PONE-D-25-23383Cohort Profile: The Dutch Wound Monitor Cohort and the Swedish Region Halland Integrated Platform (RHIP) Wound CohortPLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Authors, thank you very much fir the article. The manuscript is clearly structured, well-written, and provides useful demographic and clinical insights into two distinct but complementary data sources.

The detailed presentation of database characteristics, strengths, and weaknesses is helpful for potential secondary users and for researchers considering cross-cohort analyses. However, there are aspects that warrant clarification or improvement to strengthen the manuscript’s rigor, contextualization, and utility.

Please consider this Major Points for Consideration

The article is positioned as a “cohort profile,” yet also discusses potential AI modelling applications. While this is valuable, the primary purpose (descriptive vs. preparatory for modelling) should be explicitly clarified in the Introduction and Conclusion.

Consider please, stating more clearly how these datasets are expected to contribute to improving wound care workflows or informing policy.

Contextualization and Literature Integration should be improived since i fekt the need to better situate these cohorts within the broader landscape of wound databases internationally. Are there similar registries (e.g., U.S., U.K., Australia) and how do these compare in scope or structure?

Please clarify or explain the rationale for comparing Dutch and Swedish data (beyond availability) should be explained, particularly regarding differences in healthcare delivery and wound care practices.

Methodological Detail and Transparency

We fekt the need to have a better description or more detail on data cleaning, quality control, and missing data handling is warranted. For example, how were errors or inconsistencies in wound classification addressed? Please, clarify whether any harmonization of variable definitions was attempted between cohorts for comparative purposes.

Regarding Ethics and Data Access, and we noticed that ethical approvals are listed, but we consider that the manuscript should explicitly address data privacy measures, especially given the use of real-world clinical data and potential re-identification risks in smaller subgroups. - just a reflection

Last suggestuoins are associated with Limitations and Biases, because while some dataset limitations are acknowledged, additional discussion of selection bias (e.g., home-care patients in the Dutch cohort vs. broader care settings in RHIP) would contextualize findings.

With these revisions to clarify objectives, strengthen contextualization, and expand discussion of methodological considerations, the paper would provide a valuable resource for researchers and clinicians in wound care and digital health.

Reviewer #2: This is a well-structured and timely manuscript that provides an in-depth cohort profile of two valuable wound care datasets: the Dutch Wound Monitor and the Swedish RHIP Wound Cohort. The manuscript is technically sound, and the conclusions are appropriately supported by the data presented.

The strengths of the study include:

Clear and meaningful comparison between patient-level and wound-level data perspectives.

Integration of demographic, clinical, and data infrastructure details.

Transparent methodology and ethical compliance.

A forward-looking discussion about AI potential in wound care.

The paper makes a strong case for how real-world data can enable information-driven care in chronic wound management.

Suggestions for minor revision:

1. Enhance the clarity of Figure 3 – the contrast between RHIP and Wound Monitor could be more intuitive to general readers.

2. Include a concise summary table comparing the wound classification systems used in both cohorts (e.g., ICD-10 vs. NPIAP/UT).

3. Briefly address the generalizability of findings outside Sweden and the Netherlands, especially in regions with limited digital infrastructure.

4. Clarify how future NLP/LLM efforts might resolve missing wound ID and outcome variables in RHIP.

These revisions are relatively minor and aimed at improving clarity and impact. Overall, I support the publication of this work and believe it will be of value to the wound care, data science, and digital health communities.

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Reviewer #1: Yes: Paulo Jorge Pereira Alves

Reviewer #2: Yes: Abdulrahman Almalki

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Cohort Profile: The Dutch Wound Monitor Cohort and the Swedish Region Halland Integrated Platform (RHIP) Wound Cohort

PONE-D-25-23383R1

Dear Dr. Gustafsson,

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,

Yih-Kuen Jan, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: (No Response)

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

Reviewer #2: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Abdulrahman Almalki

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