PONE-D-20-01058

Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors:  a systematic review

PLOS ONE

Dear Dr. Soon,

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.

Specifically, the reviewers have raised overlapping concerns about the statistical methodology and reporting of the search strategy in the manuscript.

Please submit your revised manuscript by Jul 18 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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We look forward to receiving your revised manuscript.

Kind regards,

Richard Hodge

Associate Editor

PLOS ONE

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2. Upon revision, please ensure that inclusion and exclusion criteria for the selected studies are clearly stated in the Methods section. Please also give a rationale for using 7 criteria as a cut-off for good reporting of CR technique. Please also list which criteria were met for each study considered.

3. We noticed you have some minor occurrence(s) of overlapping text with the following previous publication(s), which needs to be addressed:

https://doi.org/10.1016/j.ijrobp.2017.06.862

https://doi.org/10.1097/MD.0000000000016124

https://doi.org/10.1200/JCO.2008.19.4522

In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the Methods section. Further consideration is dependent on these concerns being addressed.

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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

Reviewer #3: Yes

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

Reviewer #1: No

Reviewer #2: No

Reviewer #3: 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: No

Reviewer #2: No

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: No

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: This meta-analysis is about "Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors: a systematic review".

In my opinion, the article does not have the necessary quality to be accepted

Reviewer #2: Tan and colleagues aimed to evaluate the quality of reporting of cranial irradiation techniques in randomized controlled trials in primary brain tumor patients. They found that the quality of reporting is suboptimal in many studies, warranting the introduction of guidelines on reporting.

1. Introduction: What is the rationale for determining predictors for the quality of reporting? How will this be used? This should be described in the introduction.

2. Method: Were only studies with malignant primary brain tumors included? Or also benign tumors? Also, it should be described if the focus is on pediatric or adult patients, or both? In short, the specific in- and exclusion criteria should be reported.

3. Methods: What was the reason to exclude PCNSL? I understand that brain metastases are excluded, as they are not primary brain tumors, but it is unclear why studies including PCNSL patients are excluded.

4. Methods: Why were only MeSH terms included in the search strategy? Also, only two databases were searched. This should be recognized as a limitation.

5. Methods: The authors state that the 10 quality criteria have been described in previous publications. What are the references? And were these 10 criteria also used in the previous reviews (as described in the introduction) to assess the quality of reporting of irradiation techniques? What were similarities and differences? And if not equal, why were different methods used?

6. Methods: Was each variable first tested in a univariable model before entering in the multivariable model? If not, this should be explained.

7. Methods: What is the rationale for including ‘bias in reporting the primary efficacy endpoint’ or ‘bias in reporting of primary toxicity endpoint’ as predictors for good quality of reporting of RT techniques? And not characteristics such as tumor type?

8. Methods: only 23 studies were classified as ‘adequate quality in reporting’. This means that only 2 (and max 3) variables can be included in the multivariable model, otherwise it would be overfitted. In this study, more than 3 variables seem to be included, limiting the reliability of the model.

9. Results: Data on each eligible study was collected, including characteristics such as patient population. It would be helpful to add characteristics (tumor type, number of patients, intervention, sociodemographics) to the supplemental table.

10. Results: Bias in reporting the primary efficacy endpoint was predictive of good quality reporting of RT techniques? This is counterintuitive: if they would not properly report the primary endpoints, why would they properly report information on RT techniques? I am not convinced by the explanation provided by the authors.

11. Results: The odds ratios 6.67 and 5.17 are converted to percentages. However, shouldn’t these be 567% and 417% instead of 667% and 517% (and OR of 2 is a 100% increase in chance, not 200%)?

12. Discussion: The authors argue in the introduction that information on the radiation techniques should be reported adequately in RCTs, to reduce the risk of deviation in daily clinical practice. In this review, all type of primary brain tumors are combined. I wonder, however, if there are differences in trials for different types of brain tumors? And what about trials that were practice-changing versus those who were not? It would be informative if these subanalysis would be performed.

13. Discussion: as a limitation, a small sample size is mentioned, and therefore no definitive conclusion can be drawn. A definitive conclusion on what?

Reviewer #3: METHODS:

Trial eligibility criteria:

1. Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

2. It should be need to present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

3. Why the authors didn't use other major database such as ISI, Scopus?

Selection of trials and Data extraction:

4. The full text article of any trial that appeared to meet the inclusion criteria was retrieved for closer inspection. Disagreements were resolved by consensus. If the agreement rate was assessed? Was the KAPPA statistics?

5. Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis

Results:

5. Describe the result of assessing risk of bias of individual studies?

6. Table 4: p-values must be reported as three digit.

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

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: 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.

PONE-D-20-01058R1

Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors:  a systematic review

PLOS ONE

Dear Dr. Soon:

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.

There have been three reviews:  one to accept, one for minor revisions, one to reject.  Please attempt to address all of these in the next submission.  I will note that the "reject" had few comments. 

Please submit your revised manuscript by Oct 18 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.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. 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,

Gayle E. Woloschak, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

There have been three reviews: one to accept, one for minor revisions, one to reject. Please attempt to address all of these in the next submission. I will note that the "reject" had few comments.

[Note: HTML markup is below. Please do not edit.]

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: (No Response)

Reviewer #2: All comments have been addressed

Reviewer #3: (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: Partly

Reviewer #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: 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: No

Reviewer #2: 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: No

Reviewer #2: No

Reviewer #3: Yes

**********

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: Thanks for submit your revised version of manuscript about "Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors: a systematic review"

In my opinion you did not write your article correctly and it should be rewrite principally.

Reviewer #2: The authors have addressed all my comments, which helped to improve the manuscript. The methodology is more clearly described, which facilitates interpretation of the results.

My only concern is the English language. I would advise to involve a native speaker for grammatical edits.

Reviewer #3: (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: No

Reviewer #2: No

Reviewer #3: 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.

Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors:  a systematic review

PONE-D-20-01058R2

Dear Dr. Soon:

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,

Gayle E. Woloschak, PhD

Section Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for addressing the concerns of the reviewers.

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 #2: 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 #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #2: Yes

Reviewer #3: 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 #2: Yes

Reviewer #3: Yes

**********

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 #2: Yes

Reviewer #3: Yes

**********

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 #2: The authors have rewritten several parts of the manuscript, and now reflects adequate English language.

Reviewer #3: Dear editor,

The revised manuscript (entitled: Quality of reporting of cranial irradiation techniques in randomized controlled trials of primary brain tumors: a systematic review) was rechecked, all comments have been addressed.

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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 #2: No

Reviewer #3: No