PONE-D-24-14073Current practices and perspectives of oncologists regarding ototoxicity monitoring in individuals with head and neck cancers undergoing radiation therapy and chemoradiotherapy: A qualitative study in a South Indian districtPLOS ONE

Dear Dr. Seethapathy,

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.

I would like to sincerely apologise for the delay you have incurred with your submission. It has been exceptionally difficult to secure reviewers to evaluate your study. We have now received two completed reviews; the comments are available below. The reviewers have raised significant scientific concerns about the study that need to be addressed in a revision.

Please revise the manuscript to address all the reviewer's comments in a point-by-point response in order to ensure it is meeting the journal's publication criteria. Please note that the revised manuscript will need to undergo further review, we thus cannot at this point anticipate the outcome of the evaluation process.

Please submit your revised manuscript by Sep 21 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.

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We look forward to receiving your revised manuscript.

Kind regards,

Miquel Vall-llosera Camps

Senior Staff 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: No

Reviewer #2: Partly

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

Reviewer #1: N/A

Reviewer #2: N/A

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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: 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 sectional headings should be arranged correctly. There critical information missing from the manuscript. The authors should describe the setting in enough detail to give the reader a clear picture. The research approach should be highlighted in order to allow the reader to identify the coherence in the methods used in the study. The authors should include a section to clearly describe all ethical considerations / issues pertaining to the study. Furthermore, the authors should clarify the inclusion and exclusion criteria instead of stating that they ensured certain qualities existed within the selected population.

The results section should be reorganized as the current form does not read well. All excerpts must be included in text to show how the quotations fit in the narrative element. I have shared an article in the track changes to guide and support this.

The discussion could benefit form more literature support as there is large pieces of paragraphs where the authors have just written form the heart.

The authors should create a separate heading for the limitations and elaborate on how these limitations impacted their study.

Include a conclusion to provide a summary of the whole study.

Reviewer #2: Current practices and perspectives of oncologists regarding ototoxicity monitoring in individuals with head and neck cancers undergoing radiation therapy and chemoradiotherapy: A qualitative study in a South Indian district

Overall comment

In a nutshell, this study explores oncologists' awareness and perspectives on ototoxicity monitoring for head and neck cancer patients in South India through qualitative interviews. The findings highlight the need to enhance oncologists' understanding of ototoxicity and advocate for monitoring programs. Given the significant impact on child development, academic achievement, balance, and mental health, this study's implications are critical. However, there are some suggestions to enhance the paper's quality.

Title

Consider shortening the title of your study to less than 15 words. A shorter title can better grab readers' attention and convey the main idea concisely. My suggestions could be;

1. “Oncologists' views on ototoxicity monitoring in head and neck cancer patients: A South Indian qualitative study”

2. “Exploring Ototoxicity Awareness Among Oncologists in South Indian Cancer Care”

Abstract

Methods – COREQ is an abbreviation, in this instance, it has been used without a prior definition. State in full before using it.

Keywords

Is “semi-structured” appropriate as a keyword?

Introduction

The introduction is well-written and effectively identifies the knowledge gap. However, a few points need to be addressed;

• Line 41 – grammatical error “In India, head and neck cancers (HNC) are one” not “is”

• Lines 45-47 – the sentence is too long and loses its meaning. Consider breaking it down into two or rephrasing it

• Line 51 – grammatical error “the” missing, treatment depends upon the stage

• Line 58 – Avoid starting a sentence with an abbreviation

Methods

• The COREQ guidelines mandate including a section that identifies the research design and provides the rationale for its selection.

• Line 111 – The abbreviation for ROs has already been defined, no need to repeat it here

• Interview details – Could you please provide a list of the interview questions that were included in the interview guide?

• Analysis – To provide clarity, it would be beneficial to specify the approach used in thematic analysis, such as employing the method outlined by Braun and Clarke. Thematic analysis is too broad

• Providing a citation and a brief explanation of what QDA Miner Lite is would be beneficial for the readers.

• While efforts have been made to describe measures for ensuring the trustworthiness of the study, it is recommended to have a dedicated section that explicitly outlines this process. Providing a detailed explanation of how your study, for instance, addresses all four criteria for assessing trustworthiness, as outlined by Lincoln and Guba, will enhance the credibility of the methods section.

Results

• I am curious about how to navigate this section. Will readers need to refer back to the quotes while simultaneously reading the results section? Why not follow the conventional approach of integrating the quotes within the results section for readability?

• Lines 221 and 227 – Avoid starting sentences with abbreviations. Correct this throughout the document

Discussion

• Lines 402-420, feel like a rehash of the findings as there is no attempt to link the stated findings to existing literature.

• Line 421 – “Contrary to beliefs of oncologists” Which oncologists? From this study or?

The statement further says numerous studies but only one study is cited. Please cite those studies

• Line 422 – include the names of the authors of the systematic review. Like “A systematic review by Theunissen et al., …”

• Line 426 – “This finding aligns with previous studies [14]” but only one study is cited, please cite the studies otherwise change to “This finding aligns with a previous study [14]”

• There is a need for a discussion on how the study’s findings align or misalign with the theoretical framework. Furthermore, suggestions for further research on how the framework employed can be improved are needed.

• There is no attempt to explore potential avenues for future research in general

• Line 475-481 – there is no attempt to link the findings to existing literature

References

Ok

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Reviewer #1: Yes: Dr L Gumede

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-24-14073 (1)LG.pdf

PONE-D-24-14073R1Oncologists' views on ototoxicity monitoring in head and neck cancer patients: A South Indian qualitative studyPLOS ONE

Dear Dr. Seethapathy,

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 Nov 18 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 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,

Ashish Wasudeo Khobragade, MD

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:

1. I recommend starting the abstract with a background or introduction and ending it with a conclusion instead of a discussion section.

2. The materials and methods section is started with ethical permission. This statement may be placed under the ethical consideration heading. There is no connectivity between the sentences in the first paragraph. Organize the materials and methods section to maintain connectivity between the sentences and paragraphs.

[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

Reviewer #2: 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

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

Reviewer #1: N/A

Reviewer #2: N/A

**********

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

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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

**********

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: I would like to thank the authors for their efforts and consideration of the comments and suggestions. I believe that the additional detail has improved this paper. The minor comments provided can be applied based on the authors' editor's decision.

Reviewer #2: (No Response)

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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.

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: Dr Lindiwe Gumede

Reviewer #2: No

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[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.

Attachments

Attachment

Submitted filename: PONE-D-24-14073_R1_reviewer 19_09_24.pdf

Oncologists' views on ototoxicity monitoring in head and neck cancer patients: A South Indian qualitative study

PONE-D-24-14073R2

Dear Dr. Seethapathy,

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.

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Kind regards,

Ashish Wasudeo Khobragade, MD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: