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PONE-D-21-32052The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysisPLOS ONE

Dear Dr. Launders,

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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Academic Editor

PLOS ONE

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“This study was supported by Public Health England (PhD2019/002 - NL), the Wellcome Trust (211085/Z/18/Z - JFH), the Medical Research Council (MC\\PC\\17216 - DPJO), University College London Hospitals NIHR Biomedical Research Centre (NL, DPJO, JFH) and the NIHR ARC North Thames Academy (DPJO, JFH).

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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: Yes

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

Reviewer #1: Yes

Reviewer #2: 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: 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: 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: The present Systematic Review and Meta-analysis aimed at identifying the hospital utilization's rates in people affected by SMI with a comorbid physical health condition. The topic is interesting and the authors made a huge effort in summarizing the available evidence, choosing multiple outcomes and health conditions.

I have a few comments that, in my opinion, may help to improve or clarify the manuscript:

- The search was conducted until March 2020. Since 2 years have passed, I think that the authors should update their original search to detect the most current studies on the topic. Additionally, I suggest to put the complete data (dd/mm/yyyy) in the main text to allow an easier reproducibility;

- Which definition of SMI did the authors adopt? I think that they should specify how they define SMI. For example, they excluded the MDD from their SMI definition (line 89), while it is included as SMI in other studies;

- Did you include only those studies adopting DSM/ICD criteria to make a diagnosis of SMI? If not, why?

- Line 117, the authors used a score of 6 as a cut-off to divide low and high-risk of bias studies. I think that the authors should motivate their decision as it could seem arbitrary (i.e., citing other studies adopting the same method);

- The Cohen's Kappa is 0.57 that is quite low compared to other reviews. I think that the authors should double-check this passage and consider to add it as a limitation;

- Table 1, I think it could be useful to add a column in which reporting the study design;

- Line 308, could you please rephrase this sentence? It appears quite unclear to me

Reviewer #2: The authors appropriately performed statistical analysis. The results are exhaustively presented and adequately discussed in the light of the most recent literature evidence. Compared to the relevant meta-analysis performed by Ronaldson A. et al. (2020), the present MA has the advantage of assessing the outcomes separately for the five medical comorbidities examined, thus adding a relevant contribution to the field.

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Reviewer #1: No

Reviewer #2: Yes: martina billeci

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The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis

PONE-D-21-32052R1

Dear Dr. Launders,

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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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,

Giuseppe Carrà, 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

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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

**********

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

Reviewer #1: 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

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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

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6. Review Comments to the Author

Reviewer #1: The authors updated their search string and implemented most of my suggestions.

Thank you so much!

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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: No

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