PONE-D-20-04286

Usability of a store and forward telehealth platform for diagnosis and management of oral mucosal lesions: a cross-sectional study

PLOS ONE

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: 1. The sample size calculation is based on a referenced manuscript that concluded 80% of a products usability problems can be detected with 4 or 5 subjects. It is not a true sample size calculation and further does depend on the likelihood of problem detection, the latter not estimated in this manuscript.

2. Also regarding the sample size estimation, it is not a sample size to detect either a difference or equivalence in the two outcomes assessed - a comparison between experienced users and inexperienced users in (1) SyUS scores and (2) time to complete the task. Therefore, there is no basis to assess the chance of an erroneous conclusion being reached based on the statistical tests applied to these outcomes. Given the current sample size rationale, these data would be better described descriptively.

3. It would appear that the response rate of 33% should read "non-response" rate based on the numbers provided by the authors, the authors should clarify.

Reviewer #2: The manuscript proposes a basic but solid assessment of satisfaction in use, which is not the entire assessment of usability, as per ISO standard 9241-11.

Overall the artcile is acceptable however, some raw statements should be removed or better specified.

First the title. As authors are not presenting measures of efficiency and effectiveness they can not claim that this study assessed usabilty but only statisfaction in use or perceived usability.

Second I know that the magic number of 5 users to discover 80% of the problems is still going around, but this is an old and complex story, and to make a long story short, NO five users are never enough - at max it could be a starting point. see for instance:

- Borsci, S., Macredie, R. D., Barnett, J., Martin, J., Kuljis, J., & Young, T. (2013). Reviewing and extending the five-user assumption: a grounded procedure for interaction evaluation. ACM Transactions on Computer-Human Interaction (TOCHI), 20(5), 1-23.

- Schmettow, M. (2012). Sample size in usability studies. Communications of the ACM, 55(4), 64-70.

I strongly suggest authors to remove references to the 5 users assumption.

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Reviewer #1: No

Reviewer #2: No

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Perceived usability of a store and forward telehealth platform for diagnosis and management of oral mucosal lesions: A cross-sectional study

PONE-D-20-04286R1

Dear Dr. Roxo-Gonçalves,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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With kind regards,

Simone Borsci, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: (No Response)

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: (No Response)

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: (No Response)

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The paper is interesting and well written. I do not have suggestion to add, and I am happy to suggest to the editor publish this article as it is.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No