PONE-D-22-22131A cross-sectional analysis of podiatrist-initiated review processes after issuing prescribed foot orthosesPLOS ONE

Dear Dr. Donnan,

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. 

Specifically1. Please respond to all comments raised by reviewer 1 and 2.2. Please align the reporting of your survey results with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).

Please submit your revised manuscript by Oct 09 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.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Matthew Carroll, PhD., MEdL., MPod., BHSc

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

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.

Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”).

For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research.

3. Thank you for stating the following in the Acknowledgments Section of your manuscript: 

"The authors would like to acknowledge Gail Fuller from the Spatial Data Analysis Network (SPAN) at Charles Sturt University for her assistance in preparing and administering the online questionnaire."

We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. 

Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: 

"We acknowledge financial support provided by Charles Sturt University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

[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

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: 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

Reviewer #2: 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: Thank you for the opportunity to review the manuscript titled ‘A cross-sectional analysis of podiatrist-initiated review processes after issuing prescribed foot orthoses’. While it fits the journal of submission, I would have thought a podiatry-focused journal may have been the target audience. However, whilst it is a relatively niche topic, the general principle related to duty of care, standardised practices and client centre management should have broad appeal. However again, given the journal audience, the rationale and presentation of outcomes of this survey could be stronger to enhance readership. The authors have covered the podiatry literature well but have stayed very podiatry-focused throughout. Perhaps identifying concepts such as ‘there is very little evidence on what FOs do, therefore the need to monitor their effect on clients is paramount’ – highlighting duty of care or alike may offer depth of premise as well as identifying that standards of care/guidelines need to be based on best practice principles and, in an absence of those, at least having an understanding of what is happening is a start. The argument for review times may also be strengthened by comparing to other professions – is there literature or guidelines for orthotists? Optometrists or any other profession that dispenses medical devices?

The writing style and the development of the manuscript has been well done. The authors should be commended on their efforts. I have made further suggestions below that may be helpful and identified a few things that require attention:

1. Please clarify ‘consent was implied’ – was consent gained specifically?

2. Where you have declared that ‘A third qualified author (AH) and an expert in online…’ Line 72, it would be helpful to put some references of previous work to show this author’s expertise.

3. Also good to identify how face validity was reviewed?

4. The reference for SurveyMonkey is needed (not the link to the platform itself)

5. Recruitment strategies via social media could be simplified to ‘social media associated with the Australian Podiatry Association or private pages aimed at disseminating podiatry related information’ rather than naming BTG.

6. I would recommend including a participant table in the manuscript (rather than as an appendices). It would be very beneficial to identify if the responding cohort represents the profession (e.g. compare to APHRA data).

7. As a suggestion, creating a table to display the main findings (including all participants regardless of experience) as your primary outcome alone with the impact of experience visually displayed via graphs might be beneficial. Having it all combined into the same tables means the reader needs to ‘seek’ results rather than have them displayed for them. A graph using a ‘stacked column’ approach would allow readers to see the impact of experience immediately and allow comparisons more readily.

Reviewer #2: Thank you for the opportunity to review this manuscript.

Abstract:

The statement on line 15 that "published information guiding the clinical use of foot orthoses is scarce" is broad and needs to be further clarified or supported.

I would suggest reviewing the way that numbers are presented throughout the manuscript as there is some inconsistency. For example on line 26, thirty-two percent should be represented as 32%.

Introduction:

Is the evidence to support the use of orthoses for back disorders strong enough to include it here? Similarly you mention that orthoses are believed to influence the function of the pelvis and thorax, is this supported by the evidence. The reference included on this statement by Cambron et al did not specifically investigate or discuss pelvic or thoracic biomechanics.

Methods:

You may benefit from clarification regarding the number of questions and specifically those questions that were omitted from this manuscript. I would suggest elaborating on what questions were excluded and why? Whilst I can understand your intention to focus this manuscript on orthotic review processes, that could have been a section of a more comprehensive review that may have provided further context for the findings. I can see in the survey within your appendix that questions which were not included relate to things like clinical assessment of orthotic suitability, patient education regarding wearing in the orthotic, adjunct interventions. These are all interesting questions which I believe would fit well into this manuscript. I do not see the benefit in removing these questions from this manuscript, I think the interest and clinical value of this study would be greatly improved if all questions were included.

Results:

You said that 238 registered podiatrists accepted the invitation. Do you have any way of confirming that they were registered? It may be better to just say podiatrists.

When reporting the volume of prescriptions I would suggest reordering these from less than one pair, one to three pairs, four to six pairs etc. I can see that it is currently listed in order of response rate but feel that it would be easier to follow if ordered by number of orthotics.

The total of people who prescribe polypropylene, EVA or carbon does not equal 100%. I understand that there are other materials considered such as PA11 and that these are included in your appendix. You may benefit from briefly listing these here.

Table 2. The totals do not add up for the question of how many weeks after you schedule your second follow up. Eg the total people who do use a second follow up is 68 people, yet there are only 52 responses to how many weeks later the session is. Is this data missing?

Discussion:

Line 207-209. Studies assessing the efficacy of orthotic devices have used a broad range of follow up times. Perhaps reword this sentence so that it is not portrayed as an exhaustive list.

Given the reliance on "professional judgement" that was found, it would be interesting to know what informed these judgements. For example, do these relate to pathology/diagnosis, biomechanics of the patient or objective, or other?

Line 247. This sentence would read better if begun with When Cambron et al compared the use of....

You had representation from 18 universities in the study, did this factor into the analysis, and if so, was a difference noted?

Line 303. You have stated in the limitations that these results may not be generalisable so should consider adjusting this sentence to read "this study has identified variation in the orthotic review processes amongst podiatrists who responded" or something similar.

I would be interested to know how you think these results will influence practice or future research? Maybe add a short section regarding future directions and research significance.

**********

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: Yes: Aaron Jackson

**********

[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.

A cross-sectional analysis of podiatrist-initiated review processes after issuing prescribed foot orthoses

PONE-D-22-22131R1

Dear Dr. Donnan,

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,

Matthew Carroll, PhD., MEdL., MPod., BHSc

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

Reviewer #2: All comments have been addressed

**********

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

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: 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

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. 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)

Reviewer #2: Thank you to the authors for making the detailed changes. I am satisfied that all comments have been addressed.

Thank you for clarifying the dissemination plan. I would suggest that this might be worthwhile briefly noting in the limitations section of this manuscript.

I look forward to reading the second half of this work once it is published.

**********

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: Yes: Helen Banwell

Reviewer #2: No

**********