A novel comprehensive metric to assess COVID-19 testing outcomes: Effects of geography, government, and policy response

PONE-D-20-20527

Dear Dr. Overgaard,

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.

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Karol Sestak

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

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

Reviewer #1: 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

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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

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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: - The manuscript has already been submitted as preprint in medRxiv.

- It describes the new metric (Testing Index = TI) that could be useful along with other, already established metrics, in evaluating and comparing the COVID-19 infection burdens among different countries/regions.

- One of the important justifications for using the TI is that this metric incorporates relative or proportional type of measurements. It is often stated in these days by politicians and non-experts that “increased testing is counterproductive because it inevitably reveals increased number of cases….”. Relative or proportional types of metrics by their nature eliminate such criticism and at the same time should be used and explained to public in order to corroborate absolute data.

- Authors emphasize the need of a single comprehensive metric that could be used universally as it would encompass characteristics of both absolute and relative metrics.

- The results presented here are statistically sound and strongly suggest that COVID-19-TI could be used for such a purpose.

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Reviewer #1: Yes: Dr. Karol Sestak

Attachments

Attachment

Submitted filename: Review.pdf

PONE-D-20-20527R1

A novel comprehensive metric to assess COVID-19 testing outcomes: Effects of geography, government, and policy response

PLOS ONE

Dear Dr. Overgaard,

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.

Your manuscript received mixed reviews in the first round of revision; subsequently, Reviewer 2, who raised a number of concerns, was unavailable in the next round to assess the revisions to your manuscript. As such, an additional reviewer was invited for this round of revision, who raised some new and important concerns regarding your study. Specifically, they noted the following:

1-  The scientific content of the paper lacks rigour : the authors take into account mostly stochastic factors (such as the political measures concerning the tests which only changed overnight depending on the availability of medical means, especially during the first phase of the covid) to ultimately propose a deterministic indicator without any analysis of the uncertainties linked to the stochasticity of the input data.

2- Some relationships have been considered linear without any justification and sometimes wrongly, for example, why is the real number of infected people linearly proportional to the number of reported cases?

The reviewer’s full comments can be viewed in full below. Please note that further consideration is dependent on the submission of a manuscript that addresses all the concerns raised in this round of review.”

Please submit your revised manuscript by Mar 05 2021 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,

Laurent Pujo-Menjouet

Academic Editor

PLOS ONE

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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 #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 #3: No

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

Reviewer #3: No

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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 #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 #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 #3: A novel comprehensive metric to assess COVID-19 testing outcomes: Effects of geography, government, and policy response.

Referee: #3

This paper develops a metric to assess COVID-19 testing outcomes ex- pressed as a linear combination of the rates CFsi, TPsi, ACsi and DRsi. These rates are computed with adjusted reported death data, the health system capacity and level of democracy of the countries.

The idea of setting up a metric to compare the level of effectiveness of COVID tests in different countries is of major interest. However, the scientific content of the paper lacks rigor and seems to me very far from the framework and the level of requirement of the journal PLOS. In fact, the authors take into account mostly stochastic factors (such as the political measures concerning the tests which only changed overnight depending on the availability of medical means, especially during the first phase of the covid) to ultimately propose a deterministic indicator without any analysis of the uncertainties linked to the stochasticity of the input data.

Some relationships have been considered linear without any justification and sometimes wrongly, for example, why is the real number of infected people linearly proportional to the number of reported cases?

I agree to the great interest to have a good metric to assess COVID-19 testing outcomes however, the one proposed in this paper seems not relevant and not rigorous. For all these reasons and despite the answers given to the first phase of the review, I will not recommend the publication of this result in PLOS ONE journal.

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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 #3: No

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A novel comprehensive metric to assess effectiveness of COVID-19 testing: Inter-country comparison and association with geography, government, and policy response

PONE-D-20-20527R2

Dear Dr. Overgaard,

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,

Laurent Pujo-Menjouet

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

After reading the comments of the readers on the second revised version, I consider at that point that they answered all the points and can be accepted for publication.

Best,

Laurent

Reviewers' comments: