Peer Review History

Original SubmissionDecember 18, 2024
Decision Letter - Alessandro De Cassai, Editor

PONE-D-24-56351Association between epidural catheter tip malposition and anesthesiologists’ experience after graduation: a cross-sectional study using postoperative CT imagesPLOS ONE

Dear Dr. Matsuo,

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.

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We look forward to receiving your revised manuscript.

Kind regards,

Alessandro De Cassai, MD

Academic Editor

PLOS ONE

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 “MM

This work was supported by JSPS KAKENHI Grant Number JP21K08918.

https://www.jsps.go.jp/j-grantsinaid/”

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: I Don't Know

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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: No

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: Although the manuscript is an original research, it has a few deficiency. Two things mentioned in the results were not included in the figure;

1) sensitivity analysis after excluding anesthesiologists who performed the most epidural anesthesia and had the highest malposition rate

2) sensitivity analysis after excluding anesthesiologists with the highest range of experience

The information given in the manuscript should also be included in the results.

Reviewer #2: Dear Authors,

A well written simple study with an interesting result on anesthesia providers. There are only a few studies investigating the malposition of epidural catheter tips and this retrospective study has the highest number of cases so far.

One negligible spelling mistake: page 4, line 4 reference in brackets not in the right position.

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Reviewer #1: No

Reviewer #2: No

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Revision 1

Response to Reviewers

Manuscript ID: PONE-D-24-56351

Title: Association between epidural catheter tip malposition and anesthesiologists’ experience after graduation: a cross-sectional study using postoperative CT images

Dear Dr. Alessandro De Cassai and Reviewers,

We would like to express our sincere appreciation for your valuable feedback and the opportunity to revise our manuscript. We carefully reviewed each comment and revised the manuscript accordingly. We believe that the quality and clarity of the manuscript have improved substantially through this process.

Below, we provide our point-by-point responses to all reviewer and editorial comments. All changes made to the manuscript are indicated in the file titled Revised Manuscript with Track Changes.

________________________________________

Reviewer #1

Comment:

Although the manuscript is an original research, it has a few deficiency. Two things mentioned in the results were not included in the figure;

1) sensitivity analysis after excluding anesthesiologists who performed the most epidural anesthesia and had the highest malposition rate

2) sensitivity analysis after excluding anesthesiologists with the highest range of experience

The information given in the manuscript should also be included in the results.

Response:

Thank you for pointing out this inconsistency. We have now included the results of both sensitivity analyses in new Supplementary Tables (S1,S3 Tables) rather than in a figure.

Regarding the second analysis, we found that the anesthesiologist with the longest experience (35.4 years) had performed only one epidural anesthesia case. Therefore, instead of excluding only this one case, we conducted a sensitivity analysis by excluding all six cases performed by anesthesiologists with ≥20 years of experience. These results are now presented in S3 Table, and the corresponding description in the Results section has been updated accordingly.

We have revised Figure 2 to display a histogram with postgraduate years grouped in 2-year intervals, which improves the clarity of the distribution of epidural procedures performed by anesthesiologists. Another sensitivity analysis, excluding procedures performed by anesthesiologists with 2.0-2.5 years’ experience, is shown in S2 Table.

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Reviewer #2

Comment:

One negligible spelling mistake: page 4, line 4 reference in brackets not in the right position.

Response:

Thank you for pointing this out. We corrected the placement of the reference brackets on page 4, line 4. In addition, we reviewed all other in-text citations throughout the manuscript to ensure that reference numbering and bracket formatting are consistent and accurate.

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Editorial Requirements

1. Formatting and File Naming:

We have revised the manuscript and file names to conform to PLOS ONE’s formatting and style requirements.

2. Funding Statement:

We have added the following sentence to clarify the role of the funders in the cover letter:

“The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

3. Data Availability:

We confirm that all raw data required to replicate the results of our study are now provided as Supporting Information (S1 Dataset). This includes:

• Data values underlying means and standard deviations

• Raw data used in statistical analyses

We believe this dataset fulfills the PLOS ONE requirement for a minimal data set.

We also re-examined the statistical outputs and found that there were numerical inaccuracies in four specific locations that are not essential to the main conclusions of the manuscript (Lines 163–164, 174, 188, and 191–193). These corrected values are fully traceable and included in the Supporting Information file titled “S1 Dataset.” We carefully verified that all other numerical values in the manuscript are accurate.

4. Reference List Review:

We have reviewed all references and confirm that none of the cited papers have been retracted.

________________________________________

We are grateful to the reviewers and the academic editor for their constructive and insightful comments. We hope that the revised manuscript now meets the standards required for publication in PLOS ONE.

Sincerely,

Mitsuhiro Matsuo, MD, PhD

On behalf of all authors

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Alessandro De Cassai, Editor

Association between epidural catheter tip malposition and anesthesiologists’ experience after graduation: a cross-sectional study using postoperative CT images

PONE-D-24-56351R1

Dear Dr. Matsuo,

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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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,

Alessandro De Cassai, MD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Manuscript is now acceptable in its current form

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 #2: (No Response)

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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 #2: Yes

**********

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

Reviewer #2: I Don't Know

**********

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 #2: 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 #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 #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 #2: No

**********

Formally Accepted
Acceptance Letter - Alessandro De Cassai, Editor

PONE-D-24-56351R1

PLOS ONE

Dear Dr. Matsuo,

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

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Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Alessandro De Cassai

Academic Editor

PLOS ONE

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