PONE-D-23-13340Prechtl’s method to assess general movements: Inter-rater reliability for the global and detailed assessment during the preterm periodPLOS ONE

Dear Dr. Angelica VALENCIA

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Academic Editor

PLOS ONE

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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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

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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

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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: This study evaluated GMA global results and GMOS scores for 65 infants videotaped at <37 weeks postmenstrual age prior to hospital discharge. Raters were well qualified to rate videos. Five pairs of raters were enlisted to test the reliability and agreement of the ratings, but one pair of raters only evaluated 4 participants and this pairing was excluded from analysis. Findings were in general agreement with other studies , however the authors identified 95% confidence intervals that included much lower values for reliability. The authors indicated this may affect the generalization of the results. However, the confidence interval would be likely to narrow with larger sample sizes and given their small number of participants, it is not clear if they have proven their conclusion.

Apart from this finding, the results are largely confirming other studies. The discussion is not clearly organized and the conclusions are somewhat vague. It is difficult to understand the main points the authors are trying to make.

Reviewer #2: The paper entitled “Prechtl’s method to assess general movements: Inter-rater reliability for the global and detailed assessment during the preterm period” report on an interesting issue on the use of general movements in preterm newborns.

This paper is of interest for physicians involved in the follow-up of this population of infants. However there are few issues that should be commented.

Introduction

Pag 9 line 57: I’m not sure that the GMs should be considered a “neuromotor test”. It measures the quality of movement detecting disorders of movement (functional limitation), as better explained few lines after.

Results

It seems that the % of abnormal GMs pattern was lower than that of normal GMs. It could be of interest to know more information about the clinical characteristics in term of risk of neurological impairment; for example the US scan data or MRI, seizures, incidence of SGA or other potential risk factors

Discussion

The results are well discussed like as the potential limitations.

Please revise all the manuscript for English

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Reviewer #1: No

Reviewer #2: No

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PONE-D-23-13340R1Prechtl’s method to assess general movements: Inter-rater reliability during the preterm periodPLOS ONE

Dear Dr. VALENCIA,

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 17 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:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Claudia Brogna

Academic Editor

PLOS ONE

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction 

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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: (No Response)

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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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

Reviewer #3: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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: Yes

Reviewer #3: Yes

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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: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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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: A table of neonatal morbidities has been added but these should be defined in the text. The rate of PVL seems unusually high and this may reflect the definition of PVL or selection of patients for the study.

Reviewer #2: The authors answered to all the queries. No further comments are needed

Reviewer #3: This study details the inter-rater reliability of preterm writhing GMA global scores as well as the General Movements Optimality Score (GMOS). Strengths of this study include the generalisability of results with raters being in different countries. The small sample size is a limitation, although the authors do very well to explore this in great detail without biasing the results in their favour, rather encouraging the reader to exercise caution and notes for future studies.

Abstract:

Would be good to use the term “preterm writhing GMA” to add clarity about which period of GMs the study focuses on. Similarly, the term “preterm writhing GMA” does not appear anywhere in the abstract. This is important to highlight to differentiate from fidgety GMs.

Introduction:

Ideally throughout the manuscript, the distinction between fidgety and writhing should be made to avoid any confusion. E.g. when discussing previous literature about interrater agreement and predictive validity – are the studies referenced in relation to writhing or fidgety movements? Sometimes it is qualified in the manuscript, and sometimes it is not.

Avoid definite statements, e.g. “…has not been reported”; “this is the first study”. There may be conference abstracts or similar that details this. Instead, consider using “little/scarce publish data exists” or “to our knowledge, few studies report…”/”there is a scarcity of data..”

The authors do well do describe the gap in knowledge (although some expressions could be less definitive, see above), but justification for the importance of the knowing the accuracy in the preterm writhing period is lacking. i.e. what is the clinical benefit of having this knowledge during the preterm period? This point may be able to be addressed easily by highlighting research about preterm writhing movements, specifically, and their relationship with later development (line 92 – unclear if this research refers to preterm writhing or fidgety GMA, best to check).

Methods:

“Crying and hiccupping episodes were suppressed with an online editing program” – I’m not sure I understand how this is possible? Which program was used? Perhaps this program needs to be quoted, as you would with statistical analysis software. This sounds like a very complex procedure and could affect how general movements are observed with human Gestalt perception. Do the authors perhaps mean they were simply edited out?

The authors may want to refer to the work by Dr Crowle Early Human Development, 104, 2017, to further justify the use of Gwets AC1.

Results:

Appropriate, tables clear to read.

Discussion:

Appropriate and well discussed limitations.

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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.

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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

Reviewer #3: No

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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.

Prechtl’s method to assess general movements: Inter-rater reliability during the preterm period

PONE-D-23-13340R2

Dear Dr. Angelica VALENCIA,

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.

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Kind regards,

Claudia Brogna

Academic Editor

PLOS ONE

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