PONE-D-21-26924

Assessment of health-related quality of life among Afghan refugees in Quetta, Pakistan

PLOS ONE

Dear Dr. Khan,

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Dylan A Mordaunt, MB ChB, MPH, MHLM, FRACP, FAIDH

Academic Editor

PLOS ONE

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Furthermore  thank you for your statement: ethical approval was obtained from the research committee department of Pharmacy

Practice, Faculty of Pharmacy and Health Sciences with number (DPP/SS/83/17) University

of Baluchistan, Quetta, Pakistan

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8. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works, some of which you are an author.

-https://www.coursehero.com/file/41355227/Refugees-of-Venezuelans-in-Colombiadocx/

-https://moam.info/refugee-protection_599bf6501723dd0f406edd9c.html

-https://journals.sagepub.com/doi/pdf/10.1177/019791839603000301

-https://academic.oup.com/jrs/article-abstract/21/1/43/1513931?redirectedFrom=fulltext

-https://www.ijidonline.com/article/S1201-9712(05)00169-4/fulltext

-https://www.livelihoods.org/hot_topics/docs/Afghans_Quetta.pdf

-https://linkinghub.elsevier.com/retrieve/pii/S0029655417300891

We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications.

Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work.

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Additional Editor Comments:

Thank you for your submission. This is an important and timely piece of work. Both reviewers have valuable suggestions but in taking on board reviewer 2's comment about timing, I have framed the revisions needed as minor and intend to progress this to acceptance assuming the issues are addressed. This doesn't discount reviewer 1's comments, which are important and should be addressed.

With specific reference to the criteria for publication:

1. The study appears to present the results of original research.

2. Results do not appear to have been published elsewhere. It would be helpful to clarify whether a preprint is already available and might be worth considering in order to make the work available early for reference.

3. Experiments, statistics, and other analyses are performed to an appropriate standard and are described in sufficient detail.

4. Conclusions are presented in an appropriate fashion and are supported by the data.

5. The article is presented in an intelligible fashion and is written in standard English- with a few comments noted by the reviewers.

6. The research meets all applicable standards for the ethics of experimentation and research integrity- an ethics approval document is included, but it would be helpful to include a line in text for ease of reference (in the methods).

7. The article adheres to appropriate reporting guidelines and community standards for data availability. Though this standard isn't directly applicable, it would be worth checking with the structure and ensuring all relevant content has been considered for inclusion- https://pubmed.ncbi.nlm.nih.gov/8973129/.

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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: Partly

Reviewer #2: Yes

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

Reviewer #1: N/A

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: No

Reviewer #2: No

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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: Assessing health-related quality of life among Afghan refugees is an important topic.

1. The manuscript requires a thorough language check. Some examples include

- Variables other than proper nouns should be lower case (abstract, methods and results)

- "Afghan" should be capitalized

-Table # should be capitalized

-Consider omitting or rephrasing the first sentences of the introduction. The current phrasing is too colloquial, the definition of refugee should be referenced

2. The flow of the introduction is hard to follow in some parts and others could be omitted or included as a supplement e.g. the sentences about the old camps and exact distribution.

3. The HRQOL sentences should be moved to the methods

4. Discussion "The current study reveals better HRQOL.. " better than what? The comparison is missing

5. Add 5-10 more current references from the last 3-5 years.

6. Table titles please add the setting/participants and year of the study possibly, Tables 2-5 need a proper title, please check the journal for examples. EQ-5d should be spelled out and described in the notes of each table

7. Table 3 the meaning of columns S No and EQ-5D are unclear

Reviewer #2: This study by Kaleem et al analysed questionnaire based data to assess health-related quality of life amongst Afghan refugees in Pakistan. This manuscript is of particular importance given the current situation in Afghanistan.

To be accepted for publication the written English must be improved within the methods, results and discussion sections. The language is currently not at a high enough standard for publication. E.g. there are capital letter appearing in the middle of sentences when they are not warranted.

The formatting of the tables is a problem (rows don't align) and need to be re-formatted to make it easier to interpret. The tables are not well described in the titles, which seem to have random numbers inserted within the titles without any description.

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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 #1: No

Reviewer #2: No

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PONE-D-21-26924R1Assessment of health-related quality of life among Afghan refugees in Quetta, PakistanPLOS ONE

Dear Dr. Faiz Ullah Khan,

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 follow the reviewer's comments and submit again if you are still interested to.

Please submit your revised manuscript by May 18 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,

AKM Alamgir, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

Please revise as suggested.

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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: (No Response)

Reviewer #3: 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

**********

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

Reviewer #2: Yes

Reviewer #3: No

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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: No

Reviewer #3: 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: No

**********

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: I thank the authors for this resubmission which is much improved. I do however have some comments to be addressed in a revised submission.

1) There is a typo in the list of authors.

Abstract:

2) The authors state in the abstract that the 729 participants were randomly enrolled. What methodology was used for randomization?

3) The authors state that this study indicates better HRQOL in the current study respondents. Better compared to what/who?

4) Although increasing monthly income is important for HRQOL, it was not a predictor of quality of EQ-5D index scores in this cohort. Therefore, does this not indicate that this is not an important factor in this cohort's EQ-5D. As such, it may be premature to suggest in the conclusions that uplifting monthly income would improve HRQOL.

Introduction:

5) Spell out UNHCR and NGO.

6) Why have the authors only included costings from mid 1980s, which is approx. 40 years out of date? It is ok to include historical costings in relation to historical resettlement, but should this should be brought more current. i.e also including recent figures.

7) QOL is defined twice within the introduction - only needs to be done in the first instance.

8) Typo - used QoL instead of QOL in last paragraph of the introduction.

Tables:

9) There are no legends, which makes it difficult to understand the tables. e.g. What is Frequency (243) in table 1, what is [mean+/-SD] referring to in table 1? Legends need to be included for each of the tables and not just a title.

10) Table 1 - "Year Living as Refugee" is mis-aligned in table 1.

Methods:

11) Further description of the scoring system(s) are required within the methods section.

Results:

11) The authors state that the majority of participants were from Kandahar. This is incorrect, Kandahar was the largest single recruitment site.

12) Define BHU.

13) should be "Table 2" not "Table 02".

14) Most of the results are just a description of the study population. Needs further reporting on the findings of the EQ-5D data and VAS score.

15) The first time VAS score is introduced is the last sentence within the results. It is not described anywhere else prior to this. Needs to be included in the methodology. This data is lacking background and context.

Discussion:

16) Some points of the scoring system(s) within the discussion need to be introduced earlier (Methodology/results). This will allow the reader to fully understand the results and what they mean before reaching the discussion.

Reviewer #3: • It is recommended to perform multivariate analysis (regression).

• Is the Urdu version of the EQ5D-3Lquestionnaire valid and reliable? Please provide a reference. And do all Afghan refugees in Pakistan have the ability to understand Urdu? Did you get the data through interviews?

• In the method field, write the name of the analysis used.

• In the discussion section, write the strengths and weaknesses of the study.

• And keep in mind that your study does not have external validity because sampling was available and cannot be generalized to the Afghan refugee community in Pakistan.

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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 #2: No

Reviewer #3: 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.]

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Assessment of health-related quality of life among Afghan refugees in Quetta, Pakistan

PONE-D-21-26924R2

Dear Dr.Faiz Ullah Khan,

We’re pleased to inform you that your manuscript has been judged scientifically and is accepted for publication.

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Kind regards,

AKM Alamgir, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: