Exploring the prevalence of atopic disease among adult cancer survivors: insights from the 2021 NHIS

Lu Xiao; Yuhui Shen; Nana Xiang; Juebo Yu

doi:10.1371/journal.pone.0322455

Peer Review History

Original SubmissionOctober 18, 2024
18 Oct 2024 Author Response https://doi.org/10.1371/journal.pone.0322455.r001
26 Dec 2024 Decision Letter - Benjamin Ansa, Editor PONE-D-24-46805Risk of Atopic Disease Among Adult Cancer Survivors Insights from the 2021 NHISPLOS ONE Dear Dr., yu, 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 read carefully the comments from the reviewers and respond to them point-by-point. If you are unable to provide a response to any of the comments, then give an explanation of the reason for this. You must address the review comments by the academic editor that are restated below. ============================== Please submit your revised manuscript by Feb 09 2025 11:59PM. 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If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. Additional Editor Comments: The author has presented a manuscript of a study titled "Risk of Atopic Disease Among Adult Cancer Survivors Insights from the 2021 NHIS" for publication consideration. The results of the study reveal that cancer survivors have a significantly higher prevalence of atopic disease than the general population. There are comments below for author consideration to help improve the quality of the paper. 1.Abstract: The sample size mentioned here is 28,617. This is different from that in the methods and in Figure 1 (2,069+18,369=20438). Revise this. 2. Methods: Include more information about the 2021 NHIS in the paper. What are the response rates, the validity and reliability indices of the survey instrument? Mention the specific exclusion criteria in the methods section as well. Statistical analysis: The use of prevalence and odds ratio for measuring risk is inappropriate. Rather, the attack rate and relative risk are the appropriate measures for measuring risk. Rate Ratios (RR) or Rate Differences (RD) may also be used for calculating the risk differences between the comparison groups. If you decide not to reanalyze the data, then I suggest you change the title and objectives to "exploring the prevalence of Atopic Disease Among Adult Cancer Survivors: Insights from the 2021 NHIS". 3. Results: The results provided in the manuscript are not reflective of the measures for RISK. This should be revised per my suggestion in the Methods or change the narrative to the measures of prevalence of AD among cancer survivors. The tables and figures look okay. 4. Conclusions: The narrative here states "prevalence of AD in cancer survivors". However, the title and objectives mention RISK. Be consistent. Otherwise, the explanation for the relationship between atopic disease and cancer was well presented in the conclusions. 5. References: Look okay. Minor comments 1. Avoid using the phrase "To our knowledge". This was used several times in the manuscript and should be deleted. 2. You may solicit the services of a scientific English writing to review the paper. Best of Luck! [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know ****** 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: The manuscript is based on the original idea of using the publicly available data from the annual nhis report for a statistical study. It must be accepted that the data collected is based solely on the information provided by the respondents and cannot be objectively verified. This considerably reduces the scientific significance of such an approach. The approach of looking for a link between cancer and atopic diseases is interesting. However, i would suggest to the individual author that, if the manuscript is revised, other co-authors with expertise in their respective fields should be consulted, namely a statistician, an allergologist and, if possible, an epidemiologist. This would strengthen the classification of the results and the credibility of the statistical analysis. The manuscript also has considerable linguistic and formal deficiencies, which would have to be revised before a new submission. ****** 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.0322455.r002
Revision 1
15 Jan 2025 Author Response Dear editors and reviewers: On behalf of all the contributing authors, I would like to express our sincere appreciations of your letter and reviewers’ constructive comments concerning our article entitled Exploring the prevalence of Atopic Disease Among Adult Cancer Survivors: Insights from the 2021 NHIS. These comments are all valuable and helpful for improving our article. According to the reviewers’ comments, we have made extensive modifications to our manuscript to make our results convincing. In this revised version, changes to our manuscript were all highlighted within the document by using itemized text. Point-by-point responses to the nice associate editor and the nice reviewers are listed below this letter. Response to Editor Comments: Question 1: .Abstract: The sample size mentioned here is 28,617. This is different from that in the methods and in Figure 1 (2,069+18,369=20438). Revise this. Response 1 : Thank you for your comments on my manuscript. We have checked and corrected it. After the application of these exclusion criteria, the final sample comprised 3651 cancer survivors and 24,966 adults without a history of cancer (Fig 1B). Question 2: Methods: Include more information about the 2021 NHIS in the paper. What are the response rates, the validity and reliability indices of the survey instrument? Mention the specific exclusion criteria in the methods section as well. Statistical analysis: The use of prevalence and odds ratio for measuring risk is inappropriate. Rather, the attack rate and relative risk are the appropriate measures for measuring risk. Rate Ratios (RR) or Rate Differences (RD) may also be used for calculating the risk differences between the comparison groups. If you decide not to reanalyze the data, then I suggest you change the title and objectives to "exploring the prevalence of Atopic Disease Among Adult Cancer Survivors: Insights from the 2021 NHIS". . Response 2: Thank you for your comments on my manuscript. The household response rate for 2021 stood at 52.8%. To account for the sample design and nonresponse, extensive procedures have been implemented. Participants without a history of ADs, those with unknown cancer history, those with missing responses to the general condition question, and those with missing demographic information were excluded in this study. The questionnaire tool used in this study is a survey tool designed by NHlS database in the United States. Although we cannot obtain accurate the validity and reliability indices of the survey instrument . But I believe this specific one is reliable and effective. Otherwise, this questionnaire could not be run in this institution for nearly ten years. NHIS's survey questionnaire tools are carefully designed and continuously optimized to effectively collect high-quality health data, providing important data support for health research and public health decision-making the validity and reliability indices of the survey instrument. NHIS's survey questionnaire tools can be downloaded from the internet (https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2021/adult-codebook.pdf) Question 3: Results: The results provided in the manuscript are not reflective of the measures for RISK. This should be revised per my suggestion in the Methods or change the narrative to the measures of prevalence of AD among cancer survivors. The tables and figures look okay. Response 3: Thank you for your comments on my manuscript.We have checked and corrected it. Question 4: Conclusions: The narrative here states "prevalence of AD in cancer survivors". However, the title and objectives mention RISK. Be consistent. Otherwise, the explanation for the relationship between atopic disease and cancer was well presented in the conclusions. Response 4: Thank you for your comments on my manuscript.We have checked and corrected it. Question 5: References: Look okay. Response 5: Thank you for your comments on my manuscript. Question 6: Minor comments 1. Avoid using the phrase "To our knowledge". This was used several times in the manuscript and should be deleted. 2. You may solicit the services of a scientific English writing to review the paper. Response 6: Thanks for your suggestion. 1. We have checked and corrected it. 2. I read through the full text and correct these errors. In addition, we feel sorry for our poor writings, however, we do invite a professional English editing agency which is a native English speaker from the USA to polish our article. And we hope the revised manuscript could be acceptable for you. I hope you can give me some good advice again. I will revise it seriously. Thank you very much your attention and time. Look forward to hearing from you. Response to Reviewer #1: The manuscript is based on the original idea of using the publicly available data from the annual nhis report for a statistical study. It must be accepted that the data collected is based solely on the information provided by the respondents and cannot be objectively verified. This considerably reduces the scientific significance of such an approach. The approach of looking for a link between cancer and atopic diseases is interesting. However, i would suggest to the individual author that, if the manuscript is revised, other co-authors with expertise in their respective fields should be consulted, namely a statistician, an allergologist and, if possible, an epidemiologist. This would strengthen the classification of the results and the credibility of the statistical analysis. The manuscript also has considerable linguistic and formal deficiencies, which would have to be revised before a new submission. Question of Reviewer #1: Dear Reviewer, thank you for your thorough evaluation of the manuscript and for highlighting the areas that require improvement. Your insights are invaluable in enhancing the quality and credibility of the research. Here is how we plan to address each of your concerns: We acknowledge the limitations inherent in relying on self-reported data from the National Health Interview Survey(NHIS).To mitigate this, we will include a detailed discussion on the potential biases and limitations of our data source in the revised manuscript. Additionally, we will explore the possibility of corroborating our findings with other studies or datasets that might offer more objective measures. Your suggestion to involve co-authors with specific expertise is well-taken. We seek collaboration with a statistician to ensure the robustness of our statistical analysis. We also consult with an allergologist to provide clinical insights into the link between cancer and atopic diseases. We invite an epidemiologist to strengthen our understanding of the population-level implications of our findings. We revise the manuscript to include a more detailed and rigorous statistical analysis. This involve refining our methods and ensuring that the statistical tests used are appropriate for the data and the research questions posed. We believe that that the results are presented in a manner that is clear and understandable to readers. We are committed to improving the manuscript's language and presentation. We engage a professional editor to review and polish the manuscript for clarity, coherence, and adherence to academic standards. This includes correcting grammatical errors, improving the flow of the text, and ensuring that the manuscript conforms to the journal's formatting guidelines. We appreciate your constructive feedback and are dedicated to revising the manuscript to meet the high standards of scientific research and publication. We believe that with these revisions, the manuscript will provide a more substantial contribution to the field. Thank you once again for your valuable comments. Yours sincerely, Juebo Yu 13 June 2023 Department of Otolaryngology, Affiliated Hospital of Yangzhou University, Yangzhou university, Yangzhou, China Corresponding Author: Juebo Yu, MD, Department of Otolaryngology, Affiliated Hospital of Yangzhou University, No. 45 Taizhou Rd, Guangling District, Yangzhou 225001, China (yujuebo2004@163.com). Attachments Attachment Submitted filename: Response to Reviewers PLOS one.pdf https://doi.org/10.1371/journal.pone.0322455.r003
19 Jan 2025 Decision Letter - Benjamin Ansa, Editor PONE-D-24-46805R1Exploring the prevalence of atopic disease among adult cancer survivors:insights from the 2021 NHISPLOS ONE Dear Dr. yu, 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. ============================== See below the reviewer's comment and an attached file for the minor revision of your paper. ============================== Please submit your revised manuscript by Mar 05 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, Benjamin Ansa Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Dear Dr. juebo yu, Thank you for submitting the revised version of your manuscript titled "Exploring the prevalence of atopic disease among adult cancer survivors: insights from the 2021 NHIS". You have responded to most of the reviewers' comments. However, there are still minor revisions to be made before the publication consideration for your paper can move forward. There are still parts of the manuscript that refer to your analysis as "Risk of ADs" instead of "Prevalence of AD's". This should be corrected. I have highlighted in yellow color those areas to be corrected in the attached file for your convenience. We hope you can resubmit the revised version soon. [Note: HTML markup is below. Please do not edit.] [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: PONE-D-24-46805_R1.pdf https://doi.org/10.1371/journal.pone.0322455.r004
Revision 2
11 Mar 2025 Author Response Dear editors and reviewers: On behalf of all the contributing authors, I would like to express our sincere appreciations of your letter and reviewers’ constructive comments concerning our article entitled Exploring the prevalence of Atopic Disease Among Adult Cancer Survivors: Insights from the 2021 NHIS. These comments are all valuable and helpful for improving our article. According to the reviewers’ comments, we have made extensive modifications to our manuscript to make our results convincing. In this revised version, changes to our manuscript were all highlighted within the document by using itemized text. Point-by-point responses to the nice associate editor is listed below this letter. Response to editor Comments: Question 1: .Thank you for submitting the revised version of your manuscript titled "Exploring the prevalence of atopic disease among adult cancer survivors: insights from the 2021 NHIS". You have responded to most of the reviewers' comments. However, there are still minor revisions to be made before the publication consideration for your paper can move forward. There are still parts of the manuscript that refer to your analysis as "Risk of ADs" instead of "Prevalence of AD's". This should be corrected. I have highlighted in yellow color those areas to be corrected in the attached file for your convenience. We hope you can resubmit the revised version soon. Response 1 : Thank you for your comments on my manuscript. We have checked and corrected it..We hope the revised manuscript could be acceptable for you. I hope you can give me some good advice again. I will revise it seriously. Thank you very much your attention and time. Look forward to hearing from you. Yours sincerely, Juebo Yu 13 June 2023 Department of Otolaryngology, Affiliated Hospital of Yangzhou University, Yangzhou university, Yangzhou, China Corresponding Author: Juebo Yu, MD, Department of Otolaryngology, Affiliated Hospital of Yangzhou University, No. 45 Taizhou Rd, Guangling District, Yangzhou 225001, China (yujuebo2004@163.com). Attachments Attachment Submitted filename: Response_to_Reviewers_PLOS_one_auresp_2.pdf https://doi.org/10.1371/journal.pone.0322455.r005
24 Mar 2025 Decision Letter - Benjamin Ansa, Editor Exploring the prevalence of atopic disease among adult cancer survivors: insights from the 2021 NHIS PONE-D-24-46805R2 Dear Dr. Yu, 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, Benjamin Ansa Academic Editor PLOS ONE Additional Editor Comments (optional): The author has revised the manuscript according to the review comments. https://doi.org/10.1371/journal.pone.0322455.r006
Formally Accepted
Acceptance Letter - Benjamin Ansa, Editor PONE-D-24-46805R2 PLOS ONE Dear Dr. yu, 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. Benjamin Ansa Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0322455.r007

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