PONE-D-21-19973

Evaluation of Albumin use in a Community Hospital Setting: A retrospective study looking at appropriate use and prescribing patterns 

PLOS ONE

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PLOS ONE

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Reviewers' comments:

Reviewer #1: Thank you for asking me to review this manuscript.

Samuel and Coyle described the use of human albumin solution (HAS) in a community hospital.

Overall, the manuscript is a clearly written however I am uncertain as to why the results warrant a publication. In its present form, the work resembles an audit rather than original research.

The introduction does not paint a convincing picture as to why the research question is important. Furthermore, why should prescribing practices of HAS vary between tertiary hospitals and community hospitals if FDA approval for HAS is standard; the authors do not discuss how their results differ from that of current literature. As such, I struggle to see where the novelty lies.

To be considered for publication, the manuscript is in need of a Major revision. The introduction and discussion needs to be improved and more evidence provided. 9 references is insufficient for an original research article.

My other comments are listed below and I hope the authors find them useful. I wish the authors all the best in their revisions and future endeavours.

Introduction

"The results could be used to influence prescribing practices in the health care system and decrease cost to the hospital and the patient."

I am unsure how describing the use of HAS in a community hospital can influence "prescribing practices in the health care system and decrease cost to the hospital and patient". It is not clearly explained how this can be achieved with the results herein.

Methods

There is mention of standard deviations although I do not reported in the results.

Observational studies should be reported using the STROBE checklist. There are missing segments in the methods e.g. inclusion and exclusion criteria.

Why wasn't data on the adverse reactions of HAS investigate? Were there any differences in the approved and "off label" use?

Results

I do not see how these results are different from data that is already available in literature.

Discussion

The discussion is very superficial and not impactful.

Reviewer #2: In a single-center community hospital study, therapeutic use of human albumin solution was analysed. Appropriate use was defined according to labelled indications and SCC Guideline recommendation. Findings are described. Such kind of analyses have been published before for other health care settings and larger patient populations. A relatively small sample size is the major limitation and prevents novel insight or meaningful conclusions. Questions regarding use of albumin arise particularly in controversial issues such as combinations of a particular clinical condition with significant hypoalbuminemia with and without hypovolemia or when 5% vs. 20% to 25% human albumin solutions are used. Inappropriate use in non-cardiac surgery would merit further analysis, however, sample size is too small.

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Evaluation of Albumin use in a Community Hospital Setting: A retrospective study looking at appropriate use and prescribing patterns

PONE-D-21-19973R1

Dear Dr. JOHN,

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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Kind regards,

Aleksandar R. Zivkovic

Academic Editor

PLOS ONE