PONE-D-21-21132Efficacy and safety of combined oral sucrose and nonnutritive sucking in pain management for infants: A systematic review and meta-analysisPLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Partly

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

Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

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Reviewer #1: Interesting, well written and well designed review and meta--analysis on efficacy and safety of non-pharmacological interventions on pain relief in infants.

Here my comments:

- introduction:once you introduce the abbreviation e.g OS, I suggest to use it instead of repeating oral sucrose.

- methods: please clarify if the research was restricted for english language articles or not; the statements were not clear for this point.

- discussion: you were discussiong about non pharamcological intervention; I think that citing studies about ketorolac was unnecessary.

Reviewer #2: The authors have made great efforts in doing this systematic review and meta-analysis. There are few concerns :

1. How was the cross over trial managed and which data was included in the meta-analysis is not mentioned. The methods section should clearly indicate how the cross-over designs will be dealt with.

2. The forests plots show critical levels of heterogeneity despite the subgroup analysis. The manuscript doesn't describe any efforts to explore the reasons for this heterogeneity. It is also worth considering if the meta-analysis with such high level of heterogeneity is required. If yes please add few lines about exploring heterogeneity. It is acceptable to have unexplained heterogeneity but a justification and reasoning with references is required.

3. Authors have interpreted the funnel plot as showing publication bias. It would be better to add Eggers test and then describe the funnel plots. Only consider funnel plots if number of studies in an analysis are more then 10

4. Authors have mentioned "sensitivity analysis conducted on 2 aspects..." please describe these 2 aspects and also add some details about sensitivity analysis in the method section

5. Overall a relook at the grammar and rephrasing of certain sentences is advised.

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Reviewer #1: No

Reviewer #2: No

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Efficacy and safety of combined oral sucrose and nonnutritive sucking in pain management for infants: A systematic review and meta-analysis

PONE-D-21-21132R1

Dear Dr. Zou,

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,

Girish Chandra Bhatt, MD, FASN

Academic Editor

PLOS ONE

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