PONE-D-23-31394Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.PLOS ONE

Dear Dr. Badrasawi,

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PLOS ONE

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

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: The article titled “Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy: a cross-sectional study” aimed to determine the prevalence of taste alterations during chemotherapy and their association with nutritional status and malnutrition. The study is interesting; the Authors determined different aspects relating to the problem using different questionnaires, however the paper is difficult to follow. In particular, the methods are not detailed enough, and this creates problems for the readers. There are some points that need to be carefully elucidated before publication.

Introduction

In lines 49-50: The author’s state: “and patients exhibiting increased sensitivity to it (6).” In reference 6, authors declare that sweet thresholds significantly declined in patients. Please correct the statement.

Methods

The authors evaluate different parameters by using specific scales or tools: TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. It is not clear why for each scale or tools the author’s used the Cronbach’s alpha test to evaluate the reliability. Please explain.

Table 2:

In the methods Authors indicate that the Charlson comorbidities index includes 17 comorbidities, why Authors include 20 comorbid conditions in the table? Please explain or correct.

What the “assigned weighing” means?

Table 3 includes Patient’s biochemical levels presented in n (%). The number of subjects is different for each parameter. Why have the Authors choice to include these parameters (albumin, hemoglobin, total protein and c-reactive protein)? and why Authors report these data only in few patients? Have these parameters an association with specific cancer? Please explain the reason for your choice. Did the Authors consider that these parameters are involved in Taste alteration or malnutrition? Please explain. If there is no specific reason, or any association with the study I would suggest removing these data.

The name Table 4 is used twice (line 176 and line 184) please correct it.

Regarding Table 4 Chemotherapy side effects. I would suggest indicating the side effects in order of greatest percentage of frequency.

Reviewer #2: The MS "Taste alteration and its relationship with nutritional status among cancer patients

receiving chemotherapy, cross-sectional study." is well written and well organized with an in-depth approach and including several parameters that can modify taste in cancers

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Reviewer #1: No

Reviewer #2: No

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PONE-D-23-31394R1Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.PLOS ONE

Dear Dr. Badrasawi,

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 May 19 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,

Naim Akhtar Khan, PhD, DSc

Academic Editor

PLOS ONE

Journal Requirements:

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 notice.

Additional Editor Comments:

The MS must be revised with minor corrections as report.

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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 #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 #3: Yes

**********

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

Reviewer #3: Yes

**********

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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 #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. 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 #3: Reviewer_Pr. EA. KOCEIR

Head of the Natural and Life Sciences Domain - Head of Nutrition and Pathologies Post Graduate School

Head of Nutrition and Human Dietetics Master - Head of Bioenergetics and Intermediary Metabolism team

Biology and Organisms Physiology laboratory - Faculty of Biological Sciences - University of Sciences and Technology "Houari Boumédiene" (USTHB) - BP 32, Elalia, 16111, Bab Ezzouar, Algiers, ALGERIA - Tel/Fax : [+ 213] (0) 21 24 72 17 - Cell phone : [+ 213] (0)6 66 74 27 70

Alternative email address : ekoceir@usthb.dz; ea.koceir@outlook.fr

Google Scholar : https://scholar.google.fr/citations? - Sciprofiles : https://sciprofiles.com/profile/455388 - ORCID: 0000-0003-1345-2535

_______________________________________________________________________________________________________________________

Peer Review for “Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study"

PONE-D-23-31394R1

PLOS ONE

Dear Dr. Koceir,

Thank you for agreeing to submit a review on PLOS ONE manuscript "Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.." As a reminder, your review is due by ven. 15 mars 2024 (UTC+1) can be submitted at https://www.editorialmanager.com/pone/.

Dear Professor Naim Akhtar Khan, Academic Editor

I'm sorry I didn't answer right away. I was busy with a national examination period to enter postgraduate school, which required me to orally examine candidates.

___________________________

General view

Authors have investigated the relationship between altered taste perceptions and the prevalence of denutrition in cancer patients receiving chemotherapy. Overall, this is an original clinical study, both in the scientific theme related to the physiology of taste dysfunction, and in the complex cancer pathology. The study was fine conducted both by methodology approach and statistically cohort. The MS is very well written with good academic English. Regarding the review, I have read that comments have been raised by other reviewers and there is no need to ask the same questions again. However, some comments relate specifically to the nutritional status.

Comments

1. In lines 184-185: Thanks to set the unit of the value body weight (79.43±17.34! and 77.41±17.23 !). It seems that the difference is not significant before and after chemotherapy. It should be remembered that the BMI is an index of corpulence and not of malnutrition. If we consider the BMI, your patients do not present malnutrition (0.83% were underweight in line 184). Moreover 70% are obese-overweight. Why?

2. This same observation (non-significant) is noted for the malnutrition serum parameters (table 3) such as albumin (10.9%) and total proteins (14.28%). Haemoglobin and C-reactive protein is not linked to malnutrition, but to anaemia and inflammation, respectively. Thank you for giving arguments

3. I am not opposed to the MUST test, but it is admitted that it is the Nutritional Risk Index (NRI) test or Buzby index which is the most practiced. In your study we do not know the degree of malnutrition: severe or moderate. Thank you for your comment.

4. If we consider that cancer patients undergoing chemotherapy present malnutrition. Is this due to anorexia (linked to cytokine storm) or to altered taste perception!!

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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 #3: No

**********

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Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.

PONE-D-23-31394R2

Dear Dr. Badrasawi,

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,

Naim Akhtar Khan, PhD, DSc

Academic Editor

PLOS ONE

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