Providing ambulatory healthcare for people aged 80 and over: Views and perspectives of physicians and dentists from a qualitative survey

Angélique Herrler; Lisa Valerius; Anna Greta Barbe; Vera Vennedey; Stephanie Stock

doi:10.1371/journal.pone.0272866

Peer Review History

Original SubmissionApril 14, 2022
14 Jul 2022 Decision Letter - Dylan A Mordaunt, Editor PONE-D-22-11053Providing ambulatory healthcare for people aged 80 and over: views and perspectives of physicians and dentists from a qualitative surveyPLOS ONE Dear Dr. Herrler, 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 submit your revised manuscript by Aug 28 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. 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Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. 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. 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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Thank you for your submission. This is written well and reads well. My main question is the study context including the reason for undertaking the study, age-group and study design, weren't entirely clear. With regards to the criteria for publication: 1. The study appears to present the results of original research. 2. Results reported do not appear to have been published elsewhere. 3. Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail, excepting the study question and context could be refined. 4. Conclusions are presented in an appropriate fashion and are supported by the data. 5. The article is presented in an intelligible fashion and is written in standard English. 6. The research appears to meet all applicable standards for the ethics of experimentation and research integrity. 7. The article adheres to appropriate reporting guidelines and community standards for data availability. I think the structure is clear and likely conforms to the main requirements. For studies that clearly meet a reporting format, I always suggest that the authors double-check conformance with that checklist, in this case it would be CROSS (https://www.equator-network.org/reporting-guidelines/a-consensus-based-checklist-for-reporting-of-survey-studies-cross/). [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 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 ****** 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 ****** 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: Manuscript by Herrler et al is well written. It’s an important survey which explains what outpatient healthcare systems require to provide proper care to patients aged 80 and over. I have few concerns before manuscript accepted for publication. Abstract: Line 28, how many ambulatory healthcare sectors were included in the survey. It would reflect the global scenario of the survey being held. Line 34; Author mentioned, ‘Caring for patients aged 80 and over was perceived as challenging because of its complexity…’ Are authors talking about the complexity of disease? Please elaborate. This survey was carried out in year 2021-2022. COVID situation must influence overall outpatient resources and care facility. Author could discuss this aspect in discussion section. Format of references should be consistent. Check references 28, 31, 45 All images are blurred. High quality images are required ****** 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 ******** [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. https://doi.org/10.1371/journal.pone.0272866.r001
Revision 1
21 Jul 2022 Author Response Comments on journal requirements 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. -- We checked and ensured the style requirements. -- 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. -- Participants had to confirm a mandatory online tick box regarding their consent to start the survey. We provided additional details in the methods section of the manuscript (p. 6, lines 115-116) and in the online submission information. -- 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. -- All relevant data are within the manuscript and its supporting information files (especially S3). Since the data are of qualitative nature, we provided the material only in its coded form and without sociodemographic information on case-level to ensure anonymity. We specified the respective information in the data availability statement. -- 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. -- The study itself did not receive specific funding. All work was conducted within a graduate school on gerontological research, that itself was funded by the Ministry of Culture and Research of the State of North-Rhine Westphalia. However, the graduate school has no grant number and the ministry was not involved in planning or conducting the study. We added additional information in this section to provide a better explanation of these circumstances. -- 5. 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. -- We checked and ensured the correctness of the reference list. -- Comments of the academic editor 1. Thank you for your submission. This is written well and reads well. My main question is the study context including the reason for undertaking the study, age-group and study design, weren't entirely clear. With regards to the criteria for publication: 1. The study appears to present the results of original research. 2. Results reported do not appear to have been published elsewhere. 3. Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail, excepting the study question and context could be refined. -- Thank you very much for your feedback. We complemented and specified the study background to further explain why we focused on the age group 80+, found there was a need to perform a qualitative explorative study among physicians and dentists, and also on the reasons to choose the specific design of a qualitative survey. Details including additional references were added in the introduction (p. 4, lines 52-53, 63-69, p. 5 lines 83-87, 98-99, p. 6 lines 100-105) and the methods section (p. 7, lines 137-140). -- 2. 4. Conclusions are presented in an appropriate fashion and are supported by the data. 5. The article is presented in an intelligible fashion and is written in standard English. 6. The research appears to meet all applicable standards for the ethics of experimentation and research integrity. 7. The article adheres to appropriate reporting guidelines and community standards for data availability. I think the structure is clear and likely conforms to the main requirements. For studies that clearly meet a reporting format, I always suggest that the authors double-check conformance with that checklist, in this case it would be CROSS (https://www.equator-network.org/reporting-guidelines/a-consensus-based-checklist-for-reporting-of-survey-studiescross/). -- Thank you for suggesting CROSS as reporting guideline. We were uncertain about referrals to reporting guidelines since there is none specifically for qualitative surveys. Because generally, this is a qualitative study, we primarily relied on COREQ. However, to ensure proper reporting of the elements of a survey design, we now also consulted CROSS and incorporated all information requirements as far as they were applicable to a qualitative survey. We added this explanation in the methods section (p. 6, lines 117-120). Moreover, we added details regarding response rates and repeated participation in the strengths and limitations section after checking CROSS (p. 33, lines 591-596). -- Comments of reviewer 1 1. Manuscript by Herrler et al is well written. It’s an important survey which explains what outpatient healthcare systems require to provide proper care to patients aged 80 and over. I have few concerns before manuscript accepted for publication. -- Thank you very much for your appreciation. -- 2. Abstract: Line 28, how many ambulatory healthcare sectors were included in the survey. It would reflect the global scenario of the survey being held. -- Thank you for this suggestion. We added the information that all medical specialties apart from child and adolescent healthcare we eligible (p. 2, lines 29-30). Moreover, we complemented information on the finally included specialties (p. 2, lines 34-36). -- 3. Line 34; Author mentioned, ‘Caring for patients aged 80 and over was perceived as challenging because of its complexity…’ Are authors talking about the complexity of disease? Please elaborate. -- Thank you for this comment. We specified what is meant by complexity on page 2, lines 37-38. -- 4. This survey was carried out in year 2021-2022. COVID situation must influence overall outpatient resources and care facility. Author could discuss this aspect in discussion section. -- Thank you very much for this important remark. We complemented the discussion with an overview on how the pandemic affected ambulatory healthcare in Germany in general, and what this might mean for the interpretation of our results (p. 30-32, lines 540-574). -- 5. Format of references should be consistent. Check references 28, 31, 45 -- Thank you for this comment, we checked the references accordingly. -- 6. All images are blurred. High quality images are required -- Thank you for this comment. This seems to be a problem of implementation while the complete submission PDF is built. When clicking on “access/download figure”, the figures appeared as intended. We will carefully check the appearance of the figures during the resubmission process. -- Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0272866.r002
28 Jul 2022 Decision Letter - Dylan A Mordaunt, Editor Providing ambulatory healthcare for people aged 80 and over: views and perspectives of physicians and dentists from a qualitative survey PONE-D-22-11053R1 Dear Dr. Herrler, 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, Dylan A Mordaunt, MD, MPH, FRACP Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for your resubmission. This now meets the criteria for publication. Reviewers' comments: https://doi.org/10.1371/journal.pone.0272866.r003
Formally Accepted
5 Aug 2022 Acceptance Letter - Dylan A Mordaunt, Editor PONE-D-22-11053R1 Providing ambulatory healthcare for people aged 80 and over: views and perspectives of physicians and dentists from a qualitative survey Dear Dr. Herrler: 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 Associate Professor Dylan A Mordaunt Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0272866.r004

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