PONE-D-23-04634Assessing swallowing disorders in adults on high-flow nasal cannula in critical and non-critical care settings. A protocol for a scoping reviewPLOS ONE

Dear Dr. Gutierrez-Arias,

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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: Partly

Reviewer #2: Partly

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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: Partly

Reviewer #2: Partly

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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

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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: No

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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: No

Reviewer #2: Yes

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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: 1. Please descibe in full the methodology. Will any reference manager be used? What is the time frame? How is the distinction between critical and non-critical setting done? Are there two or three researchers engaged in the analysis of publications?

2. Figure 1 is not mentioned int the text, it also does not add any value to the publication.

3. The protocol requires english editing.

4. Line 32 and line 33 - two consecutive sentences start with "However". Please replace it with a different vocabulary.

5. Line 40 - the authors declare the research in any language will be considered. How are the authors planning to perform translation to understant the full context of the publication?

6. Line 44, line 166 - the term "hurt" seems to be ambiguous, please consider different term.

7. Line 45-48 - this sentence is too long and unclear, please consider rephrasing.

9. Line 56 - please consider adding a subject, e.g "especially in patients with hypoxemic respiratory failure" instead of effectivenes in [...], especially in hypoxemic respiratory failure

9. Line 59 - please consider using a different term instead of "known", "set" or "planned" seems to be more adequate verb here

10. Line 63 0 please consider adding "its" or "HFNC" before the word "use"

11. Line 70 - none of the cited studies [19-21] concerns newborns. In study 19 & 20 pediatric population is being studied, however very few newborns are included. Study 21 reffers mainly to adults.

12. Line 76 - please refrain from repeating an adjective "different" in one sentence.

13. Line 77-78 - the sentence "The flow used in HFNC needed to trigger them in adults with and without diseases in incomprehensible

14. Line 98 - 99 - repeated phrase "through the Ovid platform"

15. Line 116-118 phrase "adults [...] who may be healthy or have a disease requiring acute or chronic use of HFNC" is unclear. Are patents requiring HFNC without any underlying diseases or with acute or chronic resp. diseases included? Please clarify

16. Line 166-167 - "altering the preathing and swallowing pattern" - is altering the synchronization of breathing and swallowing ment?

17. Line 168-170 - the sentence "This could be explained [...]." is unclear, the term "vitellus" stands for an egg yolk, what was ment?

Reviewer #2: The authors present the protocol for a narrative review on swallowing disorders in adult patients with ongoing high flow nasal therapy. Authors properly state pitfalls of previous similar studies: not systematic searches or not adequately summarized.

Authors aim to review the frequency of swallowing disorders and scales used for assessment. Some confoundings are commented: flow, oxygen fraction, device, location of patients (critical vs non-critical), age.

My main concern is about management of these confoundings to present the results. Could authors detail?

Authors state that aspiration pneumonia has been associated with HFNC, but a cite is lacking.

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Reviewer #1: Yes: Joanna Maria Jassem-Bobowicz

Reviewer #2: No

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Assessing swallowing disorders in adults on high-flow nasal cannula in critical and non-critical care settings. A scoping review protocol

PONE-D-23-04634R1

Dear Dr. Ruvistay Gutierrez-Arias,

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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Kind regards,

Silvia Fiorelli

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Congratulations to the authors and thanks to the reviewers for the suggestions provided which really helped improve the quality of the manuscript

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 #2: Yes

Reviewer #3: Yes

**********

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 #2: Yes

Reviewer #3: 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 #2: Yes

Reviewer #3: 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 #2: Yes

Reviewer #3: 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 #2: Yes

Reviewer #3: 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 #2: All my comments were adequately answered. The protocol has been clearly improved. I have no further comments.

Reviewer #3: Many thanks for asking me to review the above Scoping Reveiw.

The authors aimed to explore the literature to identify and map the evidence regarding the frequency and methods of assessing swallowing disorders in adult HFNC users in critical and non critical units.

It is a well written manuscript and the findings, provide insight into the methodological characteristics, the frequency of swallowing disorders, and the instruments used to assess their presence.

The authors have clearly and precisely responded to the comments of previous Reviewers, thus clarifying some "grey" areas of the Study's methodology.

Not having to point out any additional comment or correction, I think the Manuscript should be published in its current form.

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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

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