A study about management of drugs for leprosy patients under medical monitoring: A solution based on AHP-Electre decision-making methods

Igor W. S. Falcão; Daniel S. Souza; Diego L. Cardoso; Fernando A. R. Costa; Karla T. F. Leite; Harold D. de M. Junior; Claudio G. Salgado; Moisés B. da Silva; Josafá G. Barreto; Patricia F. da Costa; Adriano M. dos Santos; Guilherme A. B. Conde; Marcos C. da R. Seruffo

doi:10.1371/journal.pone.0276508

Peer Review History

Original SubmissionNovember 18, 2021
17 Jan 2022 Decision Letter - Fausto Cavallaro, Editor PONE-D-21-36593Use of Multi-criteria Methods to Support Decision-Making in Drug Management for Leprosy PatientsPLOS ONE Dear Dr. FALCÃO, 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 Mar 03 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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[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: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: 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 Reviewer #2: No ****** 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: No Reviewer #2: No ****** 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 main contribution of this paper is to use MCDM models (AHP [21] and TOPSIS [27]) to Support Decision-Making in Drug Management for Leprosy Patients through the study of analyzing the drug distribution scenario in the state of Par´a in the period 2016-2020. However, the paper in the present version is not acceptable. Because the research methodology that was developed in this work and many essential subjects are not clear, moreover many mistakes (typos, grammar errors, and others) can be found in it. Nevertheless, I have the feeling that the content may be of interest. But the paper should be better written and situate its results with respect to the literature. Some comment is as follows: 1-The captions (description at figures) for figures are missing. 2-Explaining the contents of Table 1 better and writing the sentence ``The calculation of CR is given by Eq2.'' before Eq.2. 3-Explaining the prioritization patient process using (AHP) and (TOPSIS), i.e. illustrative of at least one case of a patient in the Case study. 4- Clarifying calculation of the Eigen value of the matrix, the corresponding Eigenvector, and Main Value, (Table 3 and Table 4). 5-There are several mistakes all over the text. Some of them have been corrected in the Manuscript Draft (see, attachment file) . Reviewer #2: Dear editor of PLOS ONE, The subject is "Use of Multi-criteria Methods to Support Decision-Making in Drug Management for Leprosy Patients"(PONE-D-21-36593), which is interesting and applicable. However, it will be suitable for publication if its shortcomings improve. In my view, the manuscript has several shortcomings as following; 1- In “Abstract”, the period of study stated as “… between 2015 and 2020”, but in the main body this state as “… 2016-2020”. Line 54, line 158, and line 262. 2- There is a series of superscript numbers and abbreviations in the text which must be modified in accordance with the format approved by the journal (e.g line 8, line 127, “…as per”). 3- The order of the references in the text is incorrect. For example, after the reference 8, the reference 10 comes, and after that, reference number 30, 26 and ... 4- Under the "Related Work", the authors stated FIVE related study (ref 13-17). Please discuss more study, For example, the following studies: • Gilabert-Perramon, A., Torrent-Farnell, J., Catalan, A., Prat, A., Fontanet, M., Puig-Peiró, R., . . . Badia, X. (2017). “Drug evaluation and decision making in catalonia: development and validation of a methodological framework based on multi-criteria decision analysis (MCDA) for orphan drugs”. International Journal of Technology Assessment in Health Care, 33(1), 111-120. doi:10.1017/S0266462317000149 • A Moosivand, M Rangchian, L Zarei, F Peiravian, G Mehralian, ... (2021). “An application of multi-criteria decision-making approach to sustainable drug shortages management: evidence from a developing country”. Journal of Pharmaceutical Health Care and Sciences 7 (1), 1-11 • Vinayak Vishwakarma, Chandra Prakash, Mukesh Kumar Barua.(2016).” A fuzzy-based multi criteria decision making approach for supply chain risk assessment in Indian pharmaceutical industry”. International Journal of Logistics Systems and Management. Vol. 25, No. 2. pp 245-265 • Jason C. Hsu , Jia-Yu Lin, Peng-Chan Lin, Yang-Cheng Lee (2019). “Comprehensive value assessment of drugs using a multi-criteria decision analysis: An example of targeted therapies for metastatic colorectal cancer treatment”. PLOS ONE. https://doi.org/10.1371/journal.pone.0225938. 5- The figure’s number in the manuscript and PDF provided for review does not match. 6- There are occasional minor typos in the manuscript. For example, “in homogeneous” instead to “inhomogeneous”. 7- In line 265-266, the authors stated that “…three factors: (a) the low quantity of medications distributed in the basic health units; (b) the in homogeneous distribution of medications; (c) patient evasion.” I did not understand the concept of "patient evasion ". I think here there is a need to add an explanation. 8- What is the meaning of "the responsible agencies" in line 269? 9- In line 273-274, it is stated that “It is worth noting that 273 only New Cases are patients confirmed for Leprosy”, which does not conform to the definition provided for “Relapse” in line 270. 10- The patient classification must be the same throughout the manuscript. At present, for example, for “Relapse“ in the text and figures, similar words such as recurrence etc. have been used, which need to be uniform. 11- The line 275 to 282 does not make sense. The numbers and percentages provided do not match. The sum of 18% and 43% is equal to 61%, which is equal to 616 out of 1010 patients. 12- The authors have stated in line 286-288 that “This condition is a function established by professionals of the field, who take into consideration several clinical, laboratory and neurological attributes to define the treatment burden.” Please provide more information about the composition and number of experts participating in the study. 13- It is expected that few of the readers of this journal are familiar with the analysis method applied by the authors. In order to make it easier for novice readers to understand the contents, please provide additional explanations on the meaning of the weights in the tables and the interpretation of the results (numerical values). 14- The authors do not discuss the implications of their findings. Doing so would make the study more interesting to the reader and actually support potential policy changes. I suggest starting the discussion by repeating the objective of the study and followed by each main finding that answered each specific research questions. 15- Overall the discussion section need to be added, and must be written exactly. ****** 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 Reviewer #2: 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. Attachments Attachment Submitted filename: Dear Associate Editor.docx https://doi.org/10.1371/journal.pone.0276508.r001
Revision 1
9 Sep 2022 Author Response Dear Editor, We thank again the evaluations of the two reviewers regarding the article “Use of Multi-criteria Methods to Support Decision-Making in Drug Management for Leprosy Patients”. Thus, after evaluating what was indicated by the reviewers, several pertinent points were considered, which led us to a profound restructuring of the manuscript, aiming to make it even more coherent and with better results. Thus, we highlight the following points: -The use of the analytical model AHP and TOPSIS, which was used in the initial version of the article, was rethought. After testing with other models, it was found that the hybrid use of AHP with ELECTRE II (instead of TOPSIS) generated more reliable results for leprosy drug decision making. Therefore, the new version of the paper brings results from the combination of AHP and ELECTRE II. -With the aforementioned change in the decision model, more accurate results were obtained, thus, it was necessary to restructure the sections of the article, so the TOPSIS section was renamed as ELECTRE II (Abstract, Introduction, Related Work, Material and Methods, Case Study, Results, Conclusion). -The title of the article "Use of Multi-criteria Methods to Support Decision-Making in Drug Management for Leprosy Patients" is consistent with the proposal, even after the modifications suggested by the reviewers and the change in the analytical model. However, the title "A Study About Management of Drugs for Leprosy Patients Under Medical Monitoring: A Solution Based on AHP-Electre Decision-Making Methods" makes the solution of the study even more evident. -With the amount of adjustments mentioned above, added with the indication of the Reviewers, comments, of English revision, it was necessary the invitation of one more author ADRIANO MADUREIRA DOS SANTOS, who was responsible for generating new results and performing a complete revision of the English writing. Therefore, this author was added to the list of authors. The authors of the paper (PONE-D-21-36593R1) would like to express their gratitude for the valuable comments and advice of the reviewers; we believe that these changes have improved the quality and readability of the paper. The captions (description at figures) for figures are missing. Authors’ response: The manuscript has been adjusted, adding the correct description and caption for the figures. Explaining the contents of Table 1 better and writing the sentence ``The calculation of CR is given by Eq2.'' before Eq.2. Authors’ response: The description in table 1 of the AHP section has been adjusted as requested. (Material and Methods section, AHP subsection, page 7) Explaining the prioritization patient process using (AHP) and (TOPSIS), i.e. illustrative of at least one case of a patient in the Case study. Authors’ response: All the items mentioned have been corrected, illustrating the patient examples in the case study (Material and Methods section, Case Study subsection, page 8). Clarifying calculation of the Eigen value of the matrix, the corresponding Eigenvector, and Main Value, (Table 3 and Table 4). Authors’ response: The table 3 and 4 corresponding Eigenvector items were correctly adjusted. (Results section, page 10). There are several mistakes all over the text. Some of them have been corrected in the Manuscript Draft (see, attachment file). Authors’ response: We have carried out an extensive spelling check, removing redundancies and typos throughout the text. In “Abstract”, the period of study stated as “… between 2015 and 2020”, but in the main body this state as “… 2016-2020”. Line 54, line 158, and line 262. Authors’ response: The cited excerpt from the abstract was adjusted according to the request (abstract, page 1). There is a series of superscript numbers and abbreviations in the text which must be modified in accordance with the format approved by the journal (e.g line 8, line 127, “…as per”). Authors’ response: We have carried out an extensive spelling check, correcting the mentioned items and checking the journal format. The order of the references in the text is incorrect. For example, after the reference 8, the reference 10 comes, and after that, reference number 30, 26 and ... Authors’ response: New references have been added to the manuscript. Thereon, the order of the references were adjusted according to the request. Under the "Related Work", the authors stated FIVE related study (ref 13-17). Please discuss more study, For example, the following studies: Authors’ response: All references recommended by the reviewers were added in the related work section of the manuscript (Related work, page 3). -Gilabert-Perramon, A., Torrent-Farnell, J., Catalan, A., Prat, A., Fontanet, M., Puig-Peiró, R., . . . Badia, X. (2017). “Drug evaluation and decision making in catalonia: development and validation of a methodological framework based on multi-criteria decision analysis (MCDA) for orphan drugs”. International Journal of Technology Assessment in Health Care, 33(1), 111-120. doi:10.1017/S0266462317000149. -A Moosivand, M Rangchian, L Zarei, F Peiravian, G Mehralian, ... (2021). “An application of multi-criteria decision-making approach to sustainable drug shortages management: evidence from a developing country”. Journal of Pharmaceutical Health Care and Sciences 7 (1), 1-11. -Vinayak Vishwakarma, Chandra Prakash, Mukesh Kumar Barua.(2016).”A fuzzy-based multi criteria decision making approach for supply chain risk assessment in Indian pharmaceutical industry”. International Journal of Logistics Systems and Management. Vol. 25, No. 2. pp 245-265. -Jason C. Hsu , Jia-Yu Lin, Peng-Chan Lin, Yang-Cheng Lee (2019). “Comprehensive value assessment of drugs using a multi-criteria decision analysis: An example of targeted therapies for metastatic colorectal cancer treatment”. PLOS ONE. https://doi.org/10.1371/journal.pone.0225938. The figure’s number in the manuscript and PDF provided for review does not match. Authors’ response: The figure’s number order in the PDF format in the manuscript were adjusted according to the review. There are occasional minor typos in the manuscript. For example, “in homogeneous” instead to “inhomogeneous”. Authors’ response: We have carried out an extensive spelling check, removing redundancies and typos throughout the text. In line 265-266, the authors stated that “…three factors: (a) the low quantity of medications distributed in the basic health units; (b) the in homogeneous distribution of medications; (c) patient evasion.” I did not understand the concept of "patient evasion ". I think here there is a need to add an explanation. Authors’ response: The cited sentence was adjusted in the manuscript, improving the explanation of items such as "patient evasion" that can confuse the reader (Material and Methods section, Case Study subsection, page 8). What is the meaning of "the responsible agencies" in line 269? Authors’ response: The mentioned expression was removed, with the aim of improving the understanding of the manuscript. In line 273-274, it is stated that “It is worth noting that 273 only New Cases are patients confirmed for Leprosy”, which does not conform to the definition provided for “Relapse” in line 270. Authors’ response: The manuscript has been adjusted, correcting the amount expressed in the text relapse cases (Results section, page 9). The patient classification must be the same throughout the manuscript. At present, for example, for “Relapse“ in the text and figures, similar words such as recurrence etc. have been used, which need to be uniform. Authors’ response: The manuscript has been adjusted, meeting all reviews in relation to the items mentioned (Material and Methods section, Case Study subsection, page 9). The line 275 to 282 does not make sense. The numbers and percentages provided do not match. The sum of 18% and 43% is equal to 61%, which is equal to 616 out of 1010 patients. Authors’ response: The percentage of new cases and relapse was adjusted in the manuscript, meeting the requested correlation (Material and Methods section, Case Study subsection, page 9). The authors have stated in line 286-288 that “This condition is a function established by professionals of the field, who take into consideration several clinical, laboratory and neurological attributes to define the treatment burden.” Please provide more information about the composition and number of experts participating in the study. Authors’ response: An explanation of the types of experts and people who participated in the study was added to the manuscript. This condition improved the explanation of the scenarios and the attributes of the experiment's inputs (Material and Methods section, Case Study subsection, page 9). It is expected that few of the readers of this journal are familiar with the analysis method applied by the authors. In order to make it easier for novice readers to understand the contents, please provide additional explanations on the meaning of the weights in the tables and the interpretation of the results (numerical values). Authors’ response: A new explanation about the meaning of the weights in the tables has been added to results, in order to facilitate the explanation of the input data in the manuscript (Results section, page 10). The authors do not discuss the implications of their findings. Doing so would make the study more interesting to the reader and actually support potential policy changes. I suggest starting the discussion by repeating the objective of the study and followed by each main finding that answered each specific research questions. Authors’ response: The text underwent an extensive spelling check, where new items were added in its structure with the aim of improving its presentation and its discussion of the contributions. Overall the discussion section need to be added, and must be written exactly. Authors’ response: The text underwent an extensive spelling check. The manuscript underwent an extensive revision in its structure, where new elements were added and a discussion was made of certain of the main contributions of the text, as the benefits of a study of this nature for the academy and on the social impact of the study We are grateful to the reviewers for all their advice and will be very pleased to add any further information if this is required. Thank you for your kind attention. Yours sincerely, Attachments Attachment Submitted filename: Response to Reviewers.pdf https://doi.org/10.1371/journal.pone.0276508.r002
10 Oct 2022 Decision Letter - Fausto Cavallaro, Editor A Study About Management of Drugs for Leprosy Patients Under Medical Monitoring: A Solution Based on AHP-Electre Decision-Making Methods PONE-D-21-36593R1 Dear Dr. FALCÃO, 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, Fausto Cavallaro, PhD Academic Editor PLOS ONE Additional Editor Comments: The authors addressed the reviewers comments. The paper can be accepted. 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: (No Response) ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) ****** 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: (No Response) ****** 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: (No Response) ****** 6. 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: (No Response) ****** 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 ******** https://doi.org/10.1371/journal.pone.0276508.r003
Formally Accepted
8 Nov 2022 Acceptance Letter - Fausto Cavallaro, Editor PONE-D-21-36593R1 A Study About Management of Drugs for Leprosy Patients Under Medical Monitoring: A Solution Based on AHP-Electre Decision-Making Methods Dear Dr. Falcão: 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 Professor Fausto Cavallaro Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0276508.r004

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