PONE-D-21-14251

Multidisciplinary aerodigestive program at a children’s hospital: A protocol for a prospective observational study

PLOS ONE

Dear Dr. Kim,

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.

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Jorge Spratley, MD, PhD

Academic Editor

PLOS ONE

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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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.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):

Dear Authors,

This is very interesting and well designed project that will for sure enable future improvements in Pediatric Otolaryngology care at your Institution.

Before publication, I would kindly advise a minor edition of the manuscript focusing on the below cited items

1 - Does the ADT meeting include psychologists, social assistants or specialty nurses in addition to physicians?

2 - If interventions are planned, do you intend to do it in a single operative time or each specialty will plan their own interventions independently? For example, if a child has indication to undergo a microlaryngoscopy, a bronchoscopy and an upper digestive endoscopy - are these done at the same surgical slot or in separate times?

3 - In which situations would it be beneficial to perform a neck x-ray?

4 - References number 2 and 7 are incomplete

5 - Line 173: please correct the word "laryngomicrosurgery"

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

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Aerodigestive programs to enhance and coordinate the management of complex children are desirable and increasingly common. However good evaluation of the value of these programs to patients is still lacking. This is the first prospective evaluation of a multidisciplinary program that I am aware of, and I applaud the effort.

My observation, however, is that in most programs, pulmonary and gastroenterology are key components. It appears to me that there are over 20 authors, and yet none is a pulmonologist or gastroenterologist. This may be a consideration?

Reviewer #2: Is the 1-10 score an visual analogue score or a subjective score by parents of a number scale?

Besides this point, the protocol of a prospective observational study is entirely appropriate.

Reviewer #3: 1 - Does the ADT meeting includes psychologists, social assistants or specialty nurses in addition to physicians?

2 - If interventions are planned, do you intent to do it in a single operative time or each specialty plans their own interventions? For example, if a child has indication to underwent a microlaryngoscopy, a bronchoscopy and an upper digestive endoscopy - are these done at the same surgical time or in separate times? Please justify your answer.

3 - In which situations would it be beneficial to perform a neck x-ray? Please justify your answer.

4 - References number 2 and 7 are incomplete

5 - Line 173: please correct the word "laryngomicrosurgery"

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Reviewer #1: Yes: Mike Rutter

Reviewer #2: No

Reviewer #3: Yes: Sónia Pires Martins

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Multidisciplinary aerodigestive program at a children’s hospital: A protocol for a prospective observational study

PONE-D-21-14251R1

Dear Dr. Kim,

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,

Jorge Spratley, MD, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Congratulations for having achieved the required level for publication at PlosOne.

Best wishes for the implementation of your well structured protocol

Reviewers' comments: