PONE-D-22-23846Development and preliminary validation of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network Research Question Importance Tool (RQITv2.0)PLOS ONE

Dear Dr. Taylor,

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Academic Editor

PLOS ONE

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"This study was partly funded by the NHMRC (Centre of Research Excellence: Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network; Chief Investigator Rachelle Buchbinder). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

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"We gratefully acknowledge the help of Emeritus Professor Jane Latimer, Helen Ramsay (Executive Officer of ANZMUSC) and Tania Pocock (Health Research Council of New Zealand), Dr Chris Dalton (National Medical Officer BUPA Australia) for participation in the consensus workshop. RB is supported by an Australian National Health and Medical Research Council (NHMRC) Investigator Fellowship (APP1194483). RSH is supported by a NHMRC Senior Research Fellowship (#1154217). ANZMUSC is supported by a Centre of Research Excellence Grant by NHMRC (APP1134856)."

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"This study was partly funded by the NHMRC (Centre of Research Excellence: Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network; Chief Investigator Rachelle Buchbinder). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

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6. One of the noted authors is a group or consortium ANZMUSC Clinical Trial Network. In addition to naming the author group, please list the individual authors and affiliations within this group in the acknowledgments section of your manuscript. Please also indicate clearly a lead author for this group along with a contact email address.

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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: No

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: The topic is very important and some of the tools used by the authors are either inoovative or scientifically robust and the authors are to be commended for this. However, there are a number of problems that limit the validity of the research or that limit the understanding of the paper:

- The title is not very clear. Please update it so that it really reflects the work of the authors.

- The developers of this tool are all from Australia or New Zealand. If the goal is to provide a tool specifically for Australia and New Zealand, I wonder if this merits an international publication.

- The inclusion of "version 2.0" in the name of the tool is somewhat misleading as there is no real version 1. The "new" version is a simple and logical evolution of the tool during its development.

- All (or most) of the experts are in the field of musculoskeletal disorders and therefore the tool cannot be considered a generic tool. This should be reflected in the name of the tool so that it will not be used in a bad way.

- The main problem with this tool is how the initial validation is done. IF and citation counts are very poor and totally arbitrary proxies for research quality. This is acknowledged by the authors, but it does not solve the problem. At least, some sentitivity analyses with the use of other journals can be made (and not anly to 5 top and down journals).

- Surprisingly, contrary to current practice, patients were not considered in the development of the tool and the potential consequence of this is that the patient perspective is not considered a potential attribute.

- Much more information needs to be provided on the 14 hypothetical research questions. If these research questions are written in a way that makes scoring easy, the bias is too great. I strongly recommend using the previously submitted applications.

- The authors state that this is a preliminary validation but they do not clearly explain what their next steps are and why this was not done for this article.

- For full transparency, it is important to include in the paper the full final version of the tool or to explain how to access it and to explain very clearly how to score it.

Reviewer #2: The subject of the article: Development and preliminary validation of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network Research Question Importance Tool (RQITv2.0).

After reading the article, the reviewer found it to be an original and innovative manuscript. The manuscript is not characterized by significant formal deficiencies and factors that interfere with interpretation. The style and language are booth good, the structure is understandable, and the authors have devoted plenty of time to providing the necessary background knowledge.

The abstract summarizes the essence of the article well.

In the introduction, the reviewer is slightly missing additional data in a global context, or in comparison with other countries. According to the reviewer, it should be considered to correct this.

The method part has been precisely defined. The methods are well described, authentic and can be followed, the results presented in the tables are understandable and convincing. The description of the results and the use of tables are appropriate.

The discussion is satisfactory both in terms of content and scope.

In summary, all of these give the manuscript its significance, while I detailed above that the authors solved this excellently. the reviewer recommends the article for publication, which, in the reviewer's opinion, contains valuable data and information.

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Reviewer #1: No

Reviewer #2: No

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Which clinical research questions are the most important? Development and preliminary validation of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network Research Question Importance Tool (ANZMUSC-RQIT)

PONE-D-22-23846R1

Dear Dr. Taylor,

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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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,

Charlotte Beaudart

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 #1: 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 #1: Yes

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

Reviewer #1: 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 #1: 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

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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 #1: ok

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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

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