Peer Review History
Original SubmissionAugust 17, 2023 |
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PONE-D-23-26045Information disclosure during the consenting process in cancer clinical care: perspectives of healthcare professionals at Uganda Cancer InstitutePLOS ONE Dear Dr. Mwaka, 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 Jan 06 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. Please include the following items when submitting your revised manuscript:
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The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge all respondents.” Please state what role the funders took in the study. If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. 5. Thank you for stating the following in the Acknowledgments Section of your manuscript: “We acknowledge Associate Professor Charles Ibingira who was a co-supervisor to RK. We would like to thank UCI management for granting us administrative clearance to conduct research at her premises. We also acknowledge all our research participants and UCI staff. Lastly, we acknowledge Adelline Twimukye for her role in data analysis. This study was supported by the Fogarty International Center of the National Institutes of Health under Award Number R25TW009730. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge all respondents.” We note that you have provided funding information that is currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “This study was supported by the Fogarty International Center of the National Institutes of Health under Award Number R25TW009730 that supported RK’s Master of Health Sciences in Bioethics program at Makerere University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge all respondents.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 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: Partly ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: N/A ********** 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 ********** 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: 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: The paper presents an interesting research based in Uganda about healthcare professionals’ perception of information disclosure to patients in the sensitive context of cancer care. My premise is that I strongly believe this kind of qualitative research is fruitful since it gives the opportunity to the main actors of a specific context to express their opinion. However, it must be rigorous, and the methodology must be solid and well described: otherwise, the high risk is for qualitative research to be biased and provide opinions instead of precious findings. I chose to give the authors the chance to show me that the research is based on a solid methodology, that unfortunately I cannot see in the article. Here some specific points I find weak: - In the Introduction I read “one way of respecting a person’s autonomy is through obtaining informed consent”. This sentence shows me a general problem about this article: instead, I would say that respecting one’s autonomy entails giving them the possibility to give their consent, that must be informed. Put in the authors’ way, this sensitive topic is quite shallow. I trust that the authors know what they are talking about, but they did not manage to well explain it in the article. Also, there is no literature about autonomy nor informed consent: adding it could help the authors’ digging into the main topic of their research in a more profound way, that consequently helps the reader to understand the overall picture. - Although every informed consent should be considered essential in persons’ care, the authors want to be sure that their readers understand that different fields of care are on different levels. Comparing the informed consent process for dental care to cancer care it is confusing and does not give to the sensitive context they are exploring the attention it deserves. Again, no literature about the sensitive context of cancer care is provided. - What’s the Charter (reference 8)? It is not obvious for a reader that is not from Uganda. No specific understanding of Uganda’s context is provided – except for a brief description of the hospital where they conducted their research. I think that it is useful to describe every context in its uniqueness, and especially such a context: it would give to the research more credibility and show its importance. From authors’ words, “the required services are not available at the primary health unit where patients are first attended”: what does this mean? That is not common and probably pertains to a delicate context that is not explained. The “linguistic challenge” that such a context must face are not obvious either. - “Materials and methods” section is quite weak. I would prefer a different structure to give a solid base to the research. I cannot find different important elements; for example, why only 10 participants? It’s quite a small number. Even more important, why only healthcare professionals and not patients, that are the main subjects of the topic? I would suggest providing a table about interviewees, with variables that the authors seemed to collect (profession, gender, age…). Also, it would be interesting to provide a table with the questions they used in the interviews; and were the interviews structured, semi-structure…? What do the authors mean when they say that “the interview guide was piloted on three cancer patients”? It is not a standard process considering that they aimed to interview healthcare professionals and not patients, so they at least need to provide a justification for that. The authors declare that translations from Luganda to English were made: what is the method implied? Was the translation provided by a mother tongue? Or a software? That is such an important point, because we well know that translations may convey different meanings compared to the original language. The authors declare that “some transcripts were returned to interviewees for member checking”: what does this mean? Is this related to the coding? This point also needs a justification. A description of the interviewers is provided at the end of the section dedicated to data management and analysis, and I do not think it is the right place. Also, the authors disclose their biases in conducting this research, but the way they do that (“it was difficult for us to be totally objective”) does not strengthen the article; instead, it could be seen as unprofessional and compromise the overall research, because even though it is true that researchers are not objective, their methodology should be in order to guarantee reliable results. - The authors report that “some respondents […] withhold or delay the disclosure of vital information”: this is such an interesting and sensitive point that must be further explored – otherwise, it could be read as a justification for this behavior that is not even legally permitted. Similarly, when the authors say that some healthcare professionals “hold discussions with the patient’s family if the patient is not competent”: what do they mean with “competent”? Can ever a patient be competent enough? Again, “patients are increasingly agitating for more active involvement” is an ambiguous sentence that needs to be further explored. - References 28 and 32 are not written in the correct way. - The “Discussion” section often repeats concepts already explored without digging more. As already said, sentences like “at times it is necessary to withhold the truth from the patient” seem to me quite dangerous if not well-contextualized. It is quite annoying for the reader that some sentences are repeated in different places without further analysis. - I suggest a revision of English: there are subjects missing and many sentences are just copied and pasted. In my opinion, the subject is interesting and I would be glad to read this article written in a more solid way; I expect the authors to show the robustness of their methodology based on the comments above. Reviewer #2: See uploaded document that includes all comments to the author as the formatting became distorted when uploaded to this box. Please note am also typing here to meet character limit so I can upload document successfully and proceed with submission of this review to PLOS One. ********** 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: Monica Consolandi 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". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.
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Revision 1 |
Informed consent in cancer clinical care: perspectives of healthcare professionals on information disclosure at a tertiary institution in Uganda PONE-D-23-26045R1 Dear Dr. Sabakaki Mwaka 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 Editorial Manager® , 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, Luca Valera Academic Editor PLOS ONE Additional Editor Comments (optional): 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 #1: 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 ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A ********** 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 ********** 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 ********** 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: "To the best of the authors’ knowledge, this is the first article to document informed consent practices in cancer care in Uganda." --> I would put this line 101 before “this study therefore…” I'm glad to see that the authors addressed all the comments and suggestions; the article sounds definitely better. I'm also happy to see that this kind of qualitative research is being pursued, providing PlosOne readers with the opportunity to better understand a particular context, such as the Ugandan one. ********** 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: Yes: Monica Consolandi ********** |
Formally Accepted |
PONE-D-23-26045R1 PLOS ONE Dear Dr. Mwaka, 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. Luca Valera Academic Editor PLOS ONE |
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