Continuity of care interventions for people with stroke and their caregivers: A scoping review protocol

Meera Premnazeer; Sarah E. P. Munce; Mark T. Bayley; Kristina M. Kokorelias; Monique Gill; Orianna L. Scali; Jill I. Cameron

doi:10.1371/journal.pone.0323344

Peer Review History

Original SubmissionJuly 19, 2024
19 Jul 2024 Author Response https://doi.org/10.1371/journal.pone.0323344.r001
5 Nov 2024 Decision Letter - Tazeen Majeed, Editor PONE-D-24-30063Continuity of Care Interventions for People with Stroke and their Caregivers: A Scoping Review ProtocolPLOS ONE Dear Dr. Cameron, 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 20 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, Dr Tazeen Majeed 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 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. 3. We note that you have indicated that there are restrictions to data sharing for this study. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For more information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Before we proceed with your manuscript, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., a Research Ethics Committee or Institutional Review Board, etc.). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. You also have the option of uploading the data as Supporting Information files, but we would recommend depositing data directly to a data repository if possible. We will update your Data Availability statement on your behalf to reflect the information you provide. 4. 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 Reviewer #2: 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 Reviewer #2: 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 Reviewer #2: 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 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 #1: Yes Reviewer #2: 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: The protocol is well-written and addresses a good clinical question but has minor corrections to be made. Reviewer #2: The manuscript presents an exceptionally well-organized and thorough study protocol that addresses an important gap in stroke care research, specifically in continuity of care interventions for people with stroke (PWS) and their caregivers. The work demonstrates a deep understanding of both the clinical and research landscapes, and the methodology is meticulously designed to ensure a comprehensive scoping review. The authors have successfully articulated the relevance of their study, which will likely contribute significantly to improving stroke care transitions. However, there are some areas for improvement that could enhance the clarity and impact of the manuscript. In the abstract, while the objectives and methods are clearly stated, further detail could be added to the methods section to outline the databases and search terms more explicitly. This would provide readers with a clearer understanding of the scope of the research at a glance. The introduction is comprehensive but could benefit from being more concise, with a more direct focus on the specific research gap. Some redundancy in the background could be streamlined to improve flow and reader engagement. In the methodology, the choice to limit the review to randomized controlled trials could be reconsidered, as scoping reviews typically aim to include a broader range of evidence types. Expanding the types of studies included would align more closely with the objectives of mapping the breadth of available evidence on continuity of care interventions. Overall, the manuscript showcases a high level of scholarly rigor and has great potential for advancing research in stroke care. With these small adjustments, the work can be further strengthened to ensure maximum impact and clarity. ****** 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: Salman Ashfaq Ahmad ******** [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: Reviewed PONE-D-24-30063_reviewer.pdf Attachment Submitted filename: Comments.docx https://doi.org/10.1371/journal.pone.0323344.r002
Revision 1
21 Nov 2024 Author Response Dear Editor, Thank you for giving us an opportunity to submit a revised draft of our manuscript “Continuity of Care Interventions for People with Stroke and their Caregivers: A Scoping Review Protocol”. We have incorporated the suggestions made by the reviewers. All line and page numbers refer to the revised manuscript file with tracked changes. We have additionally changed the following: (1) added initials for all authors (Line 5-6) and (2) the ordering in our acknowledgement section has been rearranged to place importance on funding most relevant to the current study (Line 328-332). All page numbers refer to the revised manuscript with tracked changes. Reviewer’s Comments to the Authors: Reviewer 2: In the abstract, while the objectives and methods are clearly stated, further detail could be added to the methods section to outline the databases and search terms more explicitly. This would provide readers with a clearer understanding of the scope of the research at a glance. Author response: Thank you for the feedback. The databases that will be used are outlined in Line 10-11 (Ovid MEDLINE, CINAHL Plus with Full Text, PsycINFO, and EMBASE). We have added additional examples for search terms beside the main concepts of stroke and continuity of care (Line 12-13). Specific Change: “The search will be conducted on Ovid MEDLINE, CINAHL Plus with Full Text, PsycINFO, and EMBASE, restricting to articles in English. Core concepts of stroke (e.g., ischemic or hemorrhagic stroke) and continuity of care (e.g., early supported discharge) and their synonyms will be used as search terms.” Page Number: 2 Reviewer 2: The introduction is comprehensive but could benefit from being more concise, with a more direct focus on the specific research gap. Some redundancy in the background could be streamlined to improve flow and reader engagement. Author response: Thank you for the suggestion. We have edited the introduction such that it is more concise and avoids redundancy. Specific Change: Removed redundant information (Line 27, 33, 74-75) Changed phrasing on Line 39 “move from one environment to another” to “navigate different environments.” Simplified section on continuity of care and its dimensions to: “Continuity of care has three dimensions that enhance trust and communication: (1) informational continuity: transfer and use of past medical history to inform present care across providers and settings; (2) management continuity – consistent and timely care is provided to manage a patient’s health needs (i.e., shared management plans across providers); and (3) relational continuity – consistent and continuous patient-provider relationship over time and/or across environments (12-14). This review will operationalize continuity of care as interventions that comprise at least one of the three main dimensions outlined above.” (Line 39-44) Simplified the summary of continuity of care interventions paragraphs (Lines 82, 85, 87, 89-90, 93-113, 117, 120): “Many reviews on continuity of care interventions and stroke have been published (15-18). A recent meta-analysis found that continuity of care interventions improved stroke patients’ independence compared to usual care (16). A systematic review found low-to-moderate strength of evidence for the effectiveness of hospital-initiated transitional care for PWS or myocardial infarction (17). Another systematic review found support interventions to home after acute stroke improved functional status and quality of life in the short-term, and depression and anxiety of PWS in the medium to long-term (15). A literature review examining the effectiveness of continuity of care interventions for hospital discharge to the home found some interventions reported positive outcomes (e.g., quality of life, depression and mood) (18). A recent review emphasized the importance of person-centered care in continuity of care interventions (19). Previous reviews did not aim to comprehensively review all transitions across the care continuum (e.g., stroke onset to the emergency department, inpatient acute care to inpatient rehabilitation). For example, O’Callaghan et al. (2022) only examined the single transition from hospital to home or inpatient settings to home. PWS and caregivers enter the healthcare system much earlier and require continuity of care support from stroke symptom onset as identified by the Canadian Best Practice Recommendations (3). Reviews to date (15-19) also focused on person-centered care and rarely considered family-centered care (e.g., providing caregivers with illness-specific education) (17). An understanding of transition-specific and stroke-specific needs over time is needed to inform the development of future continuity of care interventions, as PWS and caregivers have differing needs and supports as they move across the care continuum (20).” Page Number: 3-5 Reviewer 2: In the methodology, the choice to limit the review to randomized controlled trials could be reconsidered, as scoping reviews typically aim to include a broader range of evidence types. Expanding the types of studies included would align more closely with the objectives of mapping the breadth of available evidence on continuity of care interventions. Author response: Thank you for your feedback regarding our choice to limit the review to randomized controlled trials (RCTs). We agree that expanding the type of studies would align more closely with the objectives of mapping the breadth of available evidence on continuity of care interventions. However, our initial searches showed a large number of continuity of care interventions in this area (100+). Thus, to ensure feasibility we decided to focus on RCTs while still capturing high-quality evidence. We also acknowledge this as a limitation (Line 192-195). Specific Change: “The review will only include randomized control trials. This was chosen to: 1) ensure feasibility of the review as we identified a large number of continuity of care interventions during our initial searches and 2) include high-quality evidence. This is a limitation of the study as it may exclude interventions not yet tested at the randomized control trial level, potentially affecting the comprehensiveness of mapping the interventions to date.” Page Number: 8 Reviewer: This is the first time this abbreviation is being mentioned, therefore the authors need to state the full meaning. Author response: Thank you for outlining this. We have expanded the abbreviation for PWS to “people with stroke” (Line 8). Specific Change: “To examine the literature on continuity of care interventions that address the needs of people with stroke and/or their caregivers specific to stroke care transitions.” Page Number: 2 Reviewer: The Joanna Briggs Institute Methodological Framework refers to a specific methodology for reviewing articles. However, the authors did not specify the exact methodology used in this study. Author response: Thank you for this feedback. We have added within the sentence “scoping review” to indicate the specific methodology that the Joanna Briggs Institute Methodological Framework refers to (Line 10). This was also added within the Methods (Line 154-155). Specific Change: “The study is guided by the Joanna Briggs Institute methodological framework for scoping reviews.” “The scoping review will be conducted following the JBI methodology for Scoping Reviews (22, 23).” Page Number: 2, 6 Reviewer: The authors have not stated why they limited their search to English language studies only. Additionally, they had earlier stated that they will include studies conducted anywhere in the world. Author response: Thank you for pointing this out. This review was limited to English as we did not have access to or resources to support translation of articles from other languages to English. We mention this as a limitation (Line 184-186). Specific Change: “The included articles must be written in English as we did not have resources to support translation. This is a limitation of the study as it may result in the exclusion of relevant articles in other languages.” Page Number: 7 Attachments Attachment Submitted filename: Response to Reviewers Letter_MP Nov 21 2024rev.docx https://doi.org/10.1371/journal.pone.0323344.r003
8 Apr 2025 Decision Letter - Marianne Clemence, Editor Continuity of Care Interventions for People with Stroke and their Caregivers: A Scoping Review Protocol PONE-D-24-30063R1 Dear Dr. Cameron, 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, Marianne Clemence Staff Editor PLOS ONE Additional Editor Comments (optional): 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 Reviewer #2: 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 Reviewer #2: 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 Reviewer #2: 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 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 #1: Yes Reviewer #2: 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: I think the authors have a good job by responding well to the concerns that were initially raised. I would recommend accepting the article for publication. Thank you Reviewer #2: The author of the study protocol has addressed all the comments. The study protocol is now up to the standards and can be published. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy . Reviewer #1: Yes: Dr Collins Ogbeivor Reviewer #2: Yes: Salman Ashfaq Ahmad ******** https://doi.org/10.1371/journal.pone.0323344.r004
Formally Accepted
Acceptance Letter - Marianne Clemence, Editor PONE-D-24-30063R1 PLOS ONE Dear Dr. Cameron, 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 You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days 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 Marianne Clemence Staff Editor PLOS ONE https://doi.org/10.1371/journal.pone.0323344.r005

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 .