-->PONE-D-26-05648-->-->Reporting quality of qualitative health studies published by Peruvian authors: a scoping review-->-->PLOS One

Dear Dr. Paredes-Angeles,

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Alfredo Luis Fort, M.D., M.Sc., Ph.D.

Academic Editor

PLOS One

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Additional Editor Comments:

The authors have designed and presented an important study to the research field. In general, they have used appropriate methodology and description of results. However, there are a few areas in the manuscript that required better explanations and corrections of a few errors. Please find the suggestions by the reviewers, plus a few additional comments I have made in the attached file. Please proceed to improve your article to get it ready for publication. Thank you.

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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?

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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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Reviewer #1: No

Reviewer #2: Yes

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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: 1. The manuscript presents a technically sound piece of scientific research. The study’s data support the conclusion. However, the following points need to be considered:

Introduction section, paragraph 4, page 6

• The authors mentioned that health research publications have increased in Peru. They cited the source of that information. Although it is okay, they could have spiced up the argument by stating the magnitude of the increase.

• The authors have claimed that “to date, no studies have specifically examined qualitative health research or assessed the quality of its reporting.” The argument lacks clarity and evidence. Can they provide evidence that their study is of the first kind in Peru?

Study eligibility, paragraph 2, page 7

• “Only studies in which at least 25% of participants were based in Peru were considered.” Why? Can this statement be supported with the reason for including studies in which at least 25% of participants were based in Peru?

Conclusion, pages 22 and 23

• Conclusion lacks recommendations from the study’s findings.

2. The authors have performed statistical analysis appropriately and rigorously. They have used simple statistical analyses by reporting prevalence ratios and frequencies. However, they should consider revising the presentation of the frequencies in Table 1. It is more appearing to arrange the frequencies of the variables in a table, either from highest to lowest percentages or vice versa. Table 1 is on pages 13 and 14.

3. The authors did not make the data underlying the findings in their manuscript fully available. However, they state that the data will be available upon reasonable request from the corresponding author.

4. The manuscript is presented in an intelligible fashion and written in standard English. However, in the discussion section (main results, page 17), the paragraph is redundant to what has already been presented in the results section. Again, on pages 7 and 8, the Spanish was mentioned twice. Additionally, using the word “to date” (page 6) will be vague if the paper is read in 2 or more years from now. Can authors replace “to date” with other word(s)?

Reviewer #2: Overall comment:

The review rationale is relevant as it aims to contribute to improving future qualitative research in health. However, several points are to be considered to enhance the manuscript’s rigor, transparency and relevance. They are detailed below in major and minor comments.

*MAJOR COMMENTS

Introduction

1/ p.6: The study aim is stated as follows: “this study aimed to describe the methodological characteristics and assess the reporting quality of qualitative studies published by Peruvian authors.” (p.6). In the eligibility criteria, authors stated: “Only studies in which at least 25% of participants were based in Peru were considered.” (p.11).

This is a bit confusing. Authors should specify clearly if it’s about qualitative studies published by Peruvian authors or qualitative studies conducted in Peru.

Methods

1/ p.6: Why focusing especially on 2022-2025 period to get recent studies? Authors have provided an explanation in Discussion. However, are the studies published prior 2022-2025 no more relevant or used to inform health practice and policy?

2/ p.6: Authors claim to have conducted a systematic search. Yet they only searched Scopus without a justification. Why did they search only one database and how inclusive/comprehensive do they think their review is? Did they consider other sources such as references lists of identified articles?

3/ p.7: How relevant do you think it would be to group studies by health disciplines? Researchers usually work in specific health disciplines and your findings would be more insightful if you provide them with discipline-based evidence.

4/ p.8: Authors used the highest tertile to define “adequate SRQR reporting”. Is this threshold a standard in the field or just authors’ choice? This should be clarified.

5/ p.8-11: This SRQR-based study assessment remains somehow subjective since the appreciation may vary by assessor. I believe that if another research group had to reproduce this review, they may give different scores to each study for each item. Are authors aware of this subjectivity and variability concern? What strategy did they implement to mitigate this limitation?

6/ It is widely recognized that study reporting quality depends on research expertise and vary both by health discipline (dentistry vs. public health) and by authors’ affiliation type (clinical vs. research institution affiliation). Since the information on health discipline was available, why did authors not consider it as a descriptive characteristic and subsequently test its association with adequate reporting categories?

Results

1/ Please format all tables according to the journal’s guidelines.

2/ Figure 1: authors stated that 287 studies were excluded by title and abstract. Can they briefly specify the reasons both in the figure and in the descriptive text?

3/ Figure 2: mandatory elements of a geographical map, such as direction (North) and gradient (scale), are missing. Please consider adding them.

4/ Adequate reporting is reported in Table 1 but not commented in the text. Please consider adding an in-text comment and a table footnote recalling how it was defined.

5/ p.15: It seems counterintuitive to interpret an association by the reference group as authors did for Table 2 regarding non-Peruvian vs. Peruvian first author’s affiliation (PR = 0.40, 95% CI: 0.26–0.62). If authors wish to keep this interpretation, I suggest them to assign the reference group to Peruvian authors.

Discussion

1/ Considering you research rationale; how do authors interpret and explain a study with one Peruvian author (for instance at sixth position) and many foreigner co-authors? Is it treated as a Peru-affiliated study at the same level as the one exclusively authored by Peru-based researchers?

2/ p.17: Please, authors should remove proportions from the Main Results recall in the Discussion section. Instead, they could use descriptive terms such as half of studies, three-quarter, one-third, etc. which are more appealing as summary.

3/ p.19-20: Authors compare their findings with the existing literature. They mainly focused on similar findings, while less is said about divergence between their results and the existing evidence. Moreover, less is said about the studies of comparison besides thematic areas. They should consider improving this.

4/ p.20: Authors should consider revising the paragraph #1 of the subsection “Factors associated with…” First, delete “…which could partially explain the observed association” because it is repetitive with the second sentence starting: “This may be explained by the tendency…”. Second, another explanation to consider may be the fact that English studies are often co-authored by international researchers, requiring English as the collaborative language and bringing additional level of rigor and expertise, as acknowledged in the subsequent paragraph.

5/ p.21-22: Two major limitations need to be considered. First, there is a rater subjectivity in using SRQR checklist that should not be dismissed, yet not discussed by authors. This can be observed in the Strengths paragraph where authors praise their “flexibility” in rating studies, which was even not mentioned in Methods. Second, regression analysis estimated crude associations that should be explicitly acknowledged in the discussion alongside their implications for both these findings and future research.

Conclusion

1/ p.22: The conclusion reads more like results recall than overall summary and practical recommendations for qualitative health research stakeholders. Authors should consider complying with the PRISMA-ScR recommendation relative to conclusion: “Provide a general interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps.”

* MINOR COMMENTS

1/ Please, revise the referencing format throughout the text according to the journal’s guidelines.

2/ p.6: I suggest to reformulate concisely the following text: From “A detailed study protocol was developed prior to study initiation and made publicly available. The protocol of this review is available at https://osf.io/jes6v/files/3rn52.” to “A detailed study protocol was developed prior to study initiation and made publicly available (https://osf.io/jes6v/files/3rn52)”

3/ p.7: Please, provide an internet link to Rayyan software to align with proper software referencing (city, company, website). Same for Stata software and revise as follows: “…Stata software, version 19.0.” (p.11)

4/ p.7: Please revise: “…with the collaboration of other authors.” or “…with the collaboration of another author.”

5/ A lot of paragraphs are too short, with only 1 to 3 sentences within a subsection. Please, revise to make paragraphs more compact.

6/ p.11: Please, use appropriate terminology: replace “numeric variables” by “quantitative variables”

7/ p.11: Please, add statistical threshold: “…crude prevalence ratios (PR) with 95% confidence intervals (CI) were estimated…”

8/ Please, reformulate Table 2 title as follows: “Factors associated with adequate…”

9/ I am just curious to know how long it took to check 147 studies against a 21-item checklist.

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Reviewer #1: No

Reviewer #2: No

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Attachments

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Submitted filename: PONE-D-26-05648-AF.pdf

Calidad de la información en estudios cualitativos de salud publicados por autores peruanos: una revisión exploratoria

PONE-D-26-05648R1

Dear Dr. Paredes-Angeles,

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,

Alfredo Luis Fort, M.D., M.Sc., Ph.D.

Academic Editor

PLOS One

Additional Editor Comments (optional):

Although the manuscript is judged to be accepted for publication, I have found a few small areas that can be improved to ensure the reader is able to see and understand better what is being described (see in attached file).

Attachments

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Submitted filename: PONE-D-26-05648_R1-AF.pdf