PONE-D-20-19268

Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

PLOS ONE

Dear Dr. Jeon,

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Academic Editor

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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: No

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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: I read with intrest the manuscript.

Authors wrote a very good article. Congrats

Below only some suggestions:

1. introduction: wello wrote

2. Methods and results: are clear

3. Discussion: I appreciate the discussion , if you can improve with these two suggestions:

3a. compare with other data of literature

3b. the possible role of ultrasound. There are interesting use of ultrasound in thoracic diseases and dignosis (cite : Di Gennaro F, et al. Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis-A Systematic Review. Int J Environ Res Public Health. 2018;15(10):2235. Published 2018 Oct;

Bobbio F, et al. Focused ultrasound to diagnose HIV-associated tuberculosis (FASH) in the extremely resource-limited setting of South Sudan: a cross-sectional study. BMJ Open. 2019;9(4):e027179. Published 2019 Apr 2.)

Discuss the possible role of Ultrasound also as future persepctive.

Reviewer #2: In the present manuscript, the authors compared the risk factors for immediate and delayed pneumothorax after CT guided lung biopsy.

Major comments

The authors have not mentioned the reference category used for estimating the odds ratio of immediate and delayed pneumothorax. The immediate pneumothorax is mostly detected during the procedure and the diagnosis of delayed pneumothorax required subsequent X-ray. Therefore, it will be more useful if the authors look for the risk of delayed pneumothorax using the immediate pneumothorax as a reference category and the results may change.

Minor comments:

• 1.Statistics. The authors mentioned “The factors that were significant in the univariate analyses”. It should be a bivariate analysis.

• 2. Table1.

o It appears that the intrapulmonary biopsy track distances were not “normally distributed”. Hence, the use of the Student’s-t test for comparison was inappropriate.

o When the parameters were significantly different between total pneumothorax and without pneumothorax, the use of separate comparison of immediate and delayed pneumothorax and without pneumothorax is unnecessary duplication of results. It will be more useful to evaluate whether these parameters were significantly different between early and delayed pneumothorax cases.

o Do the distributions of gender and lesion type in groups were comparable?

Discussion

The authors mentioned “the elastic recoil of the normal lung parenchyma and

pleura over the lesion may seal the small opening of the pleura initially to prevent

pneumothorax” (page no 13). The elastic recoil of the lung and chest wall are in the opposite direction, how elastic recoil will prevent the pneumothorax.

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Reviewer #1: Yes: Francesco Di Gennaro

Reviewer #2: No

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Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence

PONE-D-20-19268R1

Dear Dr. Jeon,

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

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Muhammad Adrish

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: All comments have been addressed

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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: Yes

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: Yes

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: I appreciate your manuscript

Authors improved their manuscript

I think can be useful to scientific community

Reviewer #2: (No Response)

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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: Yes: Francesco Di Gennaro

Reviewer #2: No