Response to reviewers after a major revision
Who wrote it
Dr Rana Fakhoury, a family physician and researcher in Beirut, leads a study of antibiotic prescribing. Her team’s paper came back with a major revision and four comments.
The writer and every detail about them are fictional.
What went into the template
- Journal, manuscript ID and title
- BMC Primary Care, PRCA-D-26-00412, “Antibiotic prescribing for acute respiratory infections in 18 primary care centres in Lebanon”
- The editor's decision
- Major revision
- What to write
- Opening and responses
- The reviewers' comments
- R1.1 The authors should explain how they handled patients who received antibiotics for a second diagnosis.
R1.2 The sample of 18 centres seems small to generalise to the whole country.
R2.1 Please report the inter-rater agreement for the classification of prescriptions.
R2.2 The discussion overstates the role of patient pressure, which was not measured. - What you changed, comment by comment
- R1.1 Excluded 112 visits with a second, bacterial diagnosis; now stated; sensitivity analysis including them, results unchanged: Methods p6 l120–128, new Table S2
R1.2 Partly disagree: stratified random sample from every governorate in the national primary care network; now say findings apply to that network, not private clinics: Methods p5 l98–104, Limitations p14 l301–306
R2.1 Omission: two investigators double-coded 10% (n = 214), kappa 0.84, disagreements resolved by discussion: Methods p7 l141–145
R2.2 Agree: rewrote the paragraph; patient expectations now one possible explanation and a question for future work: Discussion p13 l270–281
The writer’s facts, as typed into the template’s form. The example uses nothing else.
The example
Response to reviewers: Journal revision
Numbered notes in the margin explain each choice.
Dear Dr Morgan,
Greeting
Thank you for the opportunity to revise our manuscript, “Antibiotic prescribing for acute respiratory infections in 18 primary care centres in Lebanon” (PRCA-D-26-00412). We are grateful to both reviewers for their careful reading. We have addressed every comment below. Changes are highlighted in the revised manuscript, and page and line numbers refer to that version1.
Opening
Note 1: Telling the editor which version the locations refer to saves a round of confused emails.
Reviewer 1
Comment 1.1: “The authors should explain how they handled patients who received antibiotics for a second diagnosis.”
Response: Visits with a second, bacterial diagnosis, such as otitis media alongside a cold, were excluded from the main analysis because an antibiotic could be appropriate for them. We now state this explicitly, and we have added a sensitivity analysis that includes these 112 visits; the results did not change materially2.
Change: Methods, page 6, lines 120–128; new Table S2.
Comment, response, change
Note 2: The answer is backed by a new analysis, not by an argument. Reviewers trust evidence over explanation.
Comment 1.2: “The sample of 18 centres seems small to generalise to the whole country.”
Response: We agree that the size of the sample limits generalisation3, and we have made this clearer. The centres were, however, selected by stratified random sampling from every governorate within the national primary care network, so the sample is broader than its size may suggest. We now state that our findings apply to centres in that network and not to private clinics, and we discuss this in the limitations.
Change: Methods, page 5, lines 98–104; Limitations, page 14, lines 301–306.
A polite disagreement
Note 3: Disagreement starts by granting what is true in the comment. Only then comes the evidence.
Reviewer 2
Comment 2.1: “Please report the inter-rater agreement for the classification of prescriptions.”
Response: Thank you; this was an omission.4 Two investigators independently classified a random 10% of prescriptions (n = 214), and agreement was high (Cohen’s kappa 0.84). Disagreements were resolved by discussion.
Change: Methods, page 7, lines 141–145.
Admitting an omission
Note 4: A thank-you only where it is earned, and an admission in five words. No defensiveness.
Comment 2.2: “The discussion overstates the role of patient pressure, which was not measured.”
Response: We agree. Patient pressure was not measured in this study, and our discussion went beyond the data5. We have rewritten the paragraph to present patient expectations as one possible explanation and as a question for future research that measures them directly.
Change: Discussion, page 13, lines 270–281.6
Conceding cleanly
Note 5: Conceding cleanly on one point makes the earlier disagreement more credible.
Note 6: Every response ends with where the change is. The reviewer can check it in seconds.
We believe these changes have strengthened the manuscript, and we hope it is now suitable for publication in BMC Primary Care.
Closing
Yours sincerely,
Rana Fakhoury, on behalf of all authors
Structure
How it is built
Each part in order, with its share of the words.
Checklist
Before you send
Go through your own draft line by line.
Before and after
Common mistakes and how to fix them
Lines like these turn up in many drafts by Arabic speakers. Each fix keeps the meaning and changes only the English.
We thank the reviewer for his very valuable and insightful comment.
Thank you; this was an omission.
The reviewer is wrong because our sample is enough.
We agree that the size of the sample limits generalisation, and we have made this clearer. The centres were, however, selected by stratified random sampling.
We did the necessary corrections.
Change: Methods, page 7, lines 141–145.
Questions people ask
How do I disagree with a reviewer politely?
Acknowledge what is fair in the comment, give your evidence calmly and change something in the manuscript, even if only a sentence, so that other readers will not have the same doubt. Never sound sarcastic or hurt.
Should I thank the reviewers in every answer?
No. Thank them once at the start, and again only where a comment really improved the paper. Repeated praise reads as a formula and takes space from your answers.
What is the difference between a major and a minor revision?
A minor revision asks for small changes and is usually close to acceptance. A major revision asks for substantial work and usually a second round of review. Neither guarantees the outcome, so answer every point fully.
Every writer in this library is fictional, and so is every detail about them. Universities and companies appear only as places someone applies to; the professors, papers and facts mentioned around them are invented for teaching. Use the examples to learn the moves, never as text to copy: committees notice, and your own facts are stronger.