PONE-D-21-18099

REVIEW ORIGINAL RESEARCH CASE REPORT CASE SERIES RAPID A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy prescription for patients with atrial fibrillation

PLOS ONE

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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

Reviewer #2: Partly

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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: Yes

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: Yes

Reviewer #2: No

Reviewer #3: No

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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: Line 78: S capital

Line 106: citations at the beginning of the sentence

Line 112 and 113 are repetitive

citation needed for line 114 to 119.

164 should be prescription instead of description.

This research review provides light on how frequently OAC is mismanaged in patients with Atrial fibrillation.

It is important to state if the majority of the patients were managed by cardiologists or primary care providers. It would be interesting to see if the cardiologist were handling the OAC doses better than their primary care colleagues.

Interesting to note that although apixaban is the most widely used OAC in the world, it was not included in the study [ author to clarify reason of not including apixaban in the review].

Overall, well conducted study.

Reviewer #2: Review comments according to the number(against the serial number): 4: Omit the word 'prescription'. 22: Replace the word 'patients and' by the word 'materials'. 27: 57.7% is the wrong typing, it will be 53.7%. 29: Replace the world 'description' by the word 'prescription'. 37: Bleeding events are 44, but I find it is 43 according to table 6. 84: Transient factors may include chest infections(pneumonia) also. 134 & 135: The term 'valvular AF' is less appropriate term at present because most of the recent study(AF) for NOACs(according to ESC guidelines for AF-2020) include other valvular AF except moderate to severe Rheumatic Mitral valvular diseases and/ or an artificial heart valve. 137: Use of NOAC with Warfarin- I think the word 'with' is replaced by the word 'over'. 159: In Table 4- Only male sex; what's about female sex? no information about female sex. 162: 56.7% will be corrected by 53.7%. 164:'Description' will be corrected by 'prescription'. 175: Regarding prohibition-Dabigartan(RE-LY trial) and Rivaroxaban(ROCKET- AF trial) is used other valvular AF except moderate to severe Rheumatic Mitral valvular diseases and/ or an artificial heart valve. 184: Table 6-shows Dabigartan(n=126), Rivaroxaban(n=163), but description shows Dabigartan was given to 132 patients and Rivaroxaban was given to 167 patients(there is discrepancy). 188: Table 6 shows bleeding events in Rivaroxaban group is 20 but description shows it is 21. 190: Rivaroxaban had the highest proportion of bleeding events but ROCKET-AF trial(ESC guidelines for AF-2020) shows that Rivaroxaban causes less intracranial bleeding than warfarin. Though this study is a retrospective study, but it should explain the possible underlying factors/ causes for (is there any history of low platelets or concomitant use of NSAID/ effects of abnormal liver or renal function?) high bleeding events than warfarin. 196: Figure 1 - shows Dabigartan causes high rate of bleeding events than warfarin, but RE-LY trail shows that Dabigartan causes less intracranial bleeding but high GIT bleeding than warfarin. Though this study is a retrospective study, but it should explain the possible underlying factors/ causes (is there any history of low platelets or concomitant use of NSAID/effects of abnormal liver or renal function?) for high bleeding events than warfarin. 288: Contraindication to NOAC therapy in valvular AF-according to ESC guidelines for AF-2020 that include other valvular AF except moderate to severe Rheumatic Mitral valvular diseases and/ or an artificial heart valve. 306: Description shows no major/fatal bleeding but Table 7 shows there are 3 fundal bleeding, 1 subdural hematoma and 1 subarachnoid haemorrhage- I think it should be included as a major bleeding events.

This is a retrospective study and the researchers had no direct contact with the study subjects (rely on the papers only). But it shows clearly the inappropriateness of prescription that will help the physicians for selecting the appropriate anticoagulation therapy during management of AF.

Reviewer #3: Dear Author, this is a retrospective cross sectional study analyzing the prescriptions of patients with AF from the electronic medical records for the appropriateness of medication indication and dosage. It is small study with good analysis and the discussion is also appropriate. Overall study and paper is presented nicely but there are some sentences are conveying with ambiguous and confusing meaning. There also some minor spell checks and grammatical errors which need correction. I request the authors to go through the document with corrections and check uploaded by me. I would like you consider your title which includes "REVIEW ORIGINAL RESEARCH CASE REPORT CASE SERIES RAPID" in it. Is this phrase needed in the title ?.

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Reviewer #1: Yes: Deepti Bhandare

Reviewer #2: Yes: Nirmol Kumar Biswas

Reviewer #3: Yes: BHAVANADHAR PENTA

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Attachments

Attachment

Submitted filename: PONE-D-21-18099_reviewer with comments.pdf

A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy prescription for patients with atrial fibrillation

PONE-D-21-18099R1

Dear Dr. Qian,

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.

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Kind regards,

Vijayaprakash Suppiah, PhD

Academic Editor

PLOS ONE

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

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 #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #1: Yes

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: Yes

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: Yes

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 #1: all comments have been answered

well written case

interesting aspect of engaging pharmacists to discuss safety profile of medications

Reviewer #2: The corrections that is made by the Authors is upto the mark for publication and fulfill the expectation.

Reviewer #3: Dear Author, the title of edited version manuscript is now according to the PLOS ONE guidelines. The corrections suggested by the reviewers and editor 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 #1: Yes: Deepti Bhandare

Reviewer #2: Yes: Nirmol Kumar Biswas

Reviewer #3: Yes: PENTA BHAVANADHAR