PONE-D-23-34488Efficacy and safety of acupuncture treatment for post-stroke depression:A protocol for systematic review and meta-analysisPLOS ONE

Dear Dr. Zou,

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Yung-Hsiang Chen, Ph.D.

Academic Editor

PLOS ONE

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Additional Editor Comments:

Thank you for submitting the following manuscript to PLOS ONE.

Please revise the manuscript according to the reviewers' comments and upload the revised file.

[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: 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: No

Reviewer #2: Yes

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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. This study failed to state why it is important to do this review. Several meta-analyses/protocols of meta-analysis have been published in recent years. However, there is no effective comparison between the previous meta-analysis and this one in the background or discussion.

2. The author needs to improve the English expression and grammar of the full text.

3. The total effective rate of AC to treat PSD was selected as the primary outcome in this study, but the author failed to state the definition of effective.

4. The protocol of data synthesis and Sensitivity analysis needs to be more detailed.

Reviewer #2: The manuscript, presenting a research protocol for a meta-analysis on the effectiveness and safety of acupuncture therapy in treating post-stroke depression, appears to be of good quality. The topic chosen is of considerable clinical significance. Although the initial quality of the manuscript is commendable, there are areas where further refinement could enhance its scientific rigor and clarity. Detailed observations and suggestions are provided below to assist in these potential improvements.

1. Innovativeness

Your manuscript mentions previous similar meta-analyses and describes their limitations. This is a good starting point. To strengthen the innovativeness of your manuscript, it is suggested to more elaborately detail how this study makes innovative contributions on this basis, and the importance of these innovations in the current field of research.

2. Structure of the Abstract

The abstract is a crucial part of the paper, aiming to concisely and clearly highlight the main points of the research. Regarding the background section, it is advised to streamline the current expression, retaining only information directly relevant to the research, to enhance the clarity and efficiency of the abstract.

3. Tense Issues

In lines 173 to 175, you refer to the characteristics of this study as a protocol. Regarding the use of tense, it is recommended to review and adjust to ensure consistency and accuracy in the text when describing the research design, methods, and expected outcomes.

4. Choice of SMD

When choosing the Standardized Mean Difference (SMD) as the measure of effect size, please provide a more detailed explanation as to why the Mean Difference (MD) is not applicable in this study.

5. Introduction to GRADE

In lines 188 to 190, the introduction to the GRADE assessment method seems overly brief. To better help readers understand how you have applied this method and its role in your research, please provide a more detailed explanation, including its assessment criteria and how it is applied in this study.

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Reviewer #1: No

Reviewer #2: No

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Efficacy and safety of acupuncture treatment for post-stroke depression:A protocol for systematic review and meta-analysis

PONE-D-23-34488R1

Dear Dr. Zou,

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,

Yung-Hsiang Chen, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Your manuscript has been evaluated by external reviewers and members of the editorial board.

Congratulations on the acceptance of your manuscript, and thank you for your interest in submitting your work to PLOS ONE.

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 #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 #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 #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 #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 #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 #3: The paper discusses the high incidence and low recognition rate of post-stroke depression (PSD), emphasizing its impact on patients’ mental well-being and the increased risk of stroke recurrence and poor prognosis. It highlights the public health concern posed by PSD. It examines the popularity and inconsistent clinical research results regarding the efficacy and safety of acupuncture as a treatment for PSD. The systematic review aims to gather and critically assess all available evidence on the effectiveness and safety of acupuncture in treating patients with PSD. The authors address the journal’s requirements and reviewers’ comments, making corrections and providing clarifications to improve the manuscript. They emphasize the significance of studying acupuncture for PSD and detail their responses to the editorial and reviewer comments. This section serves as an introduction to the study protocol for a systematic review and meta-analysis on acupuncture treatment for PSD. It sets the stage for the detailed methodology and expected outcomes of the review. The manuscript has undergone a thorough review, and the revisions have been commendably executed. I advocate considering this manuscript for publication.

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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 #3: No

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