Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia

Hirofumi Hirano; Hanayo Masaki; Teppei Kamada; Yoshie Taniguchi; Eiji Masaki

doi:10.1371/journal.pone.0250258

Peer Review History

Original SubmissionJanuary 24, 2021
1 Mar 2021 Decision Letter - Benedikt Ley, Editor PONE-D-21-02589 Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia PLOS ONE Dear Dr. Masaki, 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. Kindly address the comments made by reviewer 1 and upload all relevant data in format that will not allow to identify any of the study participants. If data can not be attached directly to the publication, kindly provide information on how and where data can be accessed by interested parties. Please submit your revised manuscript by Apr 10 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. 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, Benedikt Ley Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. 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To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ 3. Please clarify whether the IRB approved the use of verbal consent, and how consent was recorded. [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 Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: 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: No Reviewer #2: 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 Reviewer #2: 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 paper would benefit from including data to support the conclusions made, including the % of obese women in the cohort; stratification of test performance by obesity; an evaluation of how BT sensitivity could be improved by combining it with auscultation and gastric pH (other point of care tools to ascertain NGT location); and a breakdown of + BT Light by anatomical site. I would recommend publication once these issues are addressed. Minor comments include: Page 6 – define ‘with or without finger pressure’. Where and how this is done? Page 7 – ‘on the basis that the lower limited of the 95% confidence interval exceeds 95%’.. please clarify exceeds 95% of what? Page 8 – Table 1. Can you provide range and % of overweight and obese patients in the cohort. One would expect performance BTL to suffer the more obese the patients are. Page 8: ‘the power of BT light to identify the correct position of the NGT was not equivalent to that of X-ray examination’ – can you rephrase this? It’s not entirely clear what is referred to here. Page 9: Remove ‘ the latter of which was quite low’ and expand on this in the discussion. Page 9: Figure 2. This figure caption mentions anatomical areas where BT light was detected. Is there a breakdown of this available per anatomical site, and how this affected test performance? You are alluding to this in the first paragraph of your discussion but you are not showing the data. Abdominal wall = epigastric area? Use consistent descriptors for your anatomical sites in the paper. Page 11: I suggest to move the section on BTL and abdominal wall thickness to the results part of the paper, including methodology of the measurements. As above, include more details of the proportion of obese patients etc in your results. Potentially stratify results BMI. Page 13 – discuss safety of BT light (here or in background section) Page 12 – can a combination of BT, auscultation, and gastric aspirate (can be done in at bedside) be used to improve sensitivity? Reviewer #2: I think it’s a clever approach.maybe more patients could have been found. Nicely presented.Helpful for clinical practice.Simple techniques.Also nice to see the pictures at the end. I have no more remarks about it ****** 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 Reviewer #2: 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.0250258.r001
Revision 1
5 Mar 2021 Author Response We responded to all comments of editor and corrected the revised manuscript according to these responses. The responses to reviewer are in the attachment file, "Response to Reviewers" Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0250258.r002
22 Mar 2021 Decision Letter - Benedikt Ley, Editor PONE-D-21-02589R1 Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia PLOS ONE Dear Dr. Masaki, 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 May 06 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. 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, Benedikt Ley Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): On page 5 You have added the sentence: "We will open all data underlying the findings described in the present study without restriction according to the request" and this sentence is suitable for a reply to the reviewers, but should not be added to the manuscript. Kindly include all underlying data never the less. Kindly have a native English speaker revise the introduced changes, the language in most cases will require some modification. Specifically reviewer 1 had earlier asked to revise the sentence on page 10, which you kindly revised to: "Because the sensitivity for verifying the correct position of the NTG with BT light did not close to 100% when X-ray examination is used as the reference standard, the usefulness of BT light to identify the correct position of the NGT was not equivalent to that of X-ray examination." Unfortunately this sentence is still hard to understand, kindly revise together with a native English speaker. [Note: HTML markup is below. Please do not edit.] [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.0250258.r003
Revision 2
30 Mar 2021 Author Response Reply to the Editor. Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. We reviewed all the references in our manuscript. We can not find any retracted papers in our references. If you have any information about the retracted paper in our references, please let me know. Additional Editor Comments (if provided): On page 5 You have added the sentence: "We will open all data underlying the findings described in the present study without restriction according to the request" and this sentence is suitable for a reply to the reviewers, but should not be added to the manuscript. Kindly include all underlying data never the less. According to the pointing out of the Editor, we delete the sentence (page 5). All underling data are included in the manuscript. Kindly have a native English speaker revise the introduced changes, the language in most cases will require some modification. Specifically reviewer 1 had earlier asked to revise the sentence on page 10, which you kindly revised to: "Because the sensitivity for verifying the correct position of the NTG with BT light did not close to 100% when X-ray examination is used as the reference standard, the usefulness of BT light to identify the correct position of the NGT was not equivalent to that of X-ray examination." Unfortunately this sentence is still hard to understand, kindly revise together with a native English speaker. We are apologize for our limited fluency in English. The manuscript has been professionally edited by a native English speaker familiar with this area of research. The sentence "Because the sensitivity for verifying the correct position of the NTG with BT light did not close to 100% when X-ray examination is used as the reference standard, the usefulness of BT light to identify the correct position of the NGT was not equivalent to that of X-ray examination." was revised to “Because the sensitivity for detecting the correct position of the NTG with BT light was not close to 100% when X-ray examination was used as the reference standard, the usefulness of BT light in identifying the correct position of the NGT was not considered equivalent to that of X-ray examination. (Page 10). The certification of the editing is enclosed. Additional correction. We are deeply sorry, but we found the simple mistakes in Table 2. The numbers of patients in Auscultation test were wrong (accordingly, sensitivity, and NPV). We corrected the numbers. Those corrections did not change any other contents in the manuscript including the conclusions at all. We are sorry again. Attachments Attachment Submitted filename: Response to the Editor.docx https://doi.org/10.1371/journal.pone.0250258.r004
5 Apr 2021 Decision Letter - Benedikt Ley, Editor Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia PONE-D-21-02589R2 Dear Dr. Masaki, 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, Benedikt Ley Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0250258.r005
Formally Accepted
12 Apr 2021 Acceptance Letter - Benedikt Ley, Editor PONE-D-21-02589R2 Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia Dear Dr. Masaki: 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. Benedikt Ley Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0250258.r006

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