-->PONE-D-25-53773-->-->The experience of individuals following non-surgical management of Achilles tendon rupture in the United Kingdom – a qualitative study-->-->PLOS One

Dear Dr. Briggs-Price,

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.

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We look forward to receiving your revised manuscript.

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Se Won Lee

Academic Editor

PLOS One

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“This project was completed as part of a Future 100 PhD Studentship at the University of Leicester”

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“This project was completed as part of a Future 100 PhD Studentship at the University of Leicester”

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“This project was completed as part of a Future 100 PhD Studentship at the University of Leicester”

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Additional Editor Comments:

Thank you for submitting this interesting draft.

I agree that this draft will benefit understanding of patients’ perspectives in Achilles tendon ruptures and conservative management.

Please address the following comments from reviewers and resubmit it.

[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: Yes

Reviewer #2: Yes

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

Reviewer #1: N/A

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: - The term “stakeholders” is vague. Please specify their roles (e.g. patients, clinicians, physiotherapists) and stage of involvement (development, piloting, refinement).

- Please provide the full name of the COREQ guideline at first mention.

- The study population requires clearer definition. It is unclear whether participants differed in injury duration, activity level (athlete vs non-athlete), or whether injuries were first-time or recurrent, all of which may influence experiences.

- Line 159: please check for a spelling error.

- Consider labelling tables more clearly to distinguish between themes and their descriptions.

- Please specify the qualitative design (e.g. thematic analysis, phenomenology).

- The concept of “lived experiences” is currently broad. Clarify key domains such as pain/function, psychological impact (e.g. fear, confidence), and interaction with healthcare services.

- Themes would benefit from greater interpretive depth, incorporating emotional responses, behavioural aspects (e.g. adherence, coping), and system-level influences.

-The study aim includes return to sport, but this is not clearly reflected as a theme or subtheme.

Thematic Structure

- Theme 1 (Subtheme 1): Currently descriptive; would benefit from a more patient-centred, interpretive approach, moving from “what happened” to “how it was experienced”.

- Theme 2: The subtheme appears procedural. Consider focusing on patient experiences and impacts, and replacing “evaluation” with experience- or perception-based terminology.

- Theme 3: While relevant, the presentation is somewhat descriptive and technical. Greater emphasis on patient experience and psychological processes is recommended.

Reviewer #2: revisions required include: expanded reflexivity statement addressing the lead author's professional positionality; clarification of the saturation assessment timeline; correction of plural possessive apostrophe errors throughout; and expanded specificity in the conclusion regarding the form of guidance and support recommended.

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-->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.

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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: No

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The experience of individuals following non-surgical management of Achilles tendon rupture in the United Kingdom – a qualitative study

PONE-D-25-53773R1

Dear Dr. Briggs-Price,

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.

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Kind regards,

Se Won Lee

Academic Editor

PLOS One

Additional Editor Comments (optional):

Thank you for incorporating all comments and writing a valuable draft.

Reviewers' comments: