PONE-D-21-35789

The effect of mother-infant group music classes on postnatal depression – a systematic review protocol

PLOS ONE

Dear Dr. Colella,

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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?

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: Review: The effect of mother-infant group music classes on postnatal depression – a systematic review protocol

Altogether, I think this is an interesting research proposal with direct impact on clinical and societal practice. The authors propose a thorough systematic review that follows all relevant guidelines, and I believe that it is a well thought-out setup. I also appreciate the intersectional approach of the proposed analysis, where the authors propose to also look at mothers who are socially disadvantaged.

However, I do think there are some concerns that the authors should address in their study. These are mainly concerned with the inclusion criteria regarding postpartum depression and the risk of selection bias and drop-outs in the studies that are included in the review, which could skew the overall results. I believe that taking these factors into account could improve the quality and generalizability of this study.

- One of the main outcomes of the study is postnatal depression. Could the authors maybe specify which kind of outcomes they will include? Will they only include studies that conducted clinical interviews or clinically validated questionnaires, or will they also include studies that used other questions to measure postpartum depression?

- I see that the inclusion criteria also do not contain a “threshold” or criterium for postpartum depression. Do the authors propose to include all studies that look at effects of music classes on postnatal depression, even when the studies only included women without postpartum depression? Or do they plan to only include studies which included women with postpartum depression, and if so, what are the diagnosis criteria?

o A short note on the reporting of the participant demographics:

I think it is also important to report participants’ level of postpartum depression before the onset of the study, so that it is clear to which postpartum depression group the results can be generalized.

- I see that the authors propose to include all studies on group music classes, regardless of the setting in which the class is organized. This might induce a possible “interest bias”, where mothers who are actively seeking out music classes are more likely to participate and benefit from the classes. Do the authors plan on addressing a form of “interest bias”, meaning women who are more interested in the classes might join the classes?

o This form of interest bias could be accounted for through only including studies which have a control group or “regular care” group as comparison group, but the authors propose to also include studies that have no control group. Do they plan on conducting separate meta-analyses or comparisons for studies with or without a control group?

- My other concern in the included studies is the amount of time and effort it will take the participating mothers to participate in the music classes. These classes could take quite some time, maybe during the day on work days, meaning that maybe mothers with more time on their hands and mothers who feel more motivated and “up for it” might be more likely to complete the study. This could introduce a form of selective drop-out bias, where mothers who have less time or energy might be more likely to drop out.

o How do the authors plan on addressing drop-out participants per study, and the possible bias this introduces in the results?

- Motherhood and maternity leave are also very dependent on national contexts. The authors do propose to do a subgroup analysis for studies which include socially disadvantaged mothers, but do they plan on accounting for or reporting other international differences, such as national policies on maternity leave or the amount of involvement of the other parent?

o It could be interesting to report the setting in which participating mothers are in, for example, do the music classes take place in the evenings or during maternity leave so that they do not have to take time off work?

Altogether, I appreciate the rather practical approach of the proposed review. I believe that this study could be an interesting starting point to consider the feasibility of music classes for women with postpartum depression, especially considering the possible improvement of social support and maternal-infant bonding for participating women. I wish the researchers the best of luck with this interesting line of research!

Reviewer #2: I thank the Editor and authors for the opportunity to review a manuscript. The paper has overall a very good technical content and it’s easily readable. I congratulate the authors on a very interesting proposal of a systematic review with a meta-analysis. I also believe the importance of this review paper. I offer the following minor comments.

1. The authors provided information for the review in the context of what is already known. However, they wrote that “are not aware of any systematic reviews specifically addressing the effect of mother-infant group music classes on postnatal depression”. It was not clearly stated in the manuscript that a search of resources for existing or ongoing reviews was taken. I recommend to add information what kind of resources/databases have been checked to ensure the current review is justified.

2. I would recommend to consider the piloting the study selection process by applying the inclusion criteria to a sample of papers in order to check that they can be reliably interpreted and that they classify the studies appropriately.

3. Please state how extracting data from multiple reports of the same study will be done (Each report separately, then combine information across multiple data collection forms OR data from all reports directly into a single data collection form.)

4. Please expand all abbreviations used in the manuscript. eg, EPDS, GAD 7, PHQ-9 was not explained while WHO abbreviation was introduced two times.

5. I found that a searching strategy is dedicated to RCTs, and since the authors plan to include non-randomized studies as well, it might be wise to not add keywords as “Randomized Controlled Trials” or “Random Allocation”.

6. At the same time, I would be pleased if the authors could consider to restrict the eligibility criteria to RCTs only for the reliability of the data. And if so, my previous comment (no 5) would be not relevant then.

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Reviewer #1: No

Reviewer #2: Yes: Łucja Bieleninik

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Attachments

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Submitted filename: Peer review PLOS one _complete.docx

The effect of mother-infant group music classes on postnatal depression – a systematic review protocol

PONE-D-21-35789R1

Dear Dr. Colella,

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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Kind regards,

Jianhong Zhou

Staff 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 #1: Yes

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 #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Reviewer #1: Yes

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 #1: Yes

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 #1: Yes

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 #1: I think the authors provided very well-thought out and thorough answers to the reviewer comments, and their clarifications have improved the proposal strongly. I wish them the best of luck conducting this interesting review!

Reviewer #2: Dear authors,

thank you for your careful revision of your manuscript. It was a pleasure to read this revised manuscript, and I appreciate the author’s consideration of my previous feedback. This manuscript is stronger since the initial submission. All comments have been addressed satisfactorily.

Best regards!

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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

Reviewer #2: No

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