Peer Review History

Original SubmissionFebruary 2, 2024
Decision Letter - Nishant Jaiswal, Editor

PONE-D-23-39716Developing a multivariable prediction model to support personalized selection among five major empirically-supported treatments for adult depression. Study protocol of a systematic review and individual participant data network meta-analysis.PLOS ONE

Dear Dr. Cohen,

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 08 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,

Nishant Premnath Jaiswal, MBBS, PhD

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. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed:

https://eprints.whiterose.ac.uk/190928/1/efficacy-and-moderators-of-cognitive-therapy-versus-behavioural-activation-for-adults-with-depression-study-protocol-of-a-systematic-review-and-meta-analysis-of-individual-participant-data.pdf?

In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed.

3. In the online submission form, you indicated that the collective de-identified individual participant database that will be developed for this study will be available for use by other researchers, provided that the authors of the original studies approve the use of their data for this purpose. Requests can be made with the corresponding author (ellen.driessen@ru.nl). Access (with limited investigator support) will be granted after approval of a study proposal by all authors and a signed data access agreement. 

All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information.

This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval. 

4. As required by our policy on Data Availability, please ensure your manuscript or supplementary information includes the following: 

A numbered table of all studies identified in the literature search, including those that were excluded from the analyses.  

For every excluded study, the table should list the reason(s) for exclusion.  

If any of the included studies are unpublished, include a link (URL) to the primary source or detailed information about how the content can be accessed. 

A table of all data extracted from the primary research sources for the systematic review and/or meta-analysis. The table must include the following information for each study: 

Name of data extractors and date of data extraction 

Confirmation that the study was eligible to be included in the review.  

All data extracted from each study for the reported systematic review and/or meta-analysis that would be needed to replicate your analyses. 

If data or supporting information were obtained from another source (e.g. correspondence with the author of the original research article), please provide the source of data and dates on which the data/information were obtained by your research group. 

If applicable for your analysis, a table showing the completed risk of bias and quality/certainty assessments for each study or outcome.  Please ensure this is provided for each domain or parameter assessed. For example, if you used the Cochrane risk-of-bias tool for randomized trials, provide answers to each of the signalling questions for each study. If you used GRADE to assess certainty of evidence, provide judgements about each of the quality of evidence factor. This should be provided for each outcome.  

An explanation of how missing data were handled. 

This information can be included in the main text, supplementary information, or relevant data repository. Please note that providing these underlying data is a requirement for publication in this journal, and if these data are not provided your manuscript might be rejected.  

5. 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. 

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this protocol for an outstanding study. This is one of the most well-written protocols and most promising trials I have recently seen. I have only a few minor comments.

1. There seems to be some confusion regarding who is the corresponding author of this manuscript (ED or ZDC).

2. The authors may want to include the following reference concerning treatment heterogeneity in the introduction section:

Volkmann C, Volkmann A, Müller CA. On the treatment effect heterogeneity of antidepressants in major depression: A Bayesian meta-analysis and simulation study. Hutson AD, ed. PLoS One. 2020;15(11):e0241497. doi:10.1371/journal.pone.0241497

3. I have a question regarding the included delivery formats. The manuscript states that guided digital interventions will be included. Are there any restrictions regarding the amount of guidance? This can differ significantly, to the point where human support is reduced to a couple of minutes per patient.

4. How will the authors account for the effect of different settings/intensities of care, as both outpatient and inpatient care settings are included?

5. Will there be a minimum depression baseline score for inclusion? How will this be operationalized?

6. Will there be exclusions of participants on an individual patient data level if the authors find indications that some inclusion criteria are not met by single persons in the IPD?

7. Regarding data checks, it appears that the authors do not compare the means/standard deviations or raw counts with those reported in the publication. This is highly recommended.

8. Multiple imputation of missing moderators (even if they are entirely missing in a study): I am not sufficiently familiar with Network Meta-Analyses to comment in detail, but if feasible, I recommend performing a sensitivity analysis where imputation is conducted within each study only.

**********

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.

Revision 1

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

Response:

We have double checked the manuscript against the abovementioned templates to ensure it meets PLOS ONE’s style requirements. As a result, we have removed abbreviations in the author affiliations (spelling out full terms instead), adapted heading formats, and updated file names.

2. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed:

https://eprints.whiterose.ac.uk/190928/1/efficacy-and-moderators-of-cognitive-therapy-versus-behavioural-activation-for-adults-with-depression-study-protocol-of-a-systematic-review-and-meta-analysis-of-individual-participant-data.pdf?

In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed.

Response:

We have compared the manuscript with the abovementioned previous publication by our group. As a consequence, we have added citations in the methods section and rephrased three sentences in the discussion section. In this way, we hope to have addressed all minor text overlap. If, despite our best efforts, any occurrences can still be identified, please let us know which specific sections are of concern and we will be more than happy to address these too.

3. In the online submission form, you indicated that the collective de-identified individual participant database that will be developed for this study will be available for use by other researchers, provided that the authors of the original studies approve the use of their data for this purpose. Requests can be made with the corresponding author (ellen.driessen@ru.nl). Access (with limited investigator support) will be granted after approval of a study proposal by all authors and a signed data access agreement.

All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information.

This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval.

Response:

This manuscript describes the protocol for a study that has not yet been conducted. Therefore, it does not describe any findings. The individual participant database described above has not yet been developed and it is currently not possible to make this available.

We can see how our phrasing in the online submission form might be confusing in this regard and have now adjusted it as follows:

Data availability is not applicable to this article as no data were analyzed for this study protocol paper.

4. As required by our policy on Data Availability, please ensure your manuscript or supplementary information includes the following:

A numbered table of all studies identified in the literature search, including those that were excluded from the analyses.

For every excluded study, the table should list the reason(s) for exclusion.

If any of the included studies are unpublished, include a link (URL) to the primary source or detailed information about how the content can be accessed.

A table of all data extracted from the primary research sources for the systematic review and/or meta-analysis. The table must include the following information for each study:

Name of data extractors and date of data extraction

Confirmation that the study was eligible to be included in the review.

All data extracted from each study for the reported systematic review and/or meta-analysis that would be needed to replicate your analyses.

If data or supporting information were obtained from another source (e.g. correspondence with the author of the original research article), please provide the source of data and dates on which the data/information were obtained by your research group.

If applicable for your analysis, a table showing the completed risk of bias and quality/certainty assessments for each study or outcome. Please ensure this is provided for each domain or parameter assessed. For example, if you used the Cochrane risk-of-bias tool for randomized trials, provide answers to each of the signalling questions for each study. If you used GRADE to assess certainty of evidence, provide judgements about each of the quality of evidence factor. This should be provided for each outcome.

An explanation of how missing data were handled.

This information can be included in the main text, supplementary information, or relevant data repository. Please note that providing these underlying data is a requirement for publication in this journal, and if these data are not provided your manuscript might be rejected.

Response:

This manuscript is a study protocol paper and does not describe any findings. Literature searches, data extraction, and risk of bias assessments have not yet been completed. These will be described in the article reporting the outcomes of the study we describe in the current protocol paper.

5. 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.

Response:

We now include captions for the Supporting Information files at the end of the manuscript and have updated their in-text citations accordingly.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

________________________________________

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

________________________________________

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

________________________________________

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

Reviewer #1: Thank you for the opportunity to review this protocol for an outstanding study. This is one of the most well-written protocols and most promising trials I have recently seen. I have only a few minor comments.

Response:

We thank Reviewer 1 for their thoughtful review and positive feedback. We are very happy to hear that our proposed study is considered promising and of high quality.

1. There seems to be some confusion regarding who is the corresponding author of this manuscript (ED or ZDC).

Response:

ED and ZDC share corresponding authorship for this manuscript and are, therefore, both listed as corresponding authors. This is in line with PLOS ONE’s submission guidelines that do “not restrict the number of corresponding authors that may be listed on the article in the event of publication” (https://journals.plos.org/plosone/s/submission-guidelines).

2. The authors may want to include the following reference concerning treatment heterogeneity in the introduction section:

Volkmann C, Volkmann A, Müller CA. On the treatment effect heterogeneity of antidepressants in major depression: A Bayesian meta-analysis and simulation study. Hutson AD, ed. PLoS One. 2020;15(11):e0241497. doi:10.1371/journal.pone.0241497

Response:

We thank Reviewer 1 for this suggestion and have included the reference [5] in the introduction (page 5, marked up copy) as follows:

People suffering from depression have a range of therapeutic options, including various antidepressant medications (ADMs) and psychological treatments such as cognitive therapy (CT), behavioral activation (BA), interpersonal psychotherapy (IPT), and short-term psychodynamic psychotherapy (STPP). Although no significant differences in average treatment effects have been found between these interventions [1,2], response is highly heterogeneous [3,4,5] warranting the need for more personalized treatment recommendations [6].

3. I have a question regarding the included delivery formats. The manuscript states that guided digital interventions will be included. Are there any restrictions regarding the amount of guidance? This can differ significantly, to the point where human support is reduced to a couple of minutes per patient.

Response:

This is a good point. To avoid large heterogeneity in the amount of guidance between studies, we decided to exclude guided digital interventions. Our literature searches so far did not identify any study of guided digital interventions meeting the inclusion criteria for this work, suggesting that this decision likely will not lead to a substantial decrease in sample size. We have adjusted the relevant methods section (page 9, marked up copy), which now reads:

We will include psychotherapies in any delivery format (i.e., face-to-face, telephone, or videoconferencing), as long as a clinician delivers the therapy [30,31]. Bibliotherapy, internet therapy, or other self-help formats will be excluded.

4. How will the authors account for the effect of different settings/intensities of care, as both outpatient and inpatient care settings are included?

Response:

We thank Reviewer 1 for this question. We realize now that inpatient psychiatric care settings by definition do not meet our inclusion criteria, as do partial hospitalization and intensive outpatient programs, since patients in these settings receive more care than psychotherapy or antidepressant monotherapy. Therefore, we have rephrased the relevant section as follows to avoid this confusion (page 9, marked up copy):

Treatment must not exceed 6 months with no restrictions on the number of sessions [30,31]. Inpatient settings, partial hospitalization programs, and intensive outpatient programs will be excluded, since by definition more care is provided than psychotherapy or antidepressant monotherapy. We will place no other restrictions on the setting in which treatment is delivered (e.g., primary care, outpatient mental health care) [30,31].

5. Will there be a minimum depression baseline score for inclusion? How will this be operationalized?

Response:

As described at page 7 (marked up copy), depression is defined at study-level, as participants 1) meeting specified criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders) for major depressive disorder or another unipolar mood disorder assessed by means of a semi-structured interview or clinicians’ assessment, or 2) presenting a score at or above a validated cut-off indicating the likelihood of clinically significant depressive symptoms on an evaluator-assessed, clinician-assessed, or self-reported measure of depression.

As such, there is no minimum depression baseline score for inclusion. For studies in the first category, baseline depression scores are allowed to vary as long as the participants meet diagnostic criteria for a unipolar mood disorder. For studies in the second category, the minimum depression baseline score is operationalized by the cut-off score of the specific measure used indicating the likelihood of clinically significant depressive symptoms (e.g., Hamilton Depression Rating Scale score ≥ 10; Beck Depression Inventory score ≥ 10).

We have now rephased the relevant section in hopes of providing further clarification:

Participants will be considered depressed if they meet specified criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders) for major depressive disorder or another unipolar mood disorder assessed by means of a semi-structured interview or clinicians’ assessment, or if they present a score at or above a validated cut-off indicating the likelihood of clinically significant depressive symptoms on an evaluator-assessed, clinician-assessed, or self-reported measure of depression (e.g., Hamilton Depression Rating Scale total score ≥ 10; Beck Depression Inventory total score ≥ 10) [29-31,34].

6. Will there be exclusions of participants on an individual patient data level if the authors find indications that some inclusion criteria are not met by single persons in the IPD?

Response:

Yes, it is part of our data integrity check procedure to check for participants reporting values that are in conflict with the eligibility criteria of the study in which they were enrolled or the meta-analysis proposed (e.g., age <18). We considered this included in our checks “for inconsistent, invalid, or out-of-range values”, but we now describe this explicitly in the relevant methods section (page 14, marked up copy) as follows:

Third, the outcome and predictor variables will be checked for inconsistent, invalid, or out-of-range values [29-31], including values that conflict with the primary study’s or this work’s eligibility criteria (e.g., ag

Attachments
Attachment
Submitted filename: Response to reviewers - 2024-11-07.docx
Decision Letter - Nishant Jaiswal, Editor

PONE-D-23-39716R1Developing a multivariable prediction model to support personalized selection among five major empirically-supported treatments for adult depression. Study protocol of a systematic review and individual participant data network meta-analysis.PLOS ONE

Dear Dr. Cohen,

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.

==============================

ACADEMIC EDITOR: The protocol is well written and explains the methodology and plans in detailsIt will be interesting to see the full review when completed

==============================

Please submit your revised manuscript by Mar 21 2025 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,

Nishant Premnath Jaiswal, MBBS, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for addressing my comments. Most of my concerns have been thoroughly addressed.

However, there is one detail that may require further clarification:

The authors state: "We will include psychotherapies in any delivery format (i.e., face-to-face, telephone, or videoconferencing), as long as a clinician delivers the therapy [30,31]. Bibliotherapy, internet therapy, or other self-help formats will be excluded."

It is somewhat disappointing that, under the current definition, guided and unguided digital interventions are excluded. These are precisely the types of interventions that hold the greatest potential for scaling psychotherapy treatments in the future.

Nevertheless, the authors might want to consider adding a specification to the inclusion/exclusion criteria clarifying how they plan to deal with mixed-methods interventions, including blended treatment formats.

Thank you once again for the opportunity to review this excellent protocol. I am eagerly looking forward to the results of this study.

**********

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

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Revision 2

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.

Reply

We have double-checked the reference list and can ensure it is complete and correct. We do not cite any papers that have been retracted.

Reviewers' comments:

Reviewer #1: Thank you for addressing my comments. Most of my concerns have been thoroughly addressed.

However, there is one detail that may require further clarification:

The authors state: "We will include psychotherapies in any delivery format (i.e., face-to-face, telephone, or videoconferencing), as long as a clinician delivers the therapy [30,31]. Bibliotherapy, internet therapy, or other self-help formats will be excluded."

It is somewhat disappointing that, under the current definition, guided and unguided digital interventions are excluded. These are precisely the types of interventions that hold the greatest potential for scaling psychotherapy treatments in the future.

Nevertheless, the authors might want to consider adding a specification to the inclusion/exclusion criteria clarifying how they plan to deal with mixed-methods interventions, including blended treatment formats.

Thank you once again for the opportunity to review this excellent protocol. I am eagerly looking forward to the results of this study.

Reply

We thank Reviewer 1 for reviewing the revised version of this manuscript. We are very happy to hear that Reviewer 1 considers this protocol of high quality and prior concerns generally addressed.

We acknowledge the potential of digital interventions as scalable depression treatments. Prior work has been conducted aimed at personalizing treatment selection in this area (e.g., https://pubmed.ncbi.nlm.nih.gov/33471111/).

We agree that the manuscript would benefit from specifying how mixed-methods interventions and blended treatment formats are dealt with. We propose to exclude such treatment formats too to avoid large heterogeneity in the amount of guidance between studies. Please note that our literature searches so far did not identify any study applying a blended format. As such, we expect this decision will not lead to many studies being excluded from consideration. We have adjusted the relevant methods section (page 9, marked up copy), which now reads:

We will include psychotherapies in any delivery format (i.e., face-to-face, telephone, or videoconferencing), as long as a clinician delivers the therapy [30,31]. Bibliotherapy, internet therapy, or other self-help formats will be excluded, as will be blended treatment formats that combine clinician-delivered therapy with internet interventions.

Attachments
Attachment
Submitted filename: Response to reviewers - 2025-03-04.docx
Decision Letter - Nishant Jaiswal, Editor

Developing a multivariable prediction model to support personalized selection among five major empirically-supported treatments for adult depression. Study protocol of a systematic review and individual participant data network meta-analysis.

PONE-D-23-39716R2

Dear Dr. Cohen,

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.

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Kind regards,

Nishant Premnath Jaiswal, MBBS, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

All the comments have been addressed satisfactorily

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

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Reviewer #1: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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6. Review Comments to the Author

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Reviewer #1: All my questions have been answered. I wish you every success with this important study. I look forward to the results!

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Reviewer #1: No

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Formally Accepted
Acceptance Letter - Nishant Jaiswal, Editor

PONE-D-23-39716R2

PLOS ONE

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on behalf of

Dr. Nishant Premnath Jaiswal

Academic Editor

PLOS ONE

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