Facing obesity in pain rehabilitation clinics: Profiles of physical activity in patients with chronic pain and obesity—A study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

Huan-Ji Dong; Britt Larsson; Marcelo Rivano Fischer; Björn Gerdle

doi:10.1371/journal.pone.0239818

Peer Review History

Original SubmissionDecember 19, 2019
27 Jul 2020 Decision Letter - Adewale L. Oyeyemi, Editor PONE-D-19-34615 Facing obesity in pain rehabilitation clinics: profiles of physical activity in patients with chronic pain and obesity – a study from the Swedish Quality Registry for Pain Rehabilitation (SQRP) PLOS ONE Dear Dr. Dong, 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. Please submit your revised manuscript by Sep 10 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Adewale L. Oyeyemi, Ph.D Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that you have stated that you will provide repository information for your data at acceptance. 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The funding source did not participate in the design of the study, collection, analysis, or interpretation of the data; or in the decision to submit the manuscript for publication.". i) Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. ii) Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. [Note: HTML markup is below. Please do not edit.] 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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 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 ****** 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 ******** 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: The authors sought to investigate the levels of physical activity and the effect of excess weight on the levels this activity through analyses of data of patients attending specialist pain rehabilitation clinics. The manuscript is well written and presented appropriately. Rigourous statistical analysis techniques have been employed and are described in suitable detail for reproduction. Reasonable interpretations have been made from the results of the analyses and limitations of the work are clearly recognised. The article would benefit form the following minor revisions: * Page 8 - Please change '....insufficient physical active' to activity. * Table 1 - Percentage of women in underweight group is incorrect, should be 87.0. * Page 14 - The statement 'most of these were severely obese patients (59.9%, P < 0.001)' is incorrect in this context. The percentage reported here is the proportion of the severe obesity group that had insufficient PA. The largest proportion of patients with insufficient PA came from the overweight (35.7%) group, with 10.2% of thetotal being in the severe obesity group. * Page 19 - Please change '...being obese were' to 'being obese was' ******** 6. 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 [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0239818.r001
Revision 1
20 Aug 2020 Author Response Responses Academic editor 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Our comments and revisions: thank you for the detailed help on our article. In the revised manuscript, we have followed the guidelines and checked the title page, manuscript main body as well as supporting information (format and structures). We also used the recommended Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool to ensure that figures meet PLOS requirements. To be noted, we have updated our affiliations because Linköping University and Lund University changed a few names of affiliations and departments in January 2020. 2. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. Our comments and revisions: Thank you for your clarification. We need to update our statement about data availability: The datasets generated and/or analysed in this study are not publicly available as the Ethical Review Board has not approved the public availability of raw data. The data that support the findings of this study are available from SQRP (https://www.ucr.uu.se/nrs/) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available upon reasonable request and with permission of SQRP research group (contact person: Marcelo Rivano Fischer, Marcelo.rivanofischer@skane.se) and data requests should be sent to the Ethical Review Board. 3. Thank you for stating in your Funding Statement: "This study was supported by grants from the County Council of Östergötland (Research-ALF) and the division research funding (SC-2017-00202-28). The funding source did not participate in the design of the study, collection, analysis, or interpretation of the data; or in the decision to submit the manuscript for publication.". i) Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. ii) Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. Our comments and revisions: Thank you for the information. We have completed some more necessary information according the PLoS guideline: This study was supported by grants from AFA insurance, the County Council of Östergötland (Research-ALF, LIO-608021, BG and SC-2017-00202-28, H-JD). AFA Insurance, a commercial founder, is owned by Sweden's labor market parties: The Confederation of Swedish Enterprise, the Swedish Trade Union Confederation (LO), and The Council for Negotiation and Co‐operation (PTK). These parties insure employees in the private sector, municipalities and county councils. The funding sources did not participate in the design of the study, collection, analysis, or interpretation of the data; or in the decision to submit the manuscript for publication. There was no additional external funding received for this study. We have updated this funding statement in the resubmission. Reviewer 1 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 ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ________________________________________ 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 ________________________________________ 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 ________________________________________ 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: The authors sought to investigate the levels of physical activity and the effect of excess weight on the levels this activity through analyses of data of patients attending specialist pain rehabilitation clinics. The manuscript is well written and presented appropriately. Rigourous statistical analysis techniques have been employed and are described in suitable detail for reproduction. Reasonable interpretations have been made from the results of the analyses and limitations of the work are clearly recognised. The article would benefit form the following minor revisions: * Page 8 - Please change '....insufficient physical active' to activity. Our comments and revisions: Point taken. Thank you for your advice. We have changed the word in the text. * Table 1 - Percentage of women in underweight group is incorrect, should be 87.0. Our comments and revisions: Point taken. Thank you for your detailed help on our article. We have checked the calculation and corrected the error. * Page 14 - The statement 'most of these were severely obese patients (59.9%, P < 0.001)' is incorrect in this context. The percentage reported here is the proportion of the severe obesity group that had insufficient PA. The largest proportion of patients with insufficient PA came from the overweight (35.7%) group, with 10.2% of the total being in the severe obesity group. Our comments and revisions: Point taken. Thank you for your help. We agree with you that the description was not correct in the context. We have updated in the revised manuscript to highlight the proportion within each BMI group for comparison: ‘nearly half of the patients were classified as having insufficient PA (47.3%) (Table 1); severe obesity had the highest proportion (59.9%), while normal weight had the lowest (40.6%, P < 0.001).’ * Page 19 - Please change '...being obese were' to 'being obese was' Our comments and revisions: Point taken. Thank you for your advice. We have changed the word in the text. ________________________________________ https://doi.org/10.1371/journal.pone.0239818.r002
15 Sep 2020 Decision Letter - Adewale L. Oyeyemi, Editor Facing obesity in pain rehabilitation clinics: profiles of physical activity in patients with chronic pain and obesity – a study from the Swedish Quality Registry for Pain Rehabilitation (SQRP) PONE-D-19-34615R1 Dear Dr. Dong, 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. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Adewale L. Oyeyemi, 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 ******** 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) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) ****** 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) ****** 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) ****** 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) ****** 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 https://doi.org/10.1371/journal.pone.0239818.r003
Formally Accepted
17 Sep 2020 Acceptance Letter - Adewale L. Oyeyemi, Editor PONE-D-19-34615R1 Facing obesity in pain rehabilitation clinics: profiles of physical activity in patients with chronic pain and obesity – a study from the Swedish Quality Registry for Pain Rehabilitation (SQRP) Dear Dr. Dong: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Adewale L. Oyeyemi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0239818.r004

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