PONE-D-21-18799The Effects of Mindfulness-Based Interventions on Symptoms of Depression, Anxiety, and Cancer-Related Fatigue in Oncology Patients: A Systematic Review and Meta-AnalysisPLOS ONE

Dear Dr. Kiropoulos,

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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The systematic review summarizes the current finding on mindfulness stress reduction therapy in cancer related depression, anxiety and fatigue. The reviewer was pleased with the work but pointed out a few issues on the search strategy, excluded studies and biases, as well as the grey literature. Please address these comments (Please see the detailed in the Reviewer's comments). In addition to the comments from the reviewers, please find the editorial comments below:

1. In the Abstract: 

1.1 Search strategy, search strategy, key words and time line should be summarized in the Methods of the Abstract.

1.2 Please define your conclusion whether mindfulness reduces the symptoms from cancer or not.

2. In the Introduction:

Please clearly define these terms: Mindfulness-Based Stress Reduction18 (MBSR), Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Cancer Recovery (MBCR). 

3. in the Methods:

3.1 Define more clearly exclusion criteria. For example, I would imagine you exclude case reports, case series, reviews, etc. (and non-English literature?)

3.2 Did you do extensive search of the references for the reviews of full text articles? 

3.3 Please add information on Grey literature (see also Reviewer's comments).

4. In Results:

 Can we have a graph to show something like effect sizes from each modality?

5. In the Discussion:

5.1  Please add a discussion on the implications with other types of patients, end stage cancer v.s. cancer treatable/inremission

5.2 Please also discuss clinical trials or studies that may not be reported, grey literature, theses, etc.

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We look forward to receiving your revised manuscript.

Kind regards,

Sompop Bencharit, DDS, MS, PhD, FACP

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

The systematic review summarizes the current finding on mindfulness stress reduction therapy in cancer related depression, anxiety and fatigue. The reviewer was pleased with the work but pointed out a few issues on the search strategy, excluded studies and biases, as well as the grey literature. Please address these comments (Please see the detailed in the Reviewer's comments). In addition to the comments from the reviewers, please find the editorial comments below:

1. In the Abstract:

1.1 Search strategy, search strategy, key words and time line should be summarized in the Methods of the Abstract.

1.2 Please define your conclusion whether mindfulness reduces the symptoms from cancer or not.

2. In the Introduction:

Please clearly define these terms: Mindfulness-Based Stress Reduction18 (MBSR), Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Cancer Recovery (MBCR).

3. in the Methods:

3.1 Define more clearly exclusion criteria. For example, I would imagine you exclude case reports, case series, reviews, etc. (and non-English literature?)

3.2 Did you do extensive search of the references for the reviews of full text articles?

3.3 Please add information on Grey literature (see also Reviewer's comments).

4. In Results:

Can we have a graph to show something like effect sizes from each modality?

5. In the Discussion:

5.1 Please add a discussion on the implications with other types of patients, end stage cancer v.s. cancer treatable/inremission

5.2 Please also discuss clinical trials or studies that may not be reported, grey literature, theses, etc.

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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

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

Reviewer #1: I Don't Know

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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

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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

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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: Thank you for this well conducted systematic review and meta-analysis. I have just a few recommendations and questions:

Recommend more fully addressing item 7 of the PRISMA checklist to provide the full search strategy used for at least one database, including the keywords and controlled vocabulary with the Boolean operators used.

Regarding PRISMA checklist item 23c - discuss any limitations of the review processes used - Please address this item more fully. For example, note that search results were limited to those in English and the impact this may have had on the review

Please comment on your choice not to search any sources of grey literature, such as conference abstracts or dissertations, as recommended by the Cochrane Collaboration, https://handbook-5-1.cochrane.org/ Perhaps address this as you further address PRISMA checklist item 23c

PRISMA flow chart - in the first box of records excluded with reasons, there are 54 items excluded due to “Publication Type.” I recommend noting which publication types were excluded.

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Reviewer #1: Yes: Erica R Brody

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The Effects of Mindfulness-Based Interventions on Symptoms of Depression, Anxiety, and Cancer-Related Fatigue in Oncology Patients: A Systematic Review and Meta-Analysis

PONE-D-21-18799R1

Dear Dr. Kiropoulos,

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,

Sompop Bencharit, DDS, MS, PhD, FACP

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for the revision.

Reviewers' comments: