Interhospital variation in the nonoperative management of acute cholecystitis

Konmal Ali; Nikhil L. Chervu; Sara Sakowitz; Syed Shahyan Bakhtiyar; Peyman Benharash; Shahin Mohseni; Jessica A. Keeley

doi:10.1371/journal.pone.0300851

Peer Review History

Original SubmissionJanuary 4, 2024
31 Jan 2024 Decision Letter - Barry Kweh, Editor PONE-D-23-42781Interhospital Variation in the Nonoperative Management of Acute CholecystitisPLOS ONE Dear Dr. Benharash, 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 Mar 16 2024 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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Additional Editor Comments: A well conducted large study which requires a broader discussion to compare the authors' findings to the existing literature. [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? 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ******** 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: 1. the topic is not unique but worthy of researching 2. there are many papers in google scholar and Refseek about this topic since 2020 3. Ethical approval is mentioned 4. the title is attractive 5. the abstract contains plagiarism. Otherwise it is good 6. the aim is clear 7. the KEYWORDS are good 8. lack of the abbreviations section 9. the introduction provide sufficient background information for readers in the immediate field to understand the problem/hypotheses 10. the text arrangement is good 11. the method section is good 12. the depth of the academic material is good 13. the study design is good 14. The suitability and accuracy of questions is good 15. The research methodology is clear 16. The materials are good 17. the logic is clear 18. the paper is novel 19. there are few grammatical errors in this article 20. the related concepts are introduced 21. the readability is sufficient 22. the results are good 23. all figures/tables are clear enough to summarize the results for presentation to the readers 24. all figures/tables are well referred to in the text 25. the theoretical analysis in this article is sufficient 26. the discussion of results from multiple angles is sufficient 27. the conclusion is tenable 28. the reference section contains too many old ref 29. please use (google scholar and Refseek) search engines then set it since 2019 30. the references are in order within the text 31. Bias is present 32. There is no conflict of interest with the author about this topic 33. Fund is mentioned 34. Conflict of interest is mentioned 35. Acknowledgement is mentioned 36. You can use my suggestions My final decision is acceptable as it is Reviewer #2: 1. Competing interests needs to be described according to the specific requirements of the journal. 2. PLOS Data Policy requires authors to explain the restrictions in detail (e.g., data contain potentially identifying or sensitive patient information) and provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. 3. Reference: The referred literature is a bit outdated so cannot reflect the latest research trends. The authors need to describe more about the new research results rather than outdated research from the past. 4. Figures: Figures should be uploaded in TIFF or EPS format. 5. Tables: Place the title above the table and the legend or footnotes below the table. 6. Page 5 line 104: Delete the comma between “including” and “age”. 7. Methods: I would suggest adding subheadings and writing in sections to understand easier for readers. 8. Table 1,2：There’s no “clinical characteristics” in tables but at the title of the tables and the text. 9. Figure 2：Please explain how to definite the “hospital rank”. 10. Figure 3: The Pval for symbol “” was not be identified. ******* 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: Yes: hazim alhiti 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
16 Feb 2024 Author Response Response to Reviewers Reviewer # 1: 1. the topic is not unique but worthy of researching 2. there are many papers in google scholar and Refseek about this topic since 2020 3. Ethical approval is mentioned 4. the title is attractive 5. the abstract contains plagiarism. Otherwise it is good Thank you for your comment. We have made the following edits within the abstract (Page 2-3). Cholecystectomy remains the standard management for acute cholecystitis. Given that rates of nonoperative management have increased, we hypothesize the existence of significant hospital-level variability in operative rates. All adult admissions for acute cholecystitis were queried using the 2016-2019 Nationwide Readmissions Database. Centers were ranked by nonoperative rate using multi-level, mixed effects modeling. We noted a significant variability in the interhospital variation of the nonoperative management of acute cholecystitis. 6. the aim is clear 7. the KEYWORDS are good 8. lack of the abbreviations section 9. the introduction provide sufficient background information for readers in the immediate field to understand the problem/hypotheses 10. the text arrangement is good 11. the method section is good 12. the depth of the academic material is good 13. the study design is good 14. The suitability and accuracy of questions is good 15. The research methodology is clear 16. The materials are good 17. the logic is clear 18. the paper is novel 19. there are few grammatical errors in this article Thank you for your comment. We have fixed grammatical errors within the article. 20. the related concepts are introduced 21. the readability is sufficient 22. the results are good 23. all figures/tables are clear enough to summarize the results for presentation to the readers 24. all figures/tables are well referred to in the text 25. the theoretical analysis in this article is sufficient 26. the discussion of results from multiple angles is sufficient 27. the conclusion is tenable 28. the reference section contains too many old ref We appreciate your comment. We have made the following amendments to the references and have minimized the usage of any older references (Pages 16-21). [2] Escartín A, González M, Cuello E, et al. Acute cholecystitis in very elderly patients: disease management, outcomes, and risk factors for complications. Surg Res Pract. 2019;2019:9709242. doi:10.1155/2019/9709242 [3] Parikh SS, Lindquester WS, Dhangana R. National cholecystostomy tube placement and cholecystectomy trends from 2010 to 2018. Journal of the American College of Radiology. 2023;20(6):537-539. doi:10.1016/j.jacr.2023.03.012 [5] Kurihara H, Binda C, Cimino MM, Manta R, Manfredi G, Anderloni A. Acute cholecystitis: Which flow-chart for the most appropriate management? Digestive and Liver Disease. 2023;55(9):1169-1177. doi:10.1016/j.dld.2023.02.005 [6] Kim SJ, Park HS, Lee DW. Outcome of nonoperative treatment for hip fractures in elderly patients: A systematic review of recent literature. J Orthop Surg (Hong Kong). 2020;28(2):230949902093684. doi:10.1177/2309499020936848 [11] Wells K, Fleshman J. Nonsurgical, minimally invasive, and surgical methods in management of acute diverticulitis. JAMA Surgery. 2019;154(2):172-173. doi:10.1001/jamasurg.2018.3112 [16] Using appropriate price indices for expenditure comparisons. Accessed February 15, 2024. https://meps.ahrq.gov/about_meps/Price_Index.shtml [25] Mora-Guzmán I, Di Martino M, Bonito A, Jodra V, Hernández S, Martin-Perez E. Conservative management of gallstone disease in the elderly population: outcomes and recurrence. Scand J Surg. 2020;109(3):205-210. doi:10.1177/1457496919832147 [28] Haque LA. The effect of delays in acute medical treatment on total cost and potential ramifications due to the coronavirus pandemic. HPHR. 2021;26. Accessed February 15, 2024. https://www.jstor.org/stable/48617322 [33] Popescu I, Fingar KR, Cutler E, Guo J, Jiang HJ. Comparison of 3 safety-net hospital definitions and association with hospital characteristics. JAMA Network Open. 2019;2(8):e198577. doi:10.1001/jamanetworkopen.2019.8577 [34] Hefner JL, Hogan TH, Opoku-Agyeman W, Menachemi N. Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal. BMC Health Services Research. 2021;21(1):278. doi:10.1186/s12913-021-06292-9 [38] Nath JB, Costigan S, Lin F, Vittinghoff E, Hsia RY. Access to federally qualified health centers and emergency department use among uninsured and medicaid‐insured adults: california, 2005 to 2013. Mycyk MB, ed. Academic Emergency Medicine. 2019;26(2):129-139. doi:10.1111/acem.13494 29. please use (google scholar and Refseek) search engines then set it since 2019 30. the references are in order within the text 31. Bias is present 32. There is no conflict of interest with the author about this topic 33. Fund is mentioned 34. Conflict of interest is mentioned 35. Acknowledgement is mentioned 36. You can use my suggestions My final decision is acceptable as it is Thank you for this comment. We have incorporated the above suggestions within our manuscript. Reviewer # 2: 1. Competing interests needs to be described according to the specific requirements of the journal. Thank you for your comment. We have provided the following statement. P. Benharash serves as a proctor for AtriCure. The content of this manuscript is unrelated to this work. The others authors have no disclosures. All authors declare no competing interests. 2. PLOS Data Policy requires authors to explain the restrictions in detail (e.g., data contain potentially identifying or sensitive patient information) and provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. We appreciate your comment. We have added the following statement with our submission. The data utilized in the present study may be obtained directly from the Agency for Healthcare Research and Quality (AHRQ), upon specific approval by the AHRQ for data access. Users must also complete a mandatory Data Use Agreement in order to access these data. For all researchers who meet these criteria, the NIS and all data of the present study may be obtained directly from the AHRQ (website: www.hcup- us.ahrq.gov; email: hcup@ahrq.gov). The authors of this work had no special privileges to access the data that others would not have. Legally, we are not permitted to share the datasets directly, as part of the Data Use Agreement. 3. Reference: The referred literature is a bit outdated so cannot reflect the latest research trends. The authors need to describe more about the new research results rather than outdated research from the past. Thank you for your comment. We have updated our reference list to ensure our work reflects the most current research trends. These changes can be found on (Pages 16-21). [2] Escartín A, González M, Cuello E, et al. Acute cholecystitis in very elderly patients: disease management, outcomes, and risk factors for complications. Surg Res Pract. 2019;2019:9709242. doi:10.1155/2019/9709242 [3] Parikh SS, Lindquester WS, Dhangana R. National cholecystostomy tube placement and cholecystectomy trends from 2010 to 2018. Journal of the American College of Radiology. 2023;20(6):537-539. doi:10.1016/j.jacr.2023.03.012 [5] Kurihara H, Binda C, Cimino MM, Manta R, Manfredi G, Anderloni A. Acute cholecystitis: Which flow-chart for the most appropriate management? Digestive and Liver Disease. 2023;55(9):1169-1177. doi:10.1016/j.dld.2023.02.005 [6] Kim SJ, Park HS, Lee DW. Outcome of nonoperative treatment for hip fractures in elderly patients: A systematic review of recent literature. J Orthop Surg (Hong Kong). 2020;28(2):230949902093684. doi:10.1177/2309499020936848 [11] Wells K, Fleshman J. Nonsurgical, minimally invasive, and surgical methods in management of acute diverticulitis. JAMA Surgery. 2019;154(2):172-173. doi:10.1001/jamasurg.2018.3112 [16] Using appropriate price indices for expenditure comparisons. Accessed February 15, 2024. https://meps.ahrq.gov/about_meps/Price_Index.shtml [25] Mora-Guzmán I, Di Martino M, Bonito A, Jodra V, Hernández S, Martin-Perez E. Conservative management of gallstone disease in the elderly population: outcomes and recurrence. Scand J Surg. 2020;109(3):205-210. doi:10.1177/1457496919832147 [28] Haque LA. The effect of delays in acute medical treatment on total cost and potential ramifications due to the coronavirus pandemic. HPHR. 2021;26. Accessed February 15, 2024. https://www.jstor.org/stable/48617322 [33] Popescu I, Fingar KR, Cutler E, Guo J, Jiang HJ. Comparison of 3 safety-net hospital definitions and association with hospital characteristics. JAMA Network Open. 2019;2(8):e198577. doi:10.1001/jamanetworkopen.2019.8577 [34] Hefner JL, Hogan TH, Opoku-Agyeman W, Menachemi N. Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal. BMC Health Services Research. 2021;21(1):278. doi:10.1186/s12913-021-06292-9 [38] Nath JB, Costigan S, Lin F, Vittinghoff E, Hsia RY. Access to federally qualified health centers and emergency department use among uninsured and medicaid‐insured adults: california, 2005 to 2013. Mycyk MB, ed. Academic Emergency Medicine. 2019;26(2):129-139. doi:10.1111/acem.13494 4. Figures: Figures should be uploaded in TIFF or EPS format. We appreciate your comment. All figures have been uploaded in TIF format. 5. Tables: Place the title above the table and the legend or footnotes below the table. Thank you for your comment. We have made the suggested changes in Table 1 and 2 (Pages 8-10). 6. Page 5 line 104: Delete the comma between “including” and “age”. We appreciate your comment. We have adjusted this error (Page 5). Patient and hospital characteristics including age, sex, income quartile, primary payer, hospital setting, hospital teaching status, and bed size were defined according to the NRD data dictionary. 7. Methods: I would suggest adding subheadings and writing in sections to understand easier for readers. Thank you for your comment. We have added subheadings within the methods section to improve understanding for readers (Pages 5-7). 8. Table 1,2：There’s no “clinical characteristics” in tables but at the title of the tables and the text. We appreciate your comment. We have updated the titles of the tables to better reflect the data demonstrated (Page 8 and 10). Table 1: Baseline patient and hospital demographics of nonoperatively and operatively managed patients admitted for acute cholecystitis 2016-2019. Table 2: Baseline patient and hospital demographics of patients admitted for acute cholecystitis 2016-2019 receiving treatment at Low Operative Hospitals (LOH) versus non-Low Operative Hospitals (nLOH). 9. Figure 2：Please explain how to definite the “hospital rank”. Thank you for your comment. We have included information about the hospital rank within our figure caption (Page 9). Figure 2: Interhospital variation in nonoperative management of acute cholecystitis with 95% confidence intervals. Centers in the top decile of nonoperative rate (>9.4%) were classified as Low Operative Hospitals; LOH, Low Operative Hospitals; nLOH, non-Low Operative Hospitals. 10. Figure 3: The Pval for symbol “” was not be identified. We appreciate your comment. We have added the symbol to Figure 3 (Page 11). Attachments Attachment Submitted filename: Response to Reviewers.docx* https://doi.org/10.1371/journal.pone.0300851.r002
6 Mar 2024 Decision Letter - Barry Kweh, Editor Interhospital Variation in the Nonoperative Management of Acute Cholecystitis PONE-D-23-42781R1 Dear Dr. Benharash, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at http://www.editorialmanager.com/pone/ and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Barry Kweh Academic Editor PLOS ONE Additional Editor Comments (optional): The authors have strengthened by manuscript including grammatical errors and literature review following revisions suggested by the reviewers Reviewers' comments: https://doi.org/10.1371/journal.pone.0300851.r003
Formally Accepted
29 Apr 2024 Acceptance Letter - Barry Kweh, Editor PONE-D-23-42781R1 PLOS ONE Dear Dr. Benharash, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Barry Kweh Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0300851.r004

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