A protocol for a systematic review of electronic early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms

Sharareh Rostam Niakan Kalhori; Thomas M. Deserno; Mostafa Haghi; Nagarajan Ganapathy

doi:10.1371/journal.pone.0283010

Peer Review History

Original SubmissionApril 20, 2022
6 Sep 2022 Decision Letter - Mohamed Yacin Sikkandar, Editor PONE-D-22-10855A protocol for a systematic review of early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithmsPLOS ONE Dear Dr. Sharareh Niakan Kalori, 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 Oct 21 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, Mohamed Yacin Sikkandar 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 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. Additional Editor Comments: title: Title reflects the scope of the study clearly Abstract: 1. Too short and it looks like expanded title 2. Methodology, data management and its conclusions can be included Introduction: 1. Necessity of this study is not clearly explained Methodology 1. Is there any significance in using the suggested the Search Strategy? 2. Is there any significance in excluding Review articles and conference papers? 3. PICO strategy is used in this study - justification not provided 4. words such as Expert system, prediction could be added in search strategy 5. Technologies and algorithms are not discussed in this paper General - manuscript would be incomplete without discussing protocol efficiency - though it is a study protocol, challenges and limitations could also be presented [Note: HTML markup is below. Please do not edit.] 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: No Reviewer #2: No ******** 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: No Reviewer #2: No ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: No Reviewer #2: No ****** 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: No 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: No ****** 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 am unable to understand the significance of this work in its current form. Authors have merely described some plan of action for performing a review on prediction of clinical deterioration. Rather, it will be certainly interesting if the review has been actually performed and the findings are discussed in detail. Reviewer #2: A review to predict clinical deterioration is performed using PRISMA. Following are the few questions to the authors: 1. CD is wide term, authors can try to be more specific 2. Authors have presented few results/observations from earlier publication. It is not clear what critical conclusions are arrived? 3. Authors have used different terms like: Features, AI, IoT etc. But no clear and indepth discussions are found. What is the inference drawn from this? How will it be useful for the future scientists/researchers? ****** 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 ******** [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. https://doi.org/10.1371/journal.pone.0283010.r001
Revision 1
9 Nov 2022 Author Response Dear Editor of PLOS ONE Thanks so much for the valuable comments on the manuscript (PONE-D-22-10855) entitled '' A protocol for a systematic review of early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms'' provided by reviewers. On behalf of the team of authors, I am writing the response to those comments which need reaction and correction. The changes are explained here in blue and presented as track changes in the text of the manuscript too. Furthermore, the revised clean version without track changes or highlights is submitted. Editor's comments: 1. The abstract is too short and it looks like the expanded title. Methodology, data management, and conclusions can be included. The abstract is extended with further necessary information. 2. In the Introduction, the necessity of this study is not clearly explained. The necessity of the study is added in the introduction section. 3. In methodology, is there any significance in using the suggested Search Strategy? The reason to use the search strategy was added in the Methodology section. The sample for Scopus is added too. 4. Is there any significance in excluding Review articles and conference papers? Review articles and conference papers were added to the inclusion criteria. They may have useful information for our study. Thanks 5. PICO strategy is used in this study, but justification is not provided. The PICO framework is removed as there is no clinical question based on an intervention here. However, other sections cover the required information regarding the EW/TTS systems, the criteria to compare them, and the possible outcomes considered. 6. Words such as Expert system, and prediction could be added to the search strategy. They were added in the related part of the search strategy. 7. Technologies and algorithms are not discussed in this paper. They are discussed in the discussion section, Thanks for the comment. 8. manuscript would be incomplete without discussing protocol efficiency. The discussion part was improved, thanks for the comment. 9. Though it is a study protocol, challenges and limitations could also be presented. challenges and limitations were added in the discussion part. Reviews' Comments : 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: No Reviewer #2: No The rationale for the proposed study was added in the introduction. Also, the academic problem that will be answered is added more clearly at the end of the introduction. 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing of 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 that 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: No Reviewer #2: No The methodology section is extended and more details are added. 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: No Reviewer #1: No The methodology section is extended and more details are added. 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 exceptions, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited in 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 We accept to provide the data available after completing the study according to the journal policy that will publish the final report. It is noted in the protocol too. 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: No The whole manuscript was checked for errors and corrections. Review Comments to the Author Reviewer #1: I am unable to understand the significance of this work in its current form. The authors have merely described some plan of action for performing a review on the prediction of clinical deterioration. Rather, it will be certainly interesting if the review has been actually performed and the findings are discussed in detail. Reviewer #2: A review to predict clinical deterioration is performed using PRISMA. Following are a few questions for the authors: 1. CD is a wide term; authors can try to be more specific. A more specific definition is provided in the introduction. 2. Authors have presented a few results/observations from earlier publications. It is not clear what critical conclusions arrive. The introduction is improved and a clear conclusion from the review of studies was added. 3. Authors have used different terms like features, AI, IoT, etc. But no clear and in-depth discussions are found. What is the inference drawn from this? How will it be useful for future scientists/researchers? The discussion section is added with details regarding the technologies, limitations, challenges, and future works. Attachments Attachment Submitted filename: Response_to_Reviewers.docx https://doi.org/10.1371/journal.pone.0283010.r002
29 Nov 2022 Decision Letter - Mohamed Yacin Sikkandar, Editor PONE-D-22-10855R1A protocol for a systematic review of early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithmsPLOS ONE Dear Dr. Sharareh Rostam Niakan Kalhori, 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 Jan 13 2023 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, Mohamed Yacin Sikkandar Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): Statistical analysis of the outcome or any recommendation to the future researchers is not elaborated. [Note: HTML markup is below. Please do not edit.] 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: No ******** 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? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. 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: The authors have implemented all the suggestions provided. The manuscript has been now modified with all required details. Reviewer #2: Yes authors have addressed few of the reviewer's comments. Major portion of the paper talks on general introduction and review process. Statistical analysis of the outcome or any recommendation to the future researchers is not elaborated. Few grammatical/typos can be looked into carefully. ****** 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 ******** [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. https://doi.org/10.1371/journal.pone.0283010.r003
Revision 2
21 Dec 2022 Author Response Rebuttal Letter Round 2 Dear Editor of PLOS ONE Thanks so much for the valuable comments on the manuscript (PONE-D-22-10855R1) entitled ''A protocol for a systematic review of early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms'' provided by reviewers. On behalf of the team of authors, I am writing the response to those comments which need reaction and correction. The changes are explained here in blue and presented as track changes in the text of the manuscript too. Furthermore, the revised clean version without track changes or highlights is submitted. Journal Requirements : 1. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. All references were checked. Here there are the changes for the references: The references 9 and 10 were replaced with each other. But still, we have both of them in the references. References 21, 22, 23, 24, and 34 were added. 2. Statistical analysis of the outcome or any recommendation to future researchers is not elaborated. The statistical analysis of the outcome and further studies suggestions were added in the discussion section. Reviewers' comments: 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: No The introduction section is revised to improve the study justifications. Also, in the discussion section, we added the provided knowledge by this study which can be the basis for further studies and system developments. ________________________________________ 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? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. 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. Reviewer #1: The authors have implemented all the suggestions provided. The manuscript has been now modified with all the required details. Reviewer #2: Yes authors have addressed a few of the reviewer's comments. The major portion of the paper talks about the general introduction and review process. Statistical analysis of the outcome or any recommendation to future researchers is not elaborated. The required improvements were applied in the introduction and discussion sections. - Few grammatical/typos can be looked into carefully. The whole paper was double-checked for grammatical/typos. Thanks for the comment. The manuscript is really improved. Thanks so much for the constructive comments. Attachments Attachment Submitted filename: Rebuttal Letter_round_2.docx https://doi.org/10.1371/journal.pone.0283010.r004
27 Dec 2022 Decision Letter - Mohamed Yacin Sikkandar, Editor PONE-D-22-10855R2A protocol for a systematic review of electronic early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms PLOS ONE Dear Dr. Rostam Niakan Kalhori, 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. ============================== Statistical analysis part need to be explained more for better understandability of readers. ============================== Please submit your revised manuscript by Feb 10 2023 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, Mohamed Yacin Sikkandar Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Statistical analysis Statistical analysis part need to be explained more for better understandability of readers. Language can be further improved. Referencing style can be formatted as per journal requirement. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: [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. https://doi.org/10.1371/journal.pone.0283010.r005
Revision 3
4 Jan 2023 Author Response Rebuttal Letter Round 3 Dear Editor of PLOS ONE Thanks so much for the valuable comments on the manuscript (PONE-D-22-10855R1) entitled ''A protocol for a systematic review of early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms'' provided by reviewers. On behalf of the team of authors, I am writing the response to those comments which need reaction and correction. The changes are explained here in blue and presented as track changes in the text of the manuscript too. Furthermore, the revised clean version without track changes or highlights is submitted. Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. The whole references were rechecked and sorted based on the Journals format. Additional Editor Comments: 1. Statistical analysis part needs to be explained more for better understandability of readers. It is written with more explanation in more understandable version. 2. Language can be further improved. The whole doc was rechecked and the text was improved. 3. Referencing style can be formatted as per journal requirements. It is done. Thanks very much. Attachments Attachment Submitted filename: Rebuttal Letter_round_3.docx https://doi.org/10.1371/journal.pone.0283010.r006
1 Mar 2023 Decision Letter - Mohamed Yacin Sikkandar, Editor A protocol for a systematic review of electronic early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms PONE-D-22-10855R3 Dear Dr. Rostam Niakan Kalhori, 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, Mohamed Yacin Sikkandar Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0283010.r007
Formally Accepted
6 Mar 2023 Acceptance Letter - Mohamed Yacin Sikkandar, Editor PONE-D-22-10855R3 A protocol for a systematic review of electronic early warning/track-and-trigger systems (EW/TTS) to predict clinical deterioration: Focus on automated features, technologies, and algorithms Dear Dr. Rostam Niakan Kalhori: 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 Dr. Mohamed Yacin Sikkandar Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0283010.r008

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