Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow—A qualitative study

Alice Giöstad; Ingela K. Carlsson; Lars B. Dahlin; Erika Nyman

doi:10.1371/journal.pone.0306327

Peer Review History

Original SubmissionOctober 30, 2023
8 Mar 2024 Decision Letter - Priti Chaudhary, Editor PONE-D-23-35335Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow – a qualitative studyPLOS ONE Dear Dr.Alice Giöstad, 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 Apr 22 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. 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Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. You also have the option of uploading the data as Supporting Information files, but we would recommend depositing data directly to a data repository if possible. We will update your Data Availability statement on your behalf to reflect the information you provide. [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: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes 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: No 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: 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: Overall, it is an interesting work discuss the management challenges for an uncommon condition. Conclusion can be made more informative and needs to be further expanded to reflect the findings from the current study. Reviewer #2: Review report Dear authors I have thoroughly reviewed your article on addressing a qualitative study that after ulnar nerve surgery. What are the differences between your study and '' Kathleen Joy Khu at all. Patients’ Perceptions of Carpal Tunnel and Ulnar Nerve Decompression Surgery ''? https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/patients-perceptions-of-carpal-tunnel-and-ulnar-nerve-decompression-surgery/FFF7A6C677FB8354C92E520437998615 Best regards ****** 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: No 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. 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Revision 1
2 Apr 2024 Author Response Question: 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: Partly Reply: No comment required. Question: Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: N/A Reply: No comment required. Question: 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: No Reviewer #2: Yes Reply: We have included a separate comment concerning this issue based on the approval by our Ethical committee: “Data availability statement Public access to research data on humans is restricted by the Swedish Authorities (Public Access to Information and Secrecy Act; https://www.government.se/information-material/2009/09/public-access-to-information-and-secrecy-act/), but data can be made available for researchers after a special review that includes approval of the research project by both the Swedish Ethical Review Authority (https://etikprovningsmyndigheten.se/en/) and the local authorities' data safety committee in the health care sector in Region Skåne, Sweden; https://vardgivare.skane.se/kompetens-utveckling/forskning-inom-region-skane/utlamnande-av-patientdata-samradkvb/; “Samrådsgrupp för kvalitetsregister, vårddatabaser och beredning”; so called KVB-group) or from the corresponding unit in Region Östergötland, Sweden – according to the “Law for ethical review of research on humans” [“Lag (2003:460) om etikprövning av forskning som avser människor”]. Thus, there are both ethical and legal restrictions on sharing even de-identified data due to potential identification as well as including sensitive information of the interviewed individuals. These restrictions are imposed by the mentioned Swedish Ethical Review Authority (see above). The data set consists of transcribed interviews which are not allowed to be presented publicly as decided in the approval by the Ethical Review Authority. “ Question: 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 Reply: Thank you. Reviewer #1: Question: Overall, it is an interesting work discuss the management challenges for an uncommon condition. Conclusion can be made more informative and needs to be further expanded to reflect the findings from the current study. Reply: Changes have been made in conclusion. Reviewer #2: Review report Question: I have thoroughly reviewed your article on addressing a qualitative study that after ulnar nerve surgery. What are the differences between your study and '' Kathleen Joy Khu at all. Patients’ Perceptions of Carpal Tunnel and Ulnar Nerve Decompression Surgery ''? https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/patients-perceptions-of-carpal-tunnel-and-ulnar-nerve-decompression-surgery/FFF7A6C677FB8354C92E520437998615 Reply: Thank you for highlighting this study, where patients with carpal tunnel syndrome or mainly ulnar nerve entrapment at the elbow were interviewed 6-24 months after surgery. We have added the reference in our Discussions at two locations and made a slight comparison; however, their study differ substantially to ours. They emphasize based on their interviews that “(1) most patients did not perceive their condition to be serious; (2) patients were satisfied with the overall surgical experience; (3) the outcome was more important to patients than the process (4) majority of patients had a realistic expectation of outcomes.” Furthermore, they concluded that their patients “had a positive experience with carpal tunnel and ulnar nerve decompression surgery, although their level of satisfaction was dependent on the surgical outcome.”. Our patients had solely undergone surgery of the ulnar nerve entrapment at the elbow and our focus was on pain problems, which makes it difficult to make a thorough comparison. Therefore, we have only made a limited comparison. We have included an updated statement for financial disclosure in the Cover letter. Updated statement for financial disclosure: This work was supported by Grants from Region Östergötland, ALF (Grant number RÖ-977957). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Sincerely yours, Alice Giöstad on behalft of the co-authors Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0306327.r002
12 Apr 2024 Decision Letter - Priti Chaudhary, Editor PONE-D-23-35335R1Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow – a qualitative studyPLOS ONE Dear Dr. Giöstad, 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. Authors are required to reply:1. Sample size calculation not done. Kindly explain.2. Sample size is very small (10). Kindly justify.3. Nothing is mentioned about validation of semi-structured interview guide. Kindly explain. Please submit your revised manuscript by May 27 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, Priti Chaudhary, M.S. 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. [Note: HTML markup is below. Please do not edit.] [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.0306327.r003
Revision 2
16 Apr 2024 Author Response Questions: 1. Sample size calculation not done. Kindly explain. Reply: Sample size calculation is common in quantitative research and sample size is most often determined before the start of the data collection for quantitative research questions. However, qualitative research studies uses smaller sample sizes but provides information in greater depth. Instead of calculating sample size beforehand, the sampling continues until data saturation has been achieved. Data saturation is reached when no new analytical information arises anymore. Two references is added in the methods section to clarify this approach. 2. Sample size is very small (10). Kindly justify. Reply: The sampling in this study was made deliberately with purposive sampling which is a common method in qualitative research. In purposive sampling the researchers selects the participants that will be most informative and provide different perspectives of the studied phenomenon. We reached data saturation after ten interviews which was possible due to the information richness in the data and the variety of the participants. 3. Nothing is mentioned about validation of semi-structured interview guide. Kindly explain. Reply: The semi-structured interview guide was developed in several steps and with care by the authors. The format of a semi-structured interview was considered as an appropriate method for data collection for this research question. By retrieving and using previous knowledge we gained a comprehensive and adequate understanding of the phenomenon under study. After this we formulated the preliminary semi-structured interview guide that was field tested in a pilot-interview with a potential study participant. The pilot interview was analysed to ensure that the research questions were being covered and that the questions were understandable. This approach is common in qualitative research. A reference have been added to the methods section to clarify this approach. We do hope that these changes are sufficient and that you now can consider the manuscript suitable for publication. Sincerely yours Alice Giöstad Ingela K. Carlsson Lars B. Dahlin Erika Nyman Attachments Attachment Submitted filename: RESPONSE TO REVIEWERS.docx https://doi.org/10.1371/journal.pone.0306327.r004
17 Jun 2024 Decision Letter - Priti Chaudhary, Editor Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow – a qualitative study PONE-D-23-35335R2 Dear Dr. Alice Giöstad, 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, Priti Chaudhary, M.S. 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: 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 ****** 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: Authors have made suggested changes. ****** 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: No ******** https://doi.org/10.1371/journal.pone.0306327.r005
Formally Accepted
20 Jun 2024 Acceptance Letter - Priti Chaudhary, Editor PONE-D-23-35335R2 PLOS ONE Dear Dr. Giöstad, 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. Priti Chaudhary Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0306327.r006

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