PONE-D-20-07652

Increased Awareness and Decreased Acceptance of Genome-Editing Technology: The Impact of Chinese Twin Babies

PLOS ONE

Dear Dr. Saito,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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PLOS ONE

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3. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information.

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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

Reviewer #3: Partly

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

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

Reviewer #3: 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

Reviewer #3: 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

Reviewer #3: 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: Thank you for this manuscript. The article presents the survey clearly and thoroughly. I found it very interesting to read. I would like to see a few more details on where the study was conducted, particularly about the location of the survey respondents. Was the survey distributed globally? What languages were used? Some comments in the article suggest that the survey was conducted in Japan only (e.g. p. 11, line 143). It would also be important to discuss the implications of this. If the survey was conducted in one country only, this needs to be stated and an acknowledgement made that this may limit the generalizability of its findings.

One small formatting issue is that reference numbers were regularly used as subjects in sentences, e..g. “[3] found that their results …” This approach is unfamiliar to me and should be checked against the journal's style guidelines.

Otherwise, this is a very good manuscript.

Reviewer #2: I think this manuscript provides important findings about the impacts of the Chinese human embryo editing controversy on public opinion about gene editing in Japan. As such, I support its publication. However, I have a few suggestions for the authors to consider:

1. I found it confusing that the article starts with the discussion of gene editing of plants and animals ("breeding" applications), even though the primary focus is on human gene editing. I think it would therefore be better to start the paper with a discussion of human gene editing and the Chinese incident. At the end of the current intro, it comes back to use of gene editing for animals and plants, which is appropriate there because one of the interesting secondary findings of the paper is that controversy over Chinese human embryo editing dis not seem to appreciably affect public opinion on breeding applications of gene editing. But it confusing to focus on animal and plant applications in the first paragraph of the paper given that the primary focus and finding is on impact on opinion about medical and embryo use of gene editing.

2. On lines 104-05, the manuscript states that the subjects were randomly selected from a "pre-registration sample." It would be useful to say more about how this pre-registraton sample was created. Was it created from a particular geographical region? How were people solicited for the pre-registration sample?-These details are important for understanding the representativeness of the sample.

3. My understanding is that the subjects were all from Japan. That should be explicitly stated. Also, it would be useful to have a little bit of information about the overall perspective of the Japanese public. For example, Japan is a world leader in stem cells, does this make the public more supportive of embryo science generally, or is it similar to European and the Americas?

4. Table 1 states that there was unequal number of males and females in 2019 (even though text says same numbers each year. How unequal was the 2019 sample, did it favor males or females, and was this likely to have had any effect on the results?

5. In table 3, I did not understand the headings “Most Impressionable” (for 2016) vs “Describes Me” (for 2018 and 2019). The meaning of these terms should be explained better.

6. In the conclusion, the authors state that public requires requires researchers to strictly follow ethical guidelines. This might be a reasonable speculation - but was not directly tested by the study. It may be that people are disturbed by embryo manipulations even if it does follow ethical guidelines. Therefore the role of ethical guidelines should be presentrd as a reasonable hypothesis, or excluded altogether since it was not evaluated in this study.

– what does this mean ?and more males or females?

Reviewer #3: I read with great interest the Manuscript titled “Increased Awareness and Decreased Acceptance of Genome-Editing Technology: The Impact of Chinese Twin Babies” (PONE-D-20-07652).

I was particularly pleased to review this paper. In my honest opinion, the topic is interesting enough to attract the readers’ attention. Methodology seems appropriate and conclusions are supported by the data analysis. Nevertheless, authors should clarify different points of methods and improve the discussion discussing limitations of the study that are not evidenced in the discussion.

In general, the Manuscript may benefit from several major revisions, as suggested below:

- All the text needs a language revision in order to improve some typos and grammatical errors.

- Please, check in all the text the use of references as subject. This is not correct, use the form Surname et al. [reference] verb …

- I would suggest checking the use of abbreviation in the abstract and in the main text, they need to be reported in the extended form at the first use.

- I would suggest checking the authors guidelines for the manuscript format.

- I would suggest providing more information about the target population included in the Macromill database, the geographic area, and how the list of the company has been built. Is it actually representative of the entire population? All these details are required to understand the possible biases and limitations of the survey which need to be better discussed.

- I would suggest providing data about non responders and discuss the possible role of this proportion of subjects on the study results. This can be a source of bias and limitations. Are more characteristics of the investigated population available, such age, education, or other? The same about who did not respond.

- I would suggest providing more detail about “how” the survey was conducted. The modality, if interviewers were adopted, which language, if the survey was validated and the process of validation. In general, more details about the methods are required to understand the actual value of provided results and specifically the inference from these results.

- I would suggest adding a methods section with deep detailed description of survey development with validation, survey distribution, target population (geographic area, language, details about list). The Authors should add this section with the aim to allow the repetition of the study by other investigators, key information and steps used to product the results need to be reported.

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Reviewer #1: Yes: Dónal O’Mathúna

Reviewer #2: No

Reviewer #3: No

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Increased Awareness and Decreased Acceptance of Genome-Editing Technology: The Impact of the Chinese Twin Babies

PONE-D-20-07652R1

Dear Dr. Saito,

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,

Simone Garzon

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 #3: 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 #3: Yes

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

Reviewer #1: I Don't Know

Reviewer #3: 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: Yes

Reviewer #3: 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 #3: 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: Thank you for responding to my earlier comments, particularly making it very clear that this survey was conducted with the Japanese public. While the article is generally written well, it could benefit from one more careful proofreading by someone with excellent English-writing skills. There are places where the English currently is awkward. e.g. p. 2, line 32 "ask" should be "inquire"; p. 3, line 45, the concluding phrase is incomplete grammatically; p. 14, line 187, "the" should be inserted between "was" and "highest".

Otherwise, the article is very good.

Reviewer #3: I carefully evaluated the revised version of this manuscript.

Authors have performed the required changes, improving significantly the quality of the paper.

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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: Dónal O'Mathúna

Reviewer #3: No