PONE-D-21-08221Does it work? Using a Meta-Impact score to examine global effects in quasi-experimental intervention studies.PLOS ONE

Dear Dr. Doyle,

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 see the reviews below. The reviewers have pointed out several areas where the motivations and arguments could be strengthened, and requested further information where some uncertainty remains.

Please submit your revised manuscript by Jan 26 2022 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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Hanna Landenmark

Senior Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please ensure that you include a title page within your main document. We do appreciate that you have a title page document uploaded as a separate file, however, as per our author guidelines (http://journals.plos.org/plosone/s/submission-guidelines#loc-title-page) we do require this to be part of the manuscript file itself and not uploaded separately.

Could you therefore please include the title page into the beginning of your manuscript file itself, listing all authors and affiliations.

3. Thank you for including your ethics statement:  "The study was reviewed by the Ethics Board of City, University of London PSYETH (R/F) 15/16 245

Consent was provided in written form for all participants".   

Please amend your current ethics statement to confirm that your named institutional review board or ethics committee specifically approved this study. 

Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”).

For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research.

4. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. 

When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section.

5. Thank you for stating the following in the Competing Interests section: 

"I have read the journal's policy and the authors of this manuscript have the following competing interests: The lead author is employed as a director by a non-profit entity who provides services for adult dyslexics."

Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to  PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests).  If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared. 

Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf.

6. Please amend your list of authors on the manuscript to ensure that each author is linked to an affiliation. Authors’ affiliations should reflect the institution where the work was done (if authors moved subsequently, you can also list the new affiliation stating “current affiliation:….” as necessary).’

7. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. 

8. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

[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: Partly

**********

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

Reviewer #1: Yes

Reviewer #2: N/A

**********

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: 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: Thank you for giving me the opportunity to review this paper. It offers a well-constructed and supported rationale for taking this innovative approach to the analysis and interpretation of data in real-world studies. As such, it is certainly needed and this need is underlined by the challenges facing all those seeking to understand ‘what works?’ It is good to see an individual differences type approach to group-level intervention, however I wonder whether there is also an opportunity to use the examples of advances in other fields – such as medicine – as leverage in the argument that work-based interventions should also move towards a more individually tailored approach.

The data presented clearly exemplify the methodological challenges faced in conducting real-world research, as well as the dilemmas in reaching decisions about whether an intervention works/doesn’t work with a client group. The authors are to be congratulated on the efforts taken in gathering and refining these data sets.

A main thrust of the paper appears to be that some participants performed better in some areas than the control group, but there is a claim on page 12 for ‘consistent person-specific indications of improvements in confidence and work-related performance’ in both of the studies described. I suspect it would help support such a statement with clear reference to where this is evidenced and/or what this means in the context of the study, i.e. were these reflected in test results, participant feedback, etc? This could be important as this is one piece of important evidence on which the premise of the rest of the paper is based.

Due care appears to have been taken in describing the various calculations and so it is the Meta-Impact score which becomes the focus of attention. Described on page 13 as ‘an aggregation of predefined levels of individual improvement across a number of different measures of a range of plausible intervention effects’, it is at least partly based on ‘assessing the numerical point at which a ‘Real World Value’ is most likely to have occurred’. This does pose an interesting question about what this ‘numerical point’ might be and I wonder whether this paper can afford to be bolder in suggesting it holds the key to how this figure might be derived, using the statistical processes described later? Alternatively, I wonder if there is also a risk that the thorny issue of when a difference on paper equates to a difference in behaviour may get in the way of what the paper is hoping to convey. Perhaps signposting other papers who do so, might help at this point?

In terms of the study design, it seems reasonable to have made ‘refinements to measures and protocol to ascertain if the mixed results were due to artefacts or if the results would be replicated in a new sample’, however it does raise the question of what these might be. It is not much of a loose end in itself, but in the later context of moving clients from one group to another, these may be seen as potential ‘liberties’ in the eyes of some readers. Care is taken to state there were ‘no significant differences in pre or post group mean scores when comparing means with and without these participants included.’ However, I did wonder whether using means actually replicates the problem to which this paper objects. Therefore, would it be prudent to subject the analysis of this subgroup of movers to the type of analysis the paper later demands?

There is effective use of data from study 1 to illustrate the ‘problem’ of masked effects when relying on means. Equally, the interim discussion promotes a necessary focus on this issue and ways around it, however I do wonder whether presenting something a little more tangible just here – in addition to this discussion – might help convince some ‘more traditional’ readers, e.g. providing percentages of participants whose test scores improved by more than a specified amount (or at least signposting these as they appear later on).

The following sections, beginning with the new hypotheses, appear to provide a convincing case for the data and analyses presented and are suitably clear and carefully described.

The Discussion makes a clear argument for adopting the statistical approach described here and also appears to point to some flexibility over the choice of variables to be included in calculating Meta Impact: ‘researchers could use the Meta-Impact analysis to gather data on several ‘possible’ variables’. Is it possible to provide some indications of alternative variables, particularly where the availability of psychometric testing may be limited, e.g. specifying workplace behaviours, etc?

Overall, the enthusiasm for a new approach is expressed effectively and hopefully will indeed inspire others to take the much-needed steps shown by the authors. Thank you for showing the way!

On a minor point, there were some typos which I’ve listed below:

Table 1 – ‘backward’ or ‘backwards’ digit span?

On p24, should it be ‘1-5 and 0-3’ rather than ‘3-0’?

Please note typo: ‘…WM training has be widely criticised…’ (p25)

and ‘…using in a Likert scales with four or five intervals (p26)

Table 7 – ‘121’ needs making clear that this refers to condition

Graph 2 – perhaps it could be made clearer what the asterisk represents?

Table 9 - Good to have included two examples with details relevant their profiles and trajectories through the study – perhaps a little more comment on ‘idiosyncratic’ is warranted, where Table 9 is referred to at the end of the Results (p.29)?

Reviewer #2: General Comments:

1. I appreciate the invitation to review this interesting manuscript. The Authors address a difficult area in applied research of measuring intervention impact when a study population is small and does not allow matched randomized comparison of intervention and control groups.

2. As noted in the manuscript, the focus on individual experiences that may not be within a general measure of response of a target population may limit the usefulness of the intervention for application in group settings.

3. The research objective is vague as stated in the two paragraphs prior to the Study Design subsection of the manuscript. A concise and focused statement of the study objective would be helpful in understanding the study objective and importance.

4. While the intent of the research is to individualize the effect, effectiveness and possible future value of an intervention, it appears there is still a tendency to subgroup analysis and group-wise comparisons as opposed to true individualized assessment of effect. It would appear that following calculation of score determinations for individuals as described in the “4. Meta-Impact Score” subsection that each individual should be treated as an autonomous measure as opposed to being re-grouped for analysis. The individual analysis component of the research should be more specifically identified and explained.

5. As noted in the discussion of study limitations, the dichotomization fo data is highly suspect for unintentional bias and error.

Specific Comments:

Page 2 or main manuscript: Please delete the phrase “and so on”.

2. “Introduction to the Meta-Impact Score”: The definition of this scoring system as described in this section refers to two main demarcations. Please list these demarcations as the comparison of subgroup improved performance in the intervention and control group is well described, but a second demarcation is not well identified.

**********

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: Yes: Samuel J. Stratton, MD, MPH

[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.

Does it work? Using a Meta-Impact score to examine global effects in quasi-experimental intervention studies.

PONE-D-21-08221R1

Dear Dr. Doyle,

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,

Guest Editor

PLOS ONE

Additional Editor Comments (optional):

Dear Author

Thank you so much for making the necessary amendments to your paper in accordance with the suggestions of both reviewers. I have noted a small number of minor errors (please see below) which you might like to address in the final version for publication. I have relayed my decision as guest editor to the senior editor with whom the final decision to publish rests.

all best wishes

Guest editor

Page 13, paragraph 1: the two sentences at the end of this paragraph should be amalgamated, so it reads, ‘…The low correlations…provided…etc’.

Page 19, paragraph 2: please check it and it’s are both intended in sentence which reads, ‘…tangible effect it creates its ‘Real World Value’.

Page 20, in section headed, ‘Defending a dichotomization’, please amend to indicates in sentence which reads, ‘Note that at the individual level of analysis, the presence of a score of =/>1, indicate success…’

Page 22, end of first paragraph: please delete ‘and’ from last sentence which currently reads, ‘Self-efficacy did not seem to contribute much to the Meta-Impact (only one improvement) with and all other measures improving…’

Page 23, in section headed, ‘CS2 Results’, please separate words as currently reads, ‘S8 Tableshows the…’

Page 23, line 6 of same section contains, ‘eight (out of 26; )’ – please amend.

Page 25, where it states, ‘Our improvement score delineation facilitates nuance at the group level by sacrificing it at the individual level’. It might just be me, but please check this is the way round you intend it to read, and whether indeed much has been sacrificed, or rather prioritised?

Page 27, line 5: should it read as, ‘…between intervention and control groups measure’ or ‘measured’?

References

2. Please relocate ‘p’ at end of reference

10. Is the journal title missing?

13. Is ‘BPS editor’ correct? If you prefer, there is a weblink: https://www.bps.org.uk/news-and-policy/psychology-work-improving-wellbeing-and-productivity-workplace

51. Should title be in block capitals?

Reviewers' comments: