Evaluation of cortical thickness and cortical thickness index in the proximal femur—CT, dual energy absorptiometry (DXA), trabecular bone score (TBS) –

Xiao Ma; Ik Yang; Sewon Lee; Jungyoun Kim; Hyunjin Park; Younghyun Yoon; Jihyo Hwang

doi:10.1371/journal.pone.0312420

Peer Review History

Original SubmissionJanuary 4, 2023
1 Sep 2023 Decision Letter - Dalia Galal Mahran, Editor PONE-D-23-00165Evaluation of cortical thickness and cortical thickness index in the proximal femur - CT, dual energy absorptiometry (DXA), trabecular bone score (TBS) -PLOS ONE Dear Dr. Hwang, 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 Oct 16 2023 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. 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We will update your Data Availability statement to reflect the information you provide in your cover letter. 5. Please upload a new copy of Figure 1 as the detail is not clear. Please follow the link for more information: "" ext-link-type="uri" xlink:type="simple">https://blogs.plos.org/plos/2019/06/looking-good-tips-for-creating-your-plos-figures-graphics/"" "" ext-link-type="uri" xlink:type="simple">https://blogs.plos.org/plos/2019/06/looking-good-tips-for-creating-your-plos-figures-graphics/"" 6. Please include a caption for figure 1. 7. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Additional Editor Comments: Dear authors Thank you for the done work. Ihave comments for needed major revisins to be done. The revisions as follows: Methods: • The study design is a cross sectional study made from patient records and not from previous cross sectional study. Correct the study design • It’s better to write the methods section into subtitles, it was written in non sectional unclear different ideas like “ study population with inclusion and exclusion criteria and study sitting, data collection, statistical analysis, ………………… • Stsastical analysis: is a section under methods sections. The details of analysis are deficient Results: All titles of the tables are deficient and some are wrong as “ Table 3:. The statistical significance in two groups “ • The tests of significance were not mentioned as footnotes • Correct the significance from 0.000 to 0.001 • No correlation test between measurements was done • Multivariate analysis was not done - Discussion: • No strengths and limitations were included • No recommendations for further studies [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: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: No Reviewer #2: No ****** 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: 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: The manuscript provides the cortical thickness and and cortical thickness index from CT scan, T-score and TBS data based on DXA in total of 600 patients from South Korea. These data source is valuable in 3D printing. The findings on correlation between fracture and bone health are consistent with the literature. The statistical analysis section mentioned all parameters were compared by Student's t-test. It works for the comparing two groups (Table 2,3,4). However, the Table 5 and table 6 listed 6 age groups, please specify which statistical tests were used for calculating p-value. Table 1 present the average data of proximal femoral geometry from CT. Authors need to specify what are the numbers follow the average, are they range of the mean i.e. (min ~max)? Also, considering the different body size between male and female, it is necessary to provide the average data by sex. Reviewer #2: The work presents a retrospective analysis of the proximal femur that can bring important clinical information, however the analysis of some parameters can improve the work. The purpose of the mentioned study should be changed in order to encompass all the analysis carried out. It seems to me that changing to: Characterizing the proximal femur of patients without alterations, with fractures...in different parameters...would be more appropriate. How did the sample of 200+200+200 arrive, was it by chance? Explain the methodology in detail. Show pictures of examples of trochanteric fracture and femoral neck fracture. Tables must be self-explanatory and in the title mention the type of sample used The data with means must be accompanied by the SD Statistically, age and gender should also be studied in the different parameters analyzed, using only the sample of 200 normal patients as a reference. Therefore, a different and more complete statistical analysis is recommended. ****** 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. 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.0312420.r001
Revision 1
10 May 2024 Author Response Respond to academic editor 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming = We changed Scipts style considering on PLOS manual style templit : Followed Title , Author , Affiliation formating guideline etc. 2. At this time, please address the following queries “The authors received no specific funding for this work” = we included this comment on cover letter 3. Thank you for stating the following in your Competing Interests section: "NO authors have competing interests" = “The authors have declared that no competing interests exist. “ was included on cover letter 4. Data availability = We uploaded our patient data on figshare and it’s DOI is 10.6084/m9.figshare.24755277 5. Please upload a new copy of Figure 1 as the detail is not clear. = Figure 1 ‘s resolution has been changed and upload a new copy 6. Please include a caption for figure 1. = Added caption for figure 1 7. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. = We changed all caption for supporting information and uploaded end of our manuscripts. it also match accordingly Additional respond to academic editor Methods: • The study design is a cross sectional study made from patient records and not from previous cross sectional study. Correct the study design = We modified the study design to fit • It’s better to write the methods section into subtitles, it was written in non sectional unclear different ideas like “ study population with inclusion and exclusion criteria and study sitting, data collection, statistical analysis, ………………… = The method section was modified with subtitles and statistical analysis was moved to the method section. • Stsastical analysis: is a section under methods sections. The details of analysis are deficient = statistical analysis was moved to the method section. and supplemented the details. Results: All tis “ • All titles of the tables are deficient and some are wrong as “ Table 3:. The statistical significance in two groups “ = all table’s title was changed and made them fit • The tests of significance were not mentioned as footnotes = The statement related to the table was written on footnote. • Correct the significance from 0.000 to 0.001 = We fixed it • No correlation test between measurements was done • Multivariante analysis was not done = It was difficult to conduct correlation tests and multivariant analysis studies because there were many missing information due to insufficient samples. However, this study is a meaningful paper in analyzing the correlation between cortical bone thickness and fractures in Far East Asia. It is unfortunate that the above research was omitted, but it was difficult due to the limitations of sample data. - Discussion: • No strengths and limitations were included • No recommendations for further studies = We added limation and recommendation for futher studies Respond to reviewer Reviewer #1: The manuscript provides the cortical thickness and and cortical thickness index from CT scan, T-score and TBS data based on DXA in total of 600 patients from South Korea. These data source is valuable in 3D printing. The findings on correlation between fracture and bone health are consistent with the literature. The statistical analysis section mentioned all parameters were compared by Student's t-test. It works for the comparing two groups (Table 2,3,4). However, the Table 5 and table 6 listed 6 age groups, please specify which statistical tests were used for calculating p-value. = Not all were done with study t-test. The statistics of tables 5 and 6 you mentioned were modified to use ANOVA because there was a mistake when writing it. Table 1 present the average data of proximal femoral geometry from CT. Authors need to specify what are the numbers follow the average, are they range of the mean i.e. (min ~max)? = I wrote the part you told me ( min ~ max ) on footnote. Also, considering the different body size between male and female, it is necessary to provide the average data by sex. Fourth, the patients included were heterogenous. A more proper and accurate geometry of the proximal femur should be obtained from the homogenous group, such as the whole non-fracture group. = As a retrospective study conducted with a limited sample, it was difficult to perform the classification according to the gender you mentioned. If research based on other samples is conducted in the future, it is believed that academic achievement will be achieved through meta-analysis. Reviewer #2: The work presents a retrospective analysis of the proximal femur that can bring important clinical information, however the analysis of some parameters can improve the work. The purpose of the mentioned study should be changed in order to encompass all the analysis carried out. It seems to me that changing to: Characterizing the proximal femur of patients without alterations, with fractures...in different parameters...would be more appropriate. = What we wanted to show was to study the correlation between fractures and anatomical features, including femoral proximal cortical bone thickness. This required a comparison between fracture and non-fracture patients. There were relatively many data on fracture patients in hospitals, so it was possible to measure and compare the opposite side, but in the case of non-fracture patients, it was difficult to perform CT and other tests for the necessary data The non-facture group was formed by collecting data from bone necrosis patients of the femoral head or suspected fracture patients who came to the outpatient clinic, and due to the nature of this medical institution, sufficient data was not accumulated, so it is regrettable that gender comparisons were not made. However, the purpose of the study was to correlate the fracture with the anatomical values of the proximal femur. How did the sample of 200+200+200 arrive, was it by chance? Explain the methodology in detail. = We changed the method section to However, among the patients who visited our hospital without fractures, it was very difficult to find patients who performed all the necessary tests when we studied. Therefore, among patients without fractures, 200 patients who had completed the examination were collected and compared with patients with fractures. Show pictures of examples of trochanteric fracture and femoral neck fracture. = We attached the femur neck fracture as figure 2 and the trochanetic fracture as figure 3, and the original figures 2,3,4,5,6,7 were revised to 4,5,6,7,8,9 respectively. Tables must be self-explanatory and in the title mention the type of sample used = We have added a new detailed description of the table to the footnote at the bottom of the table Statistically, age and gender should also be studied in the different parameters analyzed, using only the sample of 200 normal patients as a reference. Therefore, a different and more complete statistical analysis is recommended. = It was difficult to conduct different and more complete statistical analysis studies because there were many missing information due to insufficient samples. However, this study is a meaningful paper in analyzing the correlation between cortical bone thickness and fractures in Far East Asia. It is unfortunate that the above research was omitted, but it was difficult due to the limitations of sample data. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0312420.r002
12 Jun 2024 Decision Letter - Alessandra Aldieri, Editor PONE-D-23-00165R1Evaluation of cortical thickness and cortical thickness index in the proximal femur - CT, dual energy absorptiometry (DXA), trabecular bone score (TBS) -PLOS ONE Dear Dr. Hwang, 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 the Jul 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-emailutm_source=authorlettersutm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Alessandra Aldieri 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: There are still a couple of changes to be implemented prior to publication [Note: HTML markup is below. Please do not edit.] 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: In the Data collection section, author stated “propensity score matching was performed to compare the data of the two groups” (i.e. hip fracture group and non-fracture group). Suggest authors specifying this selection method in the table 2 footnote and describing what parameters were included in the propensity score calculation. For Table 6, authors need to specify what are the numbers after the +/- sign. The presentation of N=600 row is not consistent across the 8 columns. The last two columns showed mean (+/-) but not the other 6 columns. Authors shall fix the inconsistency. ****** 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 ******** [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.0312420.r003
Revision 2
20 Jul 2024 Author Response Respond to reviewer Reviewer #1: In the Data collection section, author stated “propensity score matching was performed to compare the data of the two groups” (i.e. hip fracture group and non-fracture group). Suggest authors specifying this selection method in the table 2 footnote and describing what parameters were included in the propensity score calculation. Thank you for your good question, we included only age and sex factors for the propensity score matching. We added comment about this in the manuscript. For Table 6, authors need to specify what are the numbers after the +/- sign. +/- sigh is standard deviation, we included explanation about this The presentation of N=600 row is not consistent across the 8 columns. Thank you for your sharp point, we corrected this at the table 6 The last two columns showed mean (+/-) but not the other 6 columns. Authors shall fix the inconsistency Thank you for your detail comments, we added standard deviation to the other 6 columns Attachments Attachment Submitted filename: Respond to reviewer.docx https://doi.org/10.1371/journal.pone.0312420.r004
25 Jul 2024 Decision Letter - Alessandra Aldieri, Editor Evaluation of cortical thickness and cortical thickness index in the proximal femur - CT, dual energy absorptiometry (DXA), trabecular bone score (TBS) - PONE-D-23-00165R2 Dear Dr. Hwang, 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, Alessandra Aldieri Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0312420.r005
Formally Accepted
13 Nov 2024 Acceptance Letter - Alessandra Aldieri, Editor PONE-D-23-00165R2 PLOS ONE Dear Dr. Hwang, 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. Alessandra Aldieri Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0312420.r006

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