Telementoring versus face-to-face mentoring in the training of scleral fixation surgery of intraocular lenses

Luiz Filipe Adami Lucatto; Juliana Moura Bastos Prazeres; Gabriel Castilho Sandoval Barbosa; Eduardo Amorim Novais; Ricardo Luz. Leitão Guerra; Emmerson Badaró; Luiz Henrique Soares Gonçalves de Lima; Eduardo Buchele Rodrigues

doi:10.1371/journal.pone.0290040

Peer Review History

Original SubmissionApril 26, 2023
10 Jul 2023 Decision Letter - Andrzej Grzybowski, Editor PONE-D-23-10630TELEMENTORING VERSUS FACE-TO-FACE MENTORING IN THE TRAINING OF SCLERAL FIXATION SURGERY OF INTRAOCULAR LENSESPLOS ONE Dear Dr. Lucatto, 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 Aug 24 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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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Interesting and novel manuscript idea - the following comments are meant to strengthen: -I am still unclear about the telementoring workflow - so was video being transmitted or only images? This is an important point to clarify -Is career time post-training? -Results section: please clarify this statement ' There is a lack of evidence between the groups (p-values > 0.05), and the standardized effects sizes were inferior to 0.2, indicating a very small effect under the Cohen’s d scale cutoffs. -Given the surgical success scale used, is there any reference point to actual OR success? This would help contextualize the 98.5% and 95.5% values. -If not inexperience with NGENUITY, why do you suppose did those with 13+ years of experience underperform wtih telemonitoring? Reviewer #2: This study is interesting and has a relevant outcome for ophthalmic education. The analyzed group is sufficient and has been analyzed in an appropriate manner. Specific remarks: In Table 2, in the p-values row, "0.000" should be replaced with "p<0.001". ****** 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
18 Jul 2023 Author Response Journal Requirements: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. 2. Please state what role the funders took in the study. 3. We note that Figure 1 in your submission contain copyrighted images. We require you to either (1) present written permission from the copyright holder to publish these figures specifically under the CC BY 4.0 license, or (2) remove the figures from your submission: We thank the Editorial Office and reviewers for the comments and suggestions. We have addressed the concerns raised, and we now believe that the manuscript is substantially improved. We hope that you will agree and find that the manuscript is now suitable for publication. 1) Ok. Done. 2) Ok. Done. 3) We have recreated an image to replace the previous "Figure 1", without copyrights. Reviewer #1 1) I am still unclear about the telementoring workflow - so was video being transmitted or only images? This is an important point to clarify 2) Is career time post-training? 3) Results section: please clarify this statement ' There is a lack of evidence between the groups (p-values > 0.05), and the standardized effects sizes were inferior to 0.2, indicating a very small effect under the Cohen’s d scale cutoffs. 4) Given the surgical success scale used, is there any reference point to actual OR success? This would help contextualize the 98.5% and 95.5% values. 5) If not inexperience with NGENUITY, why do you suppose did those with 13+ years of experience underperform wtih telemonitoring? 1) Yes, telementoring took place via videoconference. To avoid misinterpretation by readers, we have replaced the word "teleconferencing" with "videoconferencing" in the methods section. 2) We considered the baseline of the career time as the year in which the participant entered the medical residency in ophthalmology. 3) Here is written as “lack of evidence” because your findings refer to a situation where the analysis does not provide sufficient evidence to support the hypothesis (e.g., the difference between the two arms on the outcome had a p-value superior to the commonly adopted significance level [0.05]). It means that the observed results are inconclusive or do not provide strong support for a specific conclusion. It is common to observe that when RCTs describe group differences that are not statistically significant, authors mistakenly state that p-values > 0.05 as the intervention having no effect. No effect means evidence of absence which is different from lack of absence. The difference between lack of evidence and evidence of absence is classically described and explored in the statistical note written by Altman & Bland (1995). In our work, we had a special attention to clearly describing such statements. Now, in the manuscript, it might be found as follows on page 7 and 8, lines 170-175. 4) In fact, surgical success was considered if the participant managed to reach the end of the procedure without committing any criterion considered as failure. They are: “Failure in the transmission of images and/or audio, which makes it impossible to complete the mentoring”; “surgeon was not able to complete one of the surgical steps” and “the procedure had any surgical complication such as loss of suture, damage to the IOL, or displacement of the IOL into the vitreous cavity”. This information is already contained in the manuscript. 5) We do not know for sure, nor did we find clear reasons for this data obtained. At first, we thought that this subgroup possibly had less contact with the Ngenuity® system, but as mentioned in the manuscript, this did not happen: "Inexperience with the Ngenuity® system is probably not the cause for these results since in our sample, 73% of this subgroup had previously used this technology." Reviewer #2 1) In Table 2, in the p-values row, "0.000" should be replaced with "p<0.001". 1) Ok. Done. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0290040.r002
1 Aug 2023 Decision Letter - Andrzej Grzybowski, Editor TELEMENTORING VERSUS FACE-TO-FACE MENTORING IN THE TRAINING OF SCLERAL FIXATION SURGERY OF INTRAOCULAR LENSES PONE-D-23-10630R1 Dear Dr. Lucatto, 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, Andrzej Grzybowski Academic Editor PLOS ONE 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 Reviewer #2: All comments have been addressed ******** 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 Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: 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 #1: Yes Reviewer #2: No ****** 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. 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: (No Response) Reviewer #2: I have no further remarks. This study is interesting and has a relevant outcome for ophthalmic education. ****** 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 ******** https://doi.org/10.1371/journal.pone.0290040.r003
Formally Accepted
3 Aug 2023 Acceptance Letter - Andrzej Grzybowski, Editor PONE-D-23-10630R1 TELEMENTORING VERSUS FACE-TO-FACE MENTORING IN THE TRAINING OF SCLERAL FIXATION SURGERY OF INTRAOCULAR LENSES Dear Dr. Lucatto: 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. Andrzej Grzybowski Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0290040.r004

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