Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogram

Daehyun Kwon; Hanbit Kang; Dongwoo Lee; Yoon-Chul Kim

doi:10.1371/journal.pone.0317630

Peer Review History

Original SubmissionJune 7, 2024
11 Jul 2024 Decision Letter - Kapil Gupta, Editor PONE-D-24-23244Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogramPLOS ONE Dear Dr. Kim, 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 Aug 25 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, Kapil Gupta, Ph.D Academic Editor PLOS ONE Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. 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, we expect all author-generated code to 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. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. 4. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This study was supported by the “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (MOE) (2022RIS-005).” We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “The author(s) received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 5. When completing the data availability statement of the submission form, you indicated that you will make your data available on acceptance. We strongly recommend all authors decide on a data sharing plan before acceptance, as the process can be lengthy and hold up publication timelines. Please note that, though access restrictions are acceptable now, your entire data will need to be made freely accessible if your manuscript is accepted for publication. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If you are unable to adhere to our open data policy, please kindly revise your statement to explain your reasoning and we will seek the editor's input on an exemption. Please be assured that, once you have provided your new statement, the assessment of your exemption will not hold up the peer review process. 6. Please amend either the abstract on the online submission form (via Edit Submission) or the abstract in the manuscript so that they are identical. Additional Editor Comments: Reviewer agree that the manuscript contains novel elements. However, it presents some aspects that need to be solved before reconsideration. The authors should explicitly mention the significant contributions of the manuscript. The novelty of the paper is not highlighted. The advantages and limitations of the proposed approach in relation to similar schemes are not clear. Please revise the structure of the paper. It is recommendable to add to each section a couple of sentences that explain the purpose of the section. With this organization, the reader can clearly understand the sequence of the paper. Under the review observations, the paper should be corrected as a major revision. [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: No ****** 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: This paper presents Deep learning-based prediction of atrial fibrillation. In general work is interesting although following issues are need to be resolve before ensuring recommendation. 1. The Research work is interesting but lags in terms of proving novelty in work. 2. Authors are required to write their contribution explicitly over the existing method. It seems that author has just used some methods and compared. 3. A little more mathematical analysis is required to support the proposed method. 4. References are need to be formed and updated properly as recently developed methods are not included in the literature work. 5. In this work, following recently published publications can be added • Pal, H. S., Kumar, A., Vishwakarma, A., & Singh, G. K. (2023). Optimized Tunable-Q Wavelet Transform-Based 2-D ECG Compression Technique Using DCT. IEEE Transactions on Instrumentation and Measurement, 72, 1-13. • Pal, H. S., Kumar, A., Vishwakarma, A., & Lee, H. N. (2023). Electrocardiogram signal compression using adaptive tunable-Q wavelet transform and modified dead-zone quantizer. ISA transactions, 142, 335-346. • Pal, H. S., Kumar, A., Vishwakarma, A., Singh, G. K., & Lee, H. N. (2024). A new automated compression technique for 2D electrocardiogram signals using discrete wavelet transform. Engineering Applications of Artificial Intelligence, 133, 108123. • Pal, H. S., Kumar, A., Vishwakarma, A., Singh, G. K., & Lee, H. N. (2024). An effective ECG signal compression algorithm with self controlled reconstruction quality. Computer Methods in Biomechanics and Biomedical Engineering, 27(7), 849-859. • Gupta, K., Bajaj, V., & Jain, S. (2024). Multi-resolution assessment of ECG sensor data for sleep apnea detection using wide neural network. IEEE Sensors Journal. • Gupta, K., Bajaj, V., & Ansari, I. A. (2023). Integrated s-transform-based learning system for detection of arrhythmic fetus. IEEE Transactions on Instrumentation and Measurement, 72, 1-8. ****** 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 ******** [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.0317630.r001
Revision 1
6 Aug 2024 Author Response Manuscript ID: PONE-D-24-23244R1 Title: Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogram Response to Review We thank the editor and reviewer for giving us the opportunity to revise this manuscript. Following the comments by the editor and reviewer, we have made significant changes to the manuscript. Listed below are responses to the comments along with descriptions of all changes to the manuscript. Journal requirements: 1. 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 Authors’ response: As requested, we have modified our paper format to meet the style requirements. 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, we expect all author-generated code to 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. Authors’ response: We have shared our code to facilitate reproducibility in research. Our lab website at https://sites.google.com/yonsei.ac.kr/yoonckim/research/dl-prediction-of-afib-from-polar-transformed-ecg-spectrogram provides the Github links for the code. 3. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. Authors’ response: We cannot modify the ‘Financial Disclosure’ section in the online submission site. Our Funding Statement should read as follows: “This study was supported by the “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (MOE) (2022RIS-005).” 4. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This study was supported by the “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (MOE) (2022RIS-005).” We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “The author(s) received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. Authors’ response: We have removed the Acknowledgments section from the revised manuscript. Our Funding Statement should read as follows: “This study was supported by the “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (MOE) (2022RIS-005).” We have included our funding statement in our cover letter as well. 5. When completing the data availability statement of the submission form, you indicated that you will make your data available on acceptance. We strongly recommend all authors decide on a data sharing plan before acceptance, as the process can be lengthy and hold up publication timelines. Please note that, though access restrictions are acceptable now, your entire data will need to be made freely accessible if your manuscript is accepted for publication. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If you are unable to adhere to our open data policy, please kindly revise your statement to explain your reasoning and we will seek the editor's input on an exemption. Please be assured that, once you have provided your new statement, the assessment of your exemption will not hold up the peer review process. Authors’ response: We have made the data available at our lab website at https://sites.google.com/yonsei.ac.kr/yoonckim/research/dl-prediction-of-afib-from-polar-transformed-ecg-spectrogram. 6. Please amend either the abstract on the online submission form (via Edit Submission) or the abstract in the manuscript so that they are identical. Authors’ response: Thank you for pointing out the discrepancy. We ensured that they are identical in the revised manuscript submission. Additional Editor Comments: Reviewer agree that the manuscript contains novel elements. However, it presents some aspects that need to be solved before reconsideration. 1) The authors should explicitly mention the significant contributions of the manuscript. The novelty of the paper is not highlighted. Authors’ response: We have provided the main contributions explicitly in the Introduction section of the revised manuscript. [Introduction section, page 5] The main contributions of this study can be summarized as follows. 1. A novel reverse polar transformed visual representation of time-frequency ECG spectrogram is presented and demonstrated for the identification of Afib in single lead ECG data. 2. The polar transformed ECG spectrogram images are used as input to a deep CNN model for the prediction of cardiac arrhythmia. 3. The effectiveness of the Pan-Tompkins (P-T) pre-processing algorithm is demonstrated for the prediction of cardiac arrhythmia when using deep CNNs. 2) The advantages and limitations of the proposed approach in relation to similar schemes are not clear. Authors’ response: We have added the advantages and limitations to the Conclusions section. [Conclusions section, page 16] In sum, the proposed method is advantageous over the standard rectangular 2D representation with regard to its compact visualization of the long duration of ECG signal and its simplicity in implementation due to its square matrix form, which is suitable for existing and widely used 2D CNN models. The drawback of the proposed method in relation to the 1D ECG waveform analysis is that the color representation of the polar spectrogram is sensitive to the preprocessing filter and ECG signal amplitude. 3) Please revise the structure of the paper. It is recommendable to add to each section a couple of sentences that explain the purpose of the section. With this organization, the reader can clearly understand the sequence of the paper. Authors’ response: We have added to each of the Methods and Results sections a couple of sentences that explain the purpose of the section. [2. Methods section, page 5] This section describes the ECG data used for our study, details of ECG signal pre-processing and polar transformation, and deep CNN model development and validation processes. The flowchart of the presented work is illustrated in Fig 1. ECG signals are processed to generate time-frequency spectrograms. After the polar coordinate transformation and mapping of it to the Cartesian grid, polar spectrogram images are generated, and then they are input to a deep CNN classifier model. [2.4. Model development section, page 8] This subsection describes the details of deep learning model development. [3. Results section, page 11] This section presents qualitative comparisons between polar transformed images and our proposed reverse polar transformed images. It also compares the visualization results between raw ECG signals and the P-T processed ECG signals. Quantitative results of deep CNN predictions on test data are shown across different CNN pre-trained models. The interpretation of deep CNN’s prediction results is made based on the reverse polar transformed spectrogram images. 4) Under the review observations, the paper should be corrected as a major revision. Authors’ response: We sincerely thank the Editor for the decision. Reviewer comments: Reviewer #1: This paper presents Deep learning-based prediction of atrial fibrillation. In general work is interesting although following issues are need to be resolve before ensuring recommendation. Authors’ response: We greatly thank the reviewer for positive comments on our manuscript. R1.1: The Research work is interesting but lags in terms of proving novelty in work. Authors’ response: The novelty is in the demonstration of a reverse polar spectrogram representation of a long duration of ECG signal and its application to the deep CNN-based prediction of atrial fibrillation. R1.2: Authors are required to write their contribution explicitly over the existing method. It seems that author has just used some methods and compared. Authors’ response: We have provided the main contributions explicitly in the Introduction section of the revised manuscript. [Introduction section, page 5] The main contributions of this study can be summarized as follows. 1. A novel reverse polar transformed visual representation of time-frequency ECG spectrogram is presented and demonstrated for the identification of Afib in single lead ECG data. 2. The polar transformed ECG spectrogram images are used as input to a deep CNN model for the prediction of cardiac arrhythmia. 3. The effectiveness of the Pan-Tompkins (P-T) pre-processing algorithm is demonstrated for the prediction of cardiac arrhythmia when using deep CNNs. R1.3: A little more mathematical analysis is required to support the proposed method. Authors’ response: We have provided the mathematical description of the proposed transformation method in section 2.3. ‘Polar transformation’ of the revised manuscript on page 8 and 9. R1.4: References are need to be formed and updated properly as recently developed methods are not included in the literature work. Authors’ response: We have added references that include recently developed methods. This is related to the response to R1.5. R1.5: In this work, following recently published publications can be added. • Pal, H. S., Kumar, A., Vishwakarma, A., & Singh, G. K. (2023). Optimized Tunable-Q Wavelet Transform-Based 2-D ECG Compression Technique Using DCT. IEEE Transactions on Instrumentation and Measurement, 72, 1-13. • Pal, H. S., Kumar, A., Vishwakarma, A., & Lee, H. N. (2023). Electrocardiogram signal compression using adaptive tunable-Q wavelet transform and modified dead-zone quantizer. ISA transactions, 142, 335-346. • Pal, H. S., Kumar, A., Vishwakarma, A., Singh, G. K., & Lee, H. N. (2024). A new automated compression technique for 2D electrocardiogram signals using discrete wavelet transform. Engineering Applications of Artificial Intelligence, 133, 108123. • Pal, H. S., Kumar, A., Vishwakarma, A., Singh, G. K., & Lee, H. N. (2024). An effective ECG signal compression algorithm with self controlled reconstruction quality. Computer Methods in Biomechanics and Biomedical Engineering, 27(7), 849-859. • Gupta, K., Bajaj, V., & Jain, S. (2024). Multi-resolution assessment of ECG sensor data for sleep apnea detection using wide neural network. IEEE Sensors Journal. • Gupta, K., Bajaj, V., & Ansari, I. A. (2023). Integrated s-transform-based learning system for detection of arrhythmic fetus. IEEE Transactions on Instrumentation and Measurement, 72, 1-8. Authors’ response: We thank the reviewer for suggesting the references. We thought the suggested references are relevant to our work, and we cited them in the revised manuscript. Attachments Attachment Submitted filename: Response_to_reviewers 2024_0806.docx https://doi.org/10.1371/journal.pone.0317630.r002
20 Oct 2024 Decision Letter - Hirenkumar Kantilal Mewada, Editor PONE-D-24-23244R1Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogramPLOS ONE Dear Dr. Kim, 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 Dec 04 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, Hirenkumar Kantilal Mewada Academic Editor PLOS ONE Additional Editor Comments: The review has been received, and it indicates that major revisions are required. Please refer to the reviewer comments for specific areas needing improvement. [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: (No Response) ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: (No Response) ****** 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: (No Response) ****** 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: (No Response) ****** 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: All the comments are addressed. 1. Improve the quality of figure 1-3 as fonts are not visible. 2. Update the references as per the journals guidelines. 3. some grammatical mistakes are need to be corrected, thus requires a thorough revision. Reviewer #2: Discuss the motivation behind reverse polar transformed visual representation of time-frequency ECG spectrogram. Deep learning models composed of the deep layers. By passing the ECG signal as an input directly to CNN model can predict or classify atrial fibrillation. For more details, authors can look at the article https://link.springer.com/chapter/10.1007/978-3-319-68385-0_18 The information behind transforming signal to an image is unclear. This database is not a new one and there are many related works on CNN and other deep learning models. The proposed method results should be compared with at least existing 3 methods. Discuss what are the advantages of the proposed method compared to the existing methods. Discuss the limitations of the proposed method. Hidden layer feature visualization can be shown for example penultimate layer feature visualization using t-SNE and add discussion on this. Features also can be visualized using SHAP models. Discuss on these will support why the proposed model achieves better performances compared to the existing models. ****** 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 Reviewer #2: Yes: Vinayakumar Ravi ******** [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.0317630.r003
Revision 2
2 Dec 2024 Author Response Please see the attached file for the response to reviewers. Attachments Attachment Submitted filename: Response_to_reviewers 2024_1202.docx https://doi.org/10.1371/journal.pone.0317630.r004
2 Jan 2025 Decision Letter - Hirenkumar Kantilal Mewada, Editor Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogram PONE-D-24-23244R2 Dear Dr. Kim, 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, Hirenkumar Kantilal Mewada 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 #2: 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 #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: 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 #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: Revised paper can be published Authors addressed all comments. Authors are suggested to check the journal guidelines ****** 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: Yes: Vinayakumar Ravi ******** https://doi.org/10.1371/journal.pone.0317630.r005
Formally Accepted
7 Jan 2025 Acceptance Letter - Hirenkumar Kantilal Mewada, Editor PONE-D-24-23244R2 PLOS ONE Dear Dr. Kim, 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. Hirenkumar Kantilal Mewada Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0317630.r006

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 .