Prenatal screening tests and prevalence of fetal aneuploidies in a tertiary hospital in Thailand

Preechaya Wongkrajang; Jiraphun Jittikoon; Sermsiri Sangroongruangsri; Pattarawalai Talungchit; Pornpimol Ruangvutilert; Tachjaree Panchalee; Usa Chaikledkaew

doi:10.1371/journal.pone.0284829

Peer Review History

Original SubmissionJanuary 4, 2023
22 Feb 2023 Decision Letter - Nur Aizati Athirah Daud, Editor PONE-D-23-00277Prenatal screening tests and prevalence of fetal aneuploidies in a tertiary hospital in ThailandPLOS ONE Dear Dr. Chaikledkaew, 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 Apr 08 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. 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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 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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [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: Yes 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. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is an interesting article highlighting various methods of prenatal testing. The title and abstract are appropriate for the content of the text. The authors however should revise and write more about the definition of aneuploidy and chromosomal abnormality in line 51 under the introduction headline. The author explained very well the methods, analytical part as well as results. Comparison has been made with other studies even though from different populations. The results of their study might contribute towards prenatal advancement mainly for genetic testing and counselling, and as a reference for obstetricians and gynaecologists in Asian countries mainly. Reviewer #2: The authors present a strong cross sectional sampling from a single hospital on fetal aneuploidies for a Thai population. It is solidly presented, and my comments are relatively minor and more suggestions for stylistic approaches for presentation if I may. 1. Abstract: The abstract presents a lot of paper, which is admirable, but it might be an idea to add an opening sentence or two on why this screening is undertaken for non-expert readers. This is optional, but can help the wide audience of PLOS one better appreciate what work you undertook 2. It would be helpful for authors to define their sensitivity analysis in the methods section is a little more depth. From table 1, I presume they simply counted the fraction of true positives over (true positive plus false negatives) from the data, and this is absolutely fine and correct. However it would be useful for non-experts to have these clearly defined (for an example from another field, table 1 in this paper does so to reduce any ambiguity https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781509 ) 3. With regards to table 1, it might be worth putting total numbers of real cases per item of interest in the table, possible in brackets after the condition as this makes it easier for readers to pick out the denominator. For example, in the first-trimester screening case for T21, there were 5TPs and 2FN, which gives N = 7 cases, which of course is whence sensitivity is derived. But putting total cases somewhere would help, maybe something like: Trisomy 21 (n =7) in the first column etc... 4. In table 3 presenting the results of others, the blacked our entries are a little confusing: am I correct in assuming these are entries for which other studies did not produce data? I think so from the text, but there might a nicer way to present this than just blacking out: text like "No estimate" or similar perhaps? 5. Finally, have you thought about a graphical representation of these results? I think you could plot all your estimates and CIs in a single plot if you wished. Congratulations again on an interesting paper. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". 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Revision 1
24 Mar 2023 Author Response 23 March 2023 Dear Editors, On behalf of my co-authors, we would like to resubmit the revised manuscript of our study entitled “Prenatal screening tests and prevalence of fetal aneuploidies in a tertiary hospital in Thailand” (Manuscript ID number: PONE-D-23-00277) for your kind consideration to be published on PLOS ONE. We would like to thank all editors and reviewers for their helpful comments and suggestions. We feel that the revised paper is much further improved as a consequence of their inputs. The next page is a point-by point form explaining how we have responded to each comment raised by the editors and reviewers. Should you have any question, please kindly contact me at usa.chi@mahidol.ac.th. Thank you very much for your kind consideration on this manuscript. Sincerely yours, Assoc. Prof. Usa Chaikledkaew, Ph.D. Corresponding author Social Administrative Pharmacy Division, Department of Pharmacy and Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University 447 Sri-Ayuthaya Road, Rajathevi, Bangkok 10400, Thailand Tel: 662-644-8679 ext 5317; Fax: 662-644-8694 Email: usa.chi@mahidol.ac.th Response to Editors and Reviewer: Journal 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 https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Response: Thank you very much. We have already checked that our manuscript meets PLOS ONE’s style requirements. 2. 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. Response: Thank you very much. We have already reviewed the reference list to ensure that our reference list is complete and correct. Reviewer #1: This is an interesting article highlighting various methods of prenatal testing. The title and abstract are appropriate for the content of the text. The authors however should revise and write more about the definition of aneuploidy and chromosomal abnormality in line 51 under the introduction headline. The author explained very well the methods, analytical part as well as results. Comparison has been made with other studies even though from different populations. The results of their study might contribute towards prenatal advancement mainly for genetic testing and counselling, and as a reference for obstetricians and gynecologists in Asian countries mainly. Response: Thank you very much for your kind suggestion. We have added more sentences about definition of aneuploidy and chromosomal abnormality in the introduction section (Line 53-57, Page 3). “In humans, each cell contains 46 chromosomes (23 pairs) and during meiosis, gamete cells (sperm and egg cells) are formed 23 single chromosomes per cell. Upon fertilization, the paternal and maternal gamete cells combine, resulting in a diploid cell with 23 pairs of chromosomes (46 chromosomes). Errors in the meiotic segregation process can lead to chromosomal abnormalities [1].” Reviewer #2: The authors present a strong cross-sectional sampling from a single hospital on fetal aneuploidies for a Thai population. It is solidly presented, and my comments are relatively minor and more suggestions for stylistic approaches for presentation if I may. 1. Introduction: The Introduction presents a lot of paper, which is admirable, but it might be an idea to add an opening sentence or two on why this screening is undertaken for non-expert readers. This is optional, but can help the wide audience of PLOS one better appreciates what work you undertook Response: Thank you very much for your kind suggestion. We have added an opening sentence on why this screening is undertaken in the introduction section (Line 68-69, Page 3). “Early detection of fetal chromosomal aneuploidies can assist parents in making pregnancy decisions [1].” 2. It would be helpful for authors to define their sensitivity analysis in the methods section is a little more depth. From table 1, I presume they simply counted the fraction of true positives over (true positive plus false negatives) from the data, and this is absolutely fine and correct. However it would be useful for non-experts to have these clearly defined (for an example from another field, table 1 in this paper does so to reduce any ambiguity https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781509 ) Response: Thank you very much for your kind suggestion. We have already added formula of sensitivity, specificity, positive predictive value, negative predictive value, accuracy and total number of trisomy in Table 1 (Page 8). 3. With regards to table 1, it might be worth putting total numbers of real cases per item of interest in the table, possible in brackets after the condition as this makes it easier for readers to pick out the denominator. For example, in the first-trimester screening case for T21, there were 5TPs and 2FN, which gives N = 7 cases, which of course is whence sensitivity is derived. But putting total cases somewhere would help, maybe something like: Trisomy 21 (n =7) in the first column etc... Response: Thank you very much for your kind suggestion. We have already added total numbers of total cases in the first column of Table 1 (Page 8). 4. In table 3 presenting the results of others, the blacked our entries are a little confusing: am I correct in assuming these are entries for which other studies did not produce data? I think so from the text, but there might a nicer way to present this than just blacking out: text like "No estimate" or similar perhaps? Response: Thank you very much for your kind suggestion. We have used "No estimate" instead of blacking out in Table 3 (Page 13). 5. Finally, have you thought about a graphical representation of these results? I think you could plot all your estimates and CIs in a single plot if you wished. Congratulations again on an interesting paper. Response: Thank you very much for your kind suggestion. However, we would like to present the results in a table format which can show all data in exact details, as these data may be more useful and helpful for obstetricians and gynecologists especially in Asian countries to use as the references. Attachments Attachment Submitted filename: Response to reviewers-23March23.docx https://doi.org/10.1371/journal.pone.0284829.r002
10 Apr 2023 Decision Letter - Nur Aizati Athirah Daud, Editor Prenatal screening tests and prevalence of fetal aneuploidies in a tertiary hospital in Thailand PONE-D-23-00277R1 Dear Dr. Chaikledkaew, 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, Nur Aizati Athirah Daud, Ph.D. Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0284829.r003
Formally Accepted
13 Apr 2023 Acceptance Letter - Nur Aizati Athirah Daud, Editor PONE-D-23-00277R1 Prenatal screening tests and prevalence of fetal aneuploidies in a tertiary hospital in Thailand Dear Dr. Chaikledkaew: 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. Nur Aizati Athirah Daud Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0284829.r004

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