by the outcomes of treatment effect and risk – further, how risk was operationalised • Figure 1 makes no sense and ideas such as treatment effect, risk assessment & focus group make no sense in the context of this work • Figure 20 has arbitrary circles added to it in a pseudo-scientific manner to identify hotspots with no formal statistical analysis.

This paper has substantial flaws readers should be aware of.