PONE-D-21-22056Online user comments responding to deemed consent organ donor legislation in Nova Scotia: a divided public or a few loud voices?PLOS ONE

Dear Dr. Marcon,

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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“The authors thank and acknowledge Health Canada, Genome Canada, Genome Alberta, and the Canadian Institutes for Health Research for their generous support of Legislative Strategies to Improve Deceased Organ Donation in Canada: A Special Focus on Evaluating the Impact of Opt-Out Legislation in Canada LEADDeR and Precision Medicine CanPREVENT AMR: Applying Precision Medicine Technologies in Canada to Prevent Antibody Mediated Rejection and Premature Kidney Transplant Loss.”

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Projects funded:

Legislative Strategies to Improve Deceased Organ Donation in Canada: A Special Focus on Evaluating the Impact of Opt-Out Legislation in Canada LEADDeR and Precision Medicine CanPREVENT AMR: Applying Precision Medicine Technologies in Canada to Prevent Antibody Mediated Rejection and Premature Kidney Transplant Loss

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Additional Editor Comments:

The paper does a statistical analysis of commentary about legislation regarding organ transplantation. The paper is quite simple and it doesn't introduce any new methods. However the topic is quite important and deserves publication. I'd like to point out the following concerns

- The analysis of just one dataset makes the relevance doubtful, as we don't know how bias are the comments.

- Do the comments represent a particular demographic? Does the site represent the population?

- Are robots present? Is there a way to find out from the content that the "language" may not be of a person but maybe automated?

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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

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

Reviewer #1: Yes

Reviewer #2: Yes

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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

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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

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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: This work attempts to understand public perceptions regarding organ donation which is an increasingly relevant issue in public health, specially its underlying presumed consent law.

Though this work is a simple statistical analysis of comments and replies generated by a small number of online users, it is the first to examine online public commentary to the presumed consent law in Nova Scotia and can contribute to raise awareness about organ donation with the design of improved public outreach.

COMMENTS

(1) It seems not to be the case that Brazil implemented presumed consent legislation. Please, double check the sentence “Some countries, such as Singapore, Brazil, and Chile11,12,13 implemented presumed consent legislation but were unsuccessful at increasing donation and transplantation rates”

(2) What is the data collection period ? The dates of the two articles published on CBC (April 2nd and April 4th, 2019) are clearly stated but what is the period regarding all the 2663 respective comments and replies ?

(3) Is the code of program that collected the comments and replies available ? I would suggest the authors to provide more detail about this program and its workflow.

(4) I wound whether bots (fake accounts) played a role in “the negative commentary was greatly influenced by small group of dedicated commentators”.

Reviewer #2: This study has great relevance, especially when the information comes from social networks, which are gaining significant visibility. In addition, the public debate around organ donation is relevant and necessary as part of the guarantee of civil rights.

It would be great, in the introduction, to show the rates, in number, of organ donation from Nova Scotia and other Canadian provinces. Also, the name of the software that you use to collect the data. I did not fully understand the definition of positive, negative, and neutral comments in the methods section. Why did you collect the data in three days (April 2nd and April 4th, 2019)? Do you think that it might be a bias toward negative comments?

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Reviewer #1: Yes: Diego Pinheiro

Reviewer #2: Yes: Sueny Paloma Lima dos Santos

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PONE-D-21-22056R1Analyzing online public commentary responding to the announcement of deemed consent organ donation legislation in the Canadian province of Nova ScotiaPLOS ONE

Dear Dr. Marcon,

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. We have obtained additional reviews from reviewers with relevant methodological expertise. Please address all reviewer requests. In addition, please also address the following request: Thank you for addressing in the discussion section the possibility of bots affecting your results. It is not clear however that assessing this possible effect is outside the purview of this research. Please further discuss, in the discussion section, this possibility as a limitation and provide plausible estimates to quantify this effect if possible.

Please submit your revised manuscript by Nov 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.

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'.
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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,

Yann Benetreau, PhD

Division Editor

PLOS ONE

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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 #2: All comments have been addressed

Reviewer #3: (No Response)

Reviewer #4: (No Response)

Reviewer #5: (No Response)

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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 #2: Yes

Reviewer #3: Partly

Reviewer #4: Yes

Reviewer #5: Partly

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

Reviewer #2: Yes

Reviewer #3: No

Reviewer #4: Yes

Reviewer #5: Yes

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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 #2: Yes

Reviewer #3: No

Reviewer #4: Yes

Reviewer #5: 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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

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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 #2: All comments have been addressed and I believe that there is no dual publication, or research ethics problem.

Reviewer #3: Comment 1: the link of the does not shows any information (i.e repository is not activate) webaddress https://giters.com/philbot9/python-cbc-commentscraper/watchers (either remove it or make activate it)

Comment 2: Table captions usually will be kept above the table. In table 1 both above and below the table caption was kept. Remove the caption from the bottom of the table.

Comment 3: While using ANOVA they should have to follow certain assumptions. (see the web address for assumptions of ANOVA How to Check ANOVA Assumptions - Statology) and the data should be of type either of Interval or ratio scale.

Comment 4: Since the authors has written “The complete data sets were organized in CSV files”, can you make available the CSV file? Similarly, the authors have quoted that “All coding analysis was conducted in shared Google Sheets”, so, if these sheets are made available then the authenticity of the research will be increased.

Comment 5: on the analysis part “ Article 1 demonstrated a higher percentage of negativity in comments (n = 251, 56.0%) than Article 2 (n = 88, 48.6%), but the difference was not significant, (X2 = 3.08, df = 2, p = .21).” I don't think the chi square value will be so less (3.08) as the difference (251-88) is so high (there must be a significant difference with chi square value more than 50.

Comment 6: If the data follows all the assumptions of ANOVA, then also the analysis done to find F value is not consistent. So I would like to request you the syntax of the analysis along with data to verify and clarify the problem.

Comment 7: Outlook of table is not in the scientific table format. Please arrange it.

Comment 8: Requested to include DOI for References wherever possible.

Reviewer #4: Comment 1: As per your reply to Reviewer 2 Comment (3), it seems that you have collected the data in three days (April 2nd and April 4th, 2019). However, in the methodology, you wrote "On May 24th, 2019, we downloaded all user comments and replies..". Does it mean that you downloaded all the comments in those two articles made since the date it was published and till March 24, or you just downloaded the comments between April 2nd and April 4th? This could be more clarified in the methodology section.

Reviewer #5: The authors perform a content analysis of comment sections in two Canadian Broadcasting Company articles, which announce changes to Nova Scotia’s deemed consent organ donation. In general, their findings suggest that negative-leaning comments comprised the majority of comments and received more replies than negative comments. Further, they noted that negative comments were most associated with “human rights,” “body autonomy,” and legality with present legislation. Positive and neutral-leaning comments shared themes of “altruism,” “ body autonomy,” and “effectiveness.” The authors provide some suggestions for the government and stakeholders to “express why [there are] changes around consenting” and “how policy will be enacted,” which seem to be helpful for the community. The analyses, as stated by the authors, are limited by the lack of demographic data on commenters and the lack of exploring the possibility of bot-generated comments. Unfortunately, the conclusions are weakened by the ambiguity of hypotheses and lack of addressing previous comments on the background of the research.

Please find detailed comments below:

Major:

Introduction: The hypothesis, “We hypothesized the existence of diverse and strong opinions that may potentially have influenced public perception and debate on this topic” does not seem to be addressed by your selected methods of analysis. The descriptor, “diverse” may denote a demographic category that, as mentioned in the Methods & Discussion, was not considered in your analysis. Furthermore, there is no qualification within the content categories for what a “strong” opinion would be. This, in turn, makes the conclusions relating to positive and neutral comments appear not to address whether or not there are opinions that influence public perception and debate. Perhaps, the authors could revise this hypothesis by replacing “diverse and strong opinions” with descriptors that more clearly outline the possible theory upon which their inductive approach may arrive at.

Minor:

Introduction, paragraph 1: The authors chose to not address previous suggestions to provide quantification on “relatively high rates of organ donation compared to other Canadian provinces.” These numbers would provide a clear perspective and improve readers’ overall understanding of the background.

Data Analysis: The link to the code does not appear to arrive at the correct GitHub repository.

Discussion, paragraph 2: Authors’ use of qualifiers such as “heated” and “relatively large” are not supported by the results of the analyses.

Discussion, paragraph 3: While the addition of mention of bots or lack of demographic information on commenters is mentioned, there is no mention of the weaknesses of this analysis and how that affects the recommendations the authors give to the community. Morse and Richards, 2002 and Polit and Beck 2006 provide insight into why this can be problematic.

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Reviewer #2: Yes: Sueny Paloma Lima dos Santos

Reviewer #3: Yes: Bijay Lal Pradhan

Reviewer #4: No

Reviewer #5: No

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Analyzing online public commentary responding to the announcement of deemed consent organ donation legislation in the Canadian province of Nova Scotia

PONE-D-21-22056R2

Dear Dr. Marcon,

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,

Ali B. Mahmoud, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #2: All comments have been addressed

Reviewer #3: All comments have been addressed

Reviewer #4: All comments have been addressed

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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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: 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 #2: Yes

Reviewer #3: Yes

Reviewer #4: 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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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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 #2: The manuscript is completed successfully, and each and every remark has been taken into consideration. Great work.

Reviewer #3: Since data did not follow normality Kruskal-Wallis test with pairwise post-hoc Dunn test that you have used is good. All the comments has been addressed.

Reviewer #4: (No Response)

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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.

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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: No

Reviewer #3: Yes: Bijay Lal Pradhan

Reviewer #4: No

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