Peer Review History

Original SubmissionNovember 11, 2019
Decision Letter - Yan Li, Editor

PONE-D-19-31436

The Evaluating Prescription Opioid Changes in Veterans (EPOCH) study: design, survey response, and baseline characteristics

PLOS ONE

Dear Dr Krebs,

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.

We would appreciate receiving your revised manuscript by Feb 02 2020 11:59PM. When you are 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.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

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). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
  • A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
  • An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Yan Li

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

http://www.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and http://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please address the following:

- Please ensure you have thoroughly discussed any potential limitations of this study within the Discussion section, including the potential bias introduced by using self-reported data.

- Please further describe how the "minimum panel size criteria" was calculated.

Thank you for your attention to these queries.

3.

In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access.

We will update your Data Availability statement to reflect the information you provide in your cover letter.

4. Please upload a copy of Figure 3, to which you refer in your text on page xx. If the figure is no longer to be included as part of the submission please remove all reference to it within the text.

5. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

[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

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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

**********

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

**********

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: This study about EPOCH has provided valuable information about the outcome of reduced/discontinued prescribed opioid among veterans and has set an example to conduct related studies. The survey is carefully designed and data is rationally analyzed. The description about results is precise as well. I personally enjoyed reading this manuscript. Some minor concerns are listed below:

1. In table 1, it shows back/spine disorder is the most commonly pain type in the survey. Is there special reason leading to massive back/spine injuries among veterans?

2. This survey has a very good response rate. What would the author think is the most important contributor?

3. I am personally very curious about what can be a potential alternative for opioid?

Reviewer #2: Thank you for the opportunity to review this manuscript, this paper is technically sound.

Please organize the tables, it's way too busy, very hard to went through, better split to 2-3 different tables,

If Fig 1 is using the table version for presenting, please rename as Table

**********

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

Reviewer #2: 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 to be viewed.]

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 us at figures@plos.org. Please note that Supporting Information files do not need this step.

Revision 1

Editorial comments:

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming.

We have applied style requirements, including those for file names.

2. Please ensure you have thoroughly discussed any potential limitations of this study within the Discussion section, including the potential bias introduced by using self-reported data.

We added limitations related to self-report and administrative data (page 22, lines 486-491).

3. Please further describe how the "minimum panel size criteria" was calculated.

We added details about our approach to identifying primary care providers and applying minimum panel size criteria. To improve clarity for readers, we put this information in a new methods subsection, “survey sample selection.” (pages 6-7, lines 145-166)

4. Please upload a copy of Figure 3, to which you refer in your text.

Figure 3 is included with the submission.

5. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly.

Supporting information captions are now included at the end of the manuscript and in-text citations are updated to match. (pages 28-29, lines 631-637)

Reviewer #1 comments:

1. In table 1, it shows back/spine disorder is the most commonly pain type in the survey. Is there special reason leading to massive back/spine injuries among veterans?

We added information about back pain prevalence to the discussion. (age 20, lines 434-438)

2. This survey has a very good response rate. What would the author think is the most important contributor?

We used multiple methods that have been found to improve response rates or that we hoped would help, so we can’t disentangle the most important reasons for our success. I added to the discussion an additional contributor—the ongoing clinical relationship study patients had with VA clinics. (page 19, lines 418-421)

3. I am personally very curious about what can be a potential alternative for opioid?

Although care should be individualized, guidelines recommend a variety of other medications, exercise therapies, psychological therapies such as cognitive behavioral therapy, manual treatments such as spinal manipulation, and mind-body approaches such as yoga.

Reviewer #2 comments:

1. Please organize the tables, it's way too busy, very hard to went through, better split to 2-3 different tables.

We split Tables 1 into two tables, separating patient characteristics from opioid treatment received. (Pages 12 and 13) I am unsure of a better way to present data in the other tables but am open to specific suggestions you may have.

2. If Fig 1 is using the table version for presenting, please rename as Table

Fig 1 is the study flow diagram and is not in table format.

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Yan Li, Editor

The Evaluating Prescription Opioid Changes in Veterans (EPOCH) study: design, survey response, and baseline characteristics

PONE-D-19-31436R1

Dear Dr. Krebs,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, 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 enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and 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.

With kind regards,

Yan Li

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Formally Accepted
Acceptance Letter - Yan Li, Editor

PONE-D-19-31436R1

The Evaluating Prescription Opioid Changes in Veterans (EPOCH) study: design, survey response, and baseline characteristics

Dear Dr. Krebs:

I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, 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.

For any other questions or concerns, please email plosone@plos.org.

Thank you for submitting your work to PLOS ONE.

With kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Yan Li

Academic Editor

PLOS ONE

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 .