Public interest in palliative care in Latin America: A Google Trends analysis

Brayan Miranda-Chavez; Niels Pacheco-Barrios; Alvaro Taype-Rondan

doi:10.1371/journal.pone.0306312

Peer Review History

Original SubmissionDecember 26, 2023
23 May 2024 Decision Letter - Martin Schneider, Editor PONE-D-23-43665Public interest in palliative care in Latin America: A Google Trends analysisPLOS ONE Dear Dr. Taype-Rondan, 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 Jul 07 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, Martin Schneider Academic Editor PLOS ONE Journal Requirements: 1. When submitting your revision, we need you to address these additional requirements. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf. 2. Please note that PLOS ONE has specific guidelines on code sharing for submissions in which author-generated code underpins the findings in the manuscript. In these cases, all author-generated code must be made available without restrictions upon publication of the work. Please review our guidelines at https://journals.plos.org/plosone/s/materials-and-software-sharing#loc-sharing-code and ensure that your code is shared in a way that follows best practice and facilitates reproducibility and reuse. 3. In your Methods section, please include additional information about your dataset and ensure that you have included a statement specifying whether the collection and analysis method complied with the terms and conditions for the source of the data. 4. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. 5. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate ""supporting information"" files. 6. 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: Dear Dr Taype-Rondan, Thank you for submitting your brief manuscript “Public interest in palliative care in Latin America: A Google Trends analysis.” It focuses on a topic of certain interest and corroborates previous studies from other geographical areas. In spite of the positive opinion of the one reviewer, there are several issues and open questions: How did other health-related keywords change over time? A quick look at “Google Trends” shows that the relative search volumes for both “health” and “salud” have increased from 2010 to 2023. This finding may put your results into a context that you have not discussed. Palliative care has historically focused on cancer patients. This is not the case any more; patient with manifold severe chronic diseases are provided palliative care. Thus, the search term “palliative chemotherapy” may have become less representative of palliative care internet queries since the late 2010s. What about searches in other South American languages than Spanish, like Quechua for the Andes, or “paliativismo,” as apparently used in Brazil? Attempts to include ethnic minorities should be visible in the analysis. During the selected time frame, public health crises occurred in Latin America. Particularly the Zika virus outbreak and the COVID pandemic can be associated with needs for palliative care. How do they show in your analysis? The correlation in figure 4 may not satisfy all statisticians… In the references, “disponible en” should be translated into English. [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 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 ****** 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: 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: Manuscript Review: Title: Public Interest in Palliative Care in Latin America: A Google Trends Analysis Manuscript Review: The manuscript presents a comprehensive analysis of public interest in palliative care in Latin America using Google Trends data. The study addresses the increasing demand for palliative care globally and the challenges associated with limited awareness and access, particularly in low- and middle-income countries. By leveraging Google Trends as a digital tool, the manuscript explores search trends related to palliative care from January 2010 to May 2023, focusing on Latin American countries. The introduction provides a thorough background on the significance of palliative care in addressing the needs of individuals with life-limiting illnesses and the gaps in awareness and access observed in Latin America. The rationale for utilizing Google Trends to analyze public interest in palliative care is well articulated, emphasizing its utility in tracking social trends and monitoring health-related topics. In the methodology section, the manuscript details the search process conducted through Google Trends and the selection of relevant search terms. The inclusion of specific keywords related to palliative care, as well as the filtering of data by region, demonstrates a systematic approach to data collection. The manuscript also employs line charts and scatterplots to visualize trends and correlations, enhancing the clarity of the analysis. The results section presents the main findings of the study, highlighting the rising trend in searches for palliative care worldwide and in Latin American countries. Notable peaks in search volume are identified and associated with specific events, such as the case of Brazilian footballer Pelé, providing valuable insights into factors influencing public interest in palliative care. The discussion section interprets the findings in the context of existing literature and offers explanations for observed trends, including the correlation between interest in palliative care and the availability of palliative care services. The manuscript also discusses regional variations in search activity and their implications for palliative care development in Latin America, contributing to our understanding of the evolving landscape of palliative care awareness and access. Overall, the manuscript effectively communicates the study's objectives, methods, and findings, providing valuable insights into public interest in palliative care in Latin America. The integration of Google Trends data with other sources enriches the analysis and enhances our understanding of the challenges and opportunities in advancing palliative care in the region. However, further discussion on the limitations of Google Trends data and potential biases in search behavior could strengthen the manuscript's comprehensiveness. ****** 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: Doaa Attia ******** [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. https://doi.org/10.1371/journal.pone.0306312.r001
Revision 1
9 Jun 2024 Author Response Dear Editor, I hereby submit for your consideration the revised version of the manuscript, now titled "Public interest in palliative care in Latin America: A Google Trends analysis," for possible publication in your prestigious journal. All co-authors have thoroughly reviewed the suggestions, comments, and annotations provided on the previous version of the manuscript, to which we received feedback on May 23rd of this year. We greatly appreciate the time spent on your review and have addressed each suggestion as follows: 1. How did other health-related keywords change over time? A quick look at “Google Trends” shows that the relative search volumes for both “health” and “salud” have increased from 2010 to 2023. This finding may put your results into a context that you have not discussed. R: The terms [salud] and [health] have consistently shown a high search volume, but it wasn't until the COVID-19 pandemic that they experienced a significant peak, which has been sustained since then. On the other hand, terms related to palliative care have been on a positive trend even before the pandemic. It is worth noting that this is a great contribution, and therefore, it has been deemed appropriate to include supplementary material showing the trend of the terms [salud] and [health] in Google Trends. 2. Palliative care has historically focused on cancer patients. This is not the case any more; patient with manifold severe chronic diseases are provided palliative care. Thus, the search term “palliative chemotherapy” may have become less representative of palliative care internet queries since the late 2010s. R: This is another valuable contribution; therefore, it has been deemed appropriate to add a paragraph in the discussion. This paragraph is the penultimate one of the discussions and is cited verbatim below: << The evaluated terms, such as "[eutanasia]", "[euthanasia]", "[muerte digna]", "[death with dignity]", "[sedación terminal]", "[terminal sedation]", "[quimioterapia paliativa]", and "[palliative chemotherapy]", did not exhibit a clear trend, potentially due to their infrequent usage. It is important to note that while palliative care has traditionally focused on cancer patients, it now encompasses individuals with various serious chronic illnesses. As a result, the terms "[quimioterapia paliativa]" and "[palliative chemotherapy]" may be less commonly used today, which could explain the low search frequency observed in our study..>> 3. What about searches in other South American languages than Spanish, like Quechua for the Andes, or “paliativismo,” as apparently used in Brazil? Attempts to include ethnic minorities should be visible in the analysis. R: This analysis with the Portuguese term [paliativismo] has been added to the supplementary material. Likewise, it's worth noting that a precise term has not been found for the Quechua or Aymara languages. 4. During the selected time frame, public health crises occurred in Latin America. Particularly the Zika virus outbreak and the COVID pandemic can be associated with needs for palliative care. How do they show in your analysis? R: This positive trend in favor of palliative care does not seem to have been influenced by the public health issues that LATAM has experienced. Accordingly, we have added the following paragraph in the discussion section: “Additionally, while the search of the terms "[salud]" and "[health]" showed an increasing trend only following the COVID-19 pandemic in 2019/2020, the terms "[paliativos/paliativo/paliativa/paliativas]" have shown a continuous rise since the 2010s. This suggests that the growing interest in palliative care is not merely a secondary effect of the increased interest in health due to the COVID-19 pandemic. Furthermore, the COVID-19 pandemic and other public health crises in Latin America, such as the Zika virus outbreak, do not appear to correlate with significant changes in the overall trend of interest in palliative care.” 5. The correlation in figure 4 may not satisfy all statisticians… R: Although a positive correlation was found between the VRS and level of development, this result is inconclusive due to the small number of countries analyzed and significant exceptions. For instance, Ecuador exhibits a low level of development but a high search volume, while Argentina displays a high level of development but a low search volume. Additionally, this was added as a new paragraph in the Discussion section, which is cited verbatim below: <<While a positive correlation between the VRS and the level of development of palliative care was observed, this finding remains inconclusive due to the limited number of countries analyzed and notable exceptions. For instance, Ecuador demonstrates a low level of development but a high search volume, whereas Argentina shows a high level of development but a low search volume.>> 6. In the references, “disponible en” should be translated into English. R: This term has been translated in the references section. Attachments Attachment Submitted filename: Response to Reviewers - atr.docx https://doi.org/10.1371/journal.pone.0306312.r002
17 Jun 2024 Decision Letter - Martin Schneider, Editor Public interest in palliative care in Latin America: A Google Trends analysis PONE-D-23-43665R1 Dear Dr. Taype-Rondan, 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 Editorial Manager® 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, Martin Schneider Academic Editor PLOS ONE Additional Editor Comments (optional): Dear Dr Taype-Rondan, Thanks for resubmitting the revised manuscript. It is almost ready for print, but 3 issues should still be resolved. Please spell “Pelé” consistently throughout the manuscript. “disponible en” translates to “available at.” Please change the correlation in figure 4 to a dotted line or remove it completely. With best regards Martin Schneider https://doi.org/10.1371/journal.pone.0306312.r003
Formally Accepted
9 Jul 2024 Acceptance Letter - Martin Schneider, Editor PONE-D-23-43665R1 PLOS ONE Dear Dr. Taype-Rondan, 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. Martin Schneider Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0306312.r004

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .