Peer Review History

Original SubmissionDecember 7, 2021
Decision Letter - Walid Kamal Abdelbasset, Editor

PONE-D-21-38630Online Parent Training Platform for complementary treatment of Disruptive Behavior Disorders in Attention Deficit Hyperactivity Disorder: a randomized controlled trial protocolPLOS ONE

Dear Dr. Chequer de Castro Paiva,

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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We look forward to receiving your revised manuscript.

Kind regards,

Walid Kamal Abdelbasset, Ph.D.

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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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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

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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

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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

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

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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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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

Reviewer #2: 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: A very interesting piece of experiment. The topic is a subject which has a great need for studies and trials and I am thrilled to see this trial. The ADHD treatment is quite complex and requires ongoing monitoring and the current available treatment protocols are not obviously the most desired treatment plans. Therefore observing the new treatment and alternative plans is a breath of fresh air. Thanks

Reviewer #2: The topic is really interesting to investigate especially in a country like Brazil where utilization of low cost healthcare services in underserved communities is a main need. Yet, I have some questions and comments regarding the methodology:

1)Why did you chose male gender only?

2)Would it be possible for more than one caregiver of the same patient to join the study?

3)The possibility of watching online videos more than once might be a potential bias since patients in the face to face group won't have the same option to revisit the material.

4)why didn't you do the post-session knowledge assessment to both face to face and online groups?

5) Will the effect of pharmacotherapy regarding dosing and type of medications be controlled during randomization of patients as it might be a major confounding factor regarding the patient outcomes.

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Reviewer #1: Yes: Dr Lily Abedipour MD

Reviewer #2: No

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Revision 1

Dear Editor and Reviewers,

Many thanks for your careful revision.

Regarding journal requirements, we have re-reviewed the list of references and PLOS ONE's style requirements. About repository information for our data, the current manuscript does not have preliminary data. The results of the study will be published once the research is completed and deidentified data will be made to be available under reasonable request to the correspondent author. We added this information to the cover letter.

Below are answers to the questions raised by Reviewer #2

Why did you choose male gender only?

In order to have a representative sample of the studied population, since the prevalence is much higher in boys and our number of participants is relatively small. Also, the clinical presentation of ADHD in girls can be very different (Hinshaw, 2018).

Hinshaw SP. Attention Deficit Hyperactivity Disorder (ADHD): Controversy, Developmental Mechanisms, and Multiple Levels of Analysis. Annu Rev Clin Psychol. 2018 May 7;14:291-316. doi: 10.1146/annurev-clinpsy-050817-084917. Epub 2017 Dec 8. PMID: 29220204.

2)Would it be possible for more than one caregiver of the same patient to join the study?

Yes, it is even recommended that all primary caregivers participate (Kazdin,2005). In the pre-intervention evaluation, there is a question that seeks to investigate the caregivers' intention to participate and in the post-intervention evaluation, a question that seeks to quantify the size of the actual participation of each caregiver.

A change has been made to the text with the intention of clarifying this issue. The change can be found in last paragraph of the "Eligibility criteria" session:

“If there is more than one primary caregiver, it is recommended that everyone participate in the intervention. The effective participation of caregivers will be reported and analyzed along with the results.”

3)The possibility of watching online videos more than once might be a potential bias since patients in the face-to-face group won't have the same option to revisit the material.

A fundamental difference from the face-to-face group is the frequent contact with the therapist, who helps parents in the application and not only in the exposure of the content, so we understand that each of the groups has specific favorable aspects inherent to the delivery format of intervention. This can be considered an important strategy to transform a face-to-face intervention into a fully self-directed model. This change must necessarily have materials and strategies to facilitate learning (Breitenstein et al., 2014).

Breitenstein, S. M., Gross, D., & Christophersen, R. (2014). Digital delivery methods of parenting training interventions: a systematic review. Worldviews on Evidence-Based Nursing / Sigma Theta Tau International, Honor Society of Nursing, 11(3), 168–176.

4) Why didn't you do the post-session knowledge assessment to both face to face and online groups?

We understand that the evaluation after each session in the face-to-face group was not necessary since the feedback of the learned content is immediate during the session, including the therapist's considerations and interventions to verify that the content is clear and that the participant has no doubts about its application to the case. The idea of the test after the online modules would be precisely to fill the information gap and to rise potential frails.

5) Will the effect of pharmacotherapy regarding dosing and type of medications be controlled during randomization of patients as it might be a major confounding factor regarding the patient outcomes.

Pharmacological treatment will be conducted by the medical team, following standard protocol and concomitantly with parent training. Frequency of drug treatment and medium dose will be described along with the results and specific statistical analyzes can be performed according to the results. The intent of the study is to verify the effectiveness of parent training as a complementary treatment to standard care.

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Walid Kamal Abdelbasset, Editor

Online Parent Training Platform for complementary treatment of Disruptive Behavior Disorders in Attention Deficit Hyperactivity Disorder: a randomized controlled trial protocol

PONE-D-21-38630R1

Dear Dr. Chequer de Castro Paiva,

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,

Walid Kamal Abdelbasset, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #2: Yes

**********

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 #2: Yes

**********

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 #2: Yes

**********

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

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 #2: Yes

**********

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 #2: Yes

**********

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 #2: All comments from first review were answered properly and minor edit was done accordingly so the manuscript is ready to proceed to next level

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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 #2: Yes: Ahmed Abdelkarim

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Formally Accepted
Acceptance Letter - Walid Kamal Abdelbasset, Editor

PONE-D-21-38630R1

Online Parent Training Platform for complementary treatment of Disruptive Behavior Disorders in Attention Deficit Hyperactivity Disorder: a randomized controlled trial protocol

Dear Dr. Chequer de Castro Paiva:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Walid Kamal Abdelbasset

Academic Editor

PLOS ONE

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